To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus i...To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months （range 12-30 months）. The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation （P〈0. 01）, the total excellent and fine rate was 91.86%. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.展开更多
BACKGROUND Lisfranc injuries have not received much attention by orthopedic doctors in the past,and there is little related research on the diagnosis and treatment of these injuries.In recent years with the rise in fo...BACKGROUND Lisfranc injuries have not received much attention by orthopedic doctors in the past,and there is little related research on the diagnosis and treatment of these injuries.In recent years with the rise in foot and ankle surgery,doctors are now paying more attention to this type of injury.However,there is still a high rate of missed diagnosis due to insufficient attention causing treatment delays or inadequate treatments,which eventually result in greater sequelae;including long-term pain,arthritis,foot deformity etc.In particular,for cases with a mild Lisfranc joint complex injury,the incidence of sequelae is higher.AIM To select an active surgical treatment for an atypical Lisfranc joint complex injury and to evaluate the clinical efficacy of the surgical treatment.METHODS The clinical data of 18 patients,including 10 males and 8 females aged 20-64 years with Lisfranc injuries treated in our department from January 2017 to September 2019 were retrospectively analyzed.All patients were treated with an open reduction and internal fixation method using locking titanium mini-plates and hollow screws or Kirschner wires.X-ray images were taken and follow-up was performed monthly after the operation;the internal fixation was then removed 4-5 mo after the operation;and the American Orthopedic Foot and Ankle Society(AOFAS)score was used for evaluation on the last follow-up.RESULTS All patients were followed up for 6-12 mo.A good/excellent AOFAS score was observed in 88.9%of patients.CONCLUSION For atypical Lisfranc joint complex injuries,active open reduction and internal fixation can be performed to enable patients to obtain a good prognosis and satisfactory functional recovery.展开更多
Objective： To evaluate the feasibility and therapeutic effect of treating sternoclavicular joint dislocation by K-wire and tension band wire fixation, and to improve the safety and stability of this technique.Methods...Objective： To evaluate the feasibility and therapeutic effect of treating sternoclavicular joint dislocation by K-wire and tension band wire fixation, and to improve the safety and stability of this technique.Methods： This study consisted of 9 cases, 6 males and 3 females with the mean age of 25 years （range, 9-62 years）.The causes were traffic accident in 7 cases, falling in 1 case and fight in 1 case. The duration from injury to operation was 2 hours to 7 days. There were 5 left dislocations and 4right dislocations; 8 anterior dislocations and 1 posterior dislocation, including one combined with left scapular fracture and one with left olecranon fracture. Open reduction and internal fixation using K-wires and tension band wires were performed to treat dislocations.Results： All patients were followed up for 6 to 24months, 10 months on average. According to Rockwood＇s rating scale on postoperative sternoclavicular joint, 8 cases achieved excellent outcomes with an average score of 13.88,and the rest case achieved a good outcome with the score of 12. Anatomical reduction was obtained in all cases. There were no such postoperative complications as severe infection, injury to blood vessel and nerve, failure of fixation,etc. Patients were all satisfied with the anatomical reduction and functional recovery.Conclusions： The technique of K-wire and tension band wire fixation is safe, simple, effective, less invasive and has been successfully used in orthopedic surgery. It is effective in treating sternoclavicular joint dislocation though it has some disadvantages.展开更多
BACKGROUND The preferred treatment for distal humeral intercondylar fractures is open reduction and internal fixation.While there is consensus about the posterior approach,several posterior approaches have been develo...BACKGROUND The preferred treatment for distal humeral intercondylar fractures is open reduction and internal fixation.While there is consensus about the posterior approach,several posterior approaches have been developed.It is debatable as to which approach is best.AIM To compare triceps reflecting anconeus pedicle(TRAP)and olecranon osteotomy approaches for internal fixation of distal humeral intercondylar fracture.METHODS In total,40 cases of Arbeitsgemeinschaft für Osteosynthesefragen/Association of the Study of Internal Fixation type C,closed,and Gustilo type I intercondylar humeral fractures were included.Patients ranged in age from 18 years to 70 years.The patients were randomized into two groups:TRAP group and olecranon osteotomy group,with 20 cases in each.All were followed up at 6 wk,3 months,6 months,and 12 months.Functional outcomes were measured in terms of flexion-extension arc,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score.RESULTS The mean age was 43.2 years in the TRAP group and 37.5 years in the olecranon osteotomy group.The mean operative time and mean duration of hospital stay in the TRAP group were significantly higher than in the olecranon osteotomy group(119.5 vs 111.5 min and 9.85 vs 5.45 d,respectively).The mean arc of flexion-extension,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score were comparable without any significant difference in the groups at the 12-month follow-up(107.0 vs 106.2,18.3 vs 15.7,and 84.2 vs 86.2,respectively).Ulnar paresthesia and superficial infections were comparable in both groups(2 cases vs 3 cases and 3 cases vs 2 cases,respectively).Hardware prominence was significantly higher in the olecranon osteotomy group,mostly due to tension band wiring.CONCLUSION Both approaches were equivalent,but there is a need for further study including higher numbers of subjects and longer study duration to prove the benefits of one approach over the other.展开更多
BACKGROUND Comminuted manubrium sterni fractures are rare,and internal fixation methods are limited.This report explored a practical and feasible method of internal fixation for comminuted manubrium sterni fractures.C...BACKGROUND Comminuted manubrium sterni fractures are rare,and internal fixation methods are limited.This report explored a practical and feasible method of internal fixation for comminuted manubrium sterni fractures.CASE SUMMARY A 17-year-old female was injured in a car accident for which she underwent debridement and suturing of her head and anterior chest wounds in another hospital.Eight days later,the patient was transferred to our hospital for surgical treatment.The manubrium sterni was found intraoperatively to be split into three irregular fragments with obvious overlap and separation displacement.Meanwhile,a manubriosternal joint dislocation and left first rib cartilage fracture were observed.The retraction force of the shape-memory alloy staples was used to pull the fracture fragments together.Two more titanium locking plates were then used to fix the manubrium sterni and corpus sterni longitudinally,and the left first rib cartilage fracture was repositioned and fixed with a titanium locking plate.A postoperative computed tomography scan showed reduced and rigid fixation of the comminuted manubrium sterni fractures.The patient recovered well with no significant complaints of discomfort.The patient was discharged 10 days postoperatively after the stitches had been removed.CONCLUSION Shape-memory alloy staples had the advantage of being safe and effective during the repositioning and internal fixation of comminuted manubrium sterni fractures.Therefore,they provided a new surgical option for comminuted manubrium sterni fractures.展开更多
目的探讨糖尿病合并跟骨结节撕脱性骨折患者实施切开复位空心螺钉结合锚钉固定术(open reduction and internal fixation,ORIF)的效果。方法回顾性研究2020年8月—2022年4月北京丰台医院收治的22例糖尿病合并跟骨结节撕脱性骨折的患者,...目的探讨糖尿病合并跟骨结节撕脱性骨折患者实施切开复位空心螺钉结合锚钉固定术(open reduction and internal fixation,ORIF)的效果。方法回顾性研究2020年8月—2022年4月北京丰台医院收治的22例糖尿病合并跟骨结节撕脱性骨折的患者,采用切开复位空心螺钉结合锚钉固定术治疗。围手术期及术后进行血糖的评估;术后随访使用足踝关节预后评分(foot and ankle outcome score,FAOS)、视觉模拟量表(visual analogue scale,VAS)、单脚跟抬高测试和X射线图像进行评估。结果所有骨折均在解剖位置愈合,没有出现术后固定失败、内固定松动移位以及皮肤感染、坏死等情况。术后随访6~8个月,所有患者都恢复了完全的足底屈曲范围和力量,没有步态异常或负重限制。FAOS评分:疼痛(80.85±6.20)分,症状(79.85±4.90)分,日常生活(72.35±8.00)分,运动和娱乐功能(68.25±11.93)分,足踝活动影响(77.47±6.70)分。VAS评分为(2.16±0.30)分。结论切开复位空心螺钉结合锚钉固定术是治疗糖尿病相关跟骨结节撕脱性骨折的有效手段,并显示出良好的功能和影像学结果。展开更多
文摘To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months （range 12-30 months）. The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation （P〈0. 01）, the total excellent and fine rate was 91.86%. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.
基金Science Foundation of Shenyang Medical College,No.20187076.
文摘BACKGROUND Lisfranc injuries have not received much attention by orthopedic doctors in the past,and there is little related research on the diagnosis and treatment of these injuries.In recent years with the rise in foot and ankle surgery,doctors are now paying more attention to this type of injury.However,there is still a high rate of missed diagnosis due to insufficient attention causing treatment delays or inadequate treatments,which eventually result in greater sequelae;including long-term pain,arthritis,foot deformity etc.In particular,for cases with a mild Lisfranc joint complex injury,the incidence of sequelae is higher.AIM To select an active surgical treatment for an atypical Lisfranc joint complex injury and to evaluate the clinical efficacy of the surgical treatment.METHODS The clinical data of 18 patients,including 10 males and 8 females aged 20-64 years with Lisfranc injuries treated in our department from January 2017 to September 2019 were retrospectively analyzed.All patients were treated with an open reduction and internal fixation method using locking titanium mini-plates and hollow screws or Kirschner wires.X-ray images were taken and follow-up was performed monthly after the operation;the internal fixation was then removed 4-5 mo after the operation;and the American Orthopedic Foot and Ankle Society(AOFAS)score was used for evaluation on the last follow-up.RESULTS All patients were followed up for 6-12 mo.A good/excellent AOFAS score was observed in 88.9%of patients.CONCLUSION For atypical Lisfranc joint complex injuries,active open reduction and internal fixation can be performed to enable patients to obtain a good prognosis and satisfactory functional recovery.
文摘Objective： To evaluate the feasibility and therapeutic effect of treating sternoclavicular joint dislocation by K-wire and tension band wire fixation, and to improve the safety and stability of this technique.Methods： This study consisted of 9 cases, 6 males and 3 females with the mean age of 25 years （range, 9-62 years）.The causes were traffic accident in 7 cases, falling in 1 case and fight in 1 case. The duration from injury to operation was 2 hours to 7 days. There were 5 left dislocations and 4right dislocations; 8 anterior dislocations and 1 posterior dislocation, including one combined with left scapular fracture and one with left olecranon fracture. Open reduction and internal fixation using K-wires and tension band wires were performed to treat dislocations.Results： All patients were followed up for 6 to 24months, 10 months on average. According to Rockwood＇s rating scale on postoperative sternoclavicular joint, 8 cases achieved excellent outcomes with an average score of 13.88,and the rest case achieved a good outcome with the score of 12. Anatomical reduction was obtained in all cases. There were no such postoperative complications as severe infection, injury to blood vessel and nerve, failure of fixation,etc. Patients were all satisfied with the anatomical reduction and functional recovery.Conclusions： The technique of K-wire and tension band wire fixation is safe, simple, effective, less invasive and has been successfully used in orthopedic surgery. It is effective in treating sternoclavicular joint dislocation though it has some disadvantages.
文摘BACKGROUND The preferred treatment for distal humeral intercondylar fractures is open reduction and internal fixation.While there is consensus about the posterior approach,several posterior approaches have been developed.It is debatable as to which approach is best.AIM To compare triceps reflecting anconeus pedicle(TRAP)and olecranon osteotomy approaches for internal fixation of distal humeral intercondylar fracture.METHODS In total,40 cases of Arbeitsgemeinschaft für Osteosynthesefragen/Association of the Study of Internal Fixation type C,closed,and Gustilo type I intercondylar humeral fractures were included.Patients ranged in age from 18 years to 70 years.The patients were randomized into two groups:TRAP group and olecranon osteotomy group,with 20 cases in each.All were followed up at 6 wk,3 months,6 months,and 12 months.Functional outcomes were measured in terms of flexion-extension arc,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score.RESULTS The mean age was 43.2 years in the TRAP group and 37.5 years in the olecranon osteotomy group.The mean operative time and mean duration of hospital stay in the TRAP group were significantly higher than in the olecranon osteotomy group(119.5 vs 111.5 min and 9.85 vs 5.45 d,respectively).The mean arc of flexion-extension,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score were comparable without any significant difference in the groups at the 12-month follow-up(107.0 vs 106.2,18.3 vs 15.7,and 84.2 vs 86.2,respectively).Ulnar paresthesia and superficial infections were comparable in both groups(2 cases vs 3 cases and 3 cases vs 2 cases,respectively).Hardware prominence was significantly higher in the olecranon osteotomy group,mostly due to tension band wiring.CONCLUSION Both approaches were equivalent,but there is a need for further study including higher numbers of subjects and longer study duration to prove the benefits of one approach over the other.
基金Supported by Shenyang Medical College Youth Scientific Research Fund,No.20202027.
文摘BACKGROUND Comminuted manubrium sterni fractures are rare,and internal fixation methods are limited.This report explored a practical and feasible method of internal fixation for comminuted manubrium sterni fractures.CASE SUMMARY A 17-year-old female was injured in a car accident for which she underwent debridement and suturing of her head and anterior chest wounds in another hospital.Eight days later,the patient was transferred to our hospital for surgical treatment.The manubrium sterni was found intraoperatively to be split into three irregular fragments with obvious overlap and separation displacement.Meanwhile,a manubriosternal joint dislocation and left first rib cartilage fracture were observed.The retraction force of the shape-memory alloy staples was used to pull the fracture fragments together.Two more titanium locking plates were then used to fix the manubrium sterni and corpus sterni longitudinally,and the left first rib cartilage fracture was repositioned and fixed with a titanium locking plate.A postoperative computed tomography scan showed reduced and rigid fixation of the comminuted manubrium sterni fractures.The patient recovered well with no significant complaints of discomfort.The patient was discharged 10 days postoperatively after the stitches had been removed.CONCLUSION Shape-memory alloy staples had the advantage of being safe and effective during the repositioning and internal fixation of comminuted manubrium sterni fractures.Therefore,they provided a new surgical option for comminuted manubrium sterni fractures.
