Background The Bennett fracture is either a common or a challenging problem to hand surgeons.It is still debated whether closed or open reduction gives optimal results.This study aimed to describe and assess a closed ...Background The Bennett fracture is either a common or a challenging problem to hand surgeons.It is still debated whether closed or open reduction gives optimal results.This study aimed to describe and assess a closed reduction and mini-external fixator fixation technique for the treatment of Bennett＇s fracture dislocation and to compare this technique versus open reduction and internal fixation.Methods From October 2002 to December 2012,56 patients with Bennett＇s fracture dislocation were treated by closed reduction and mini-external fixator fixation and 32 patients were treated by open reduction and internal fixation in Jishuitan Hospital.Patients with an articular step-off of more than 1 mm were excluded.All patients were assessed at a mean followup of 7 years （range 2-10 years） and the two groups were compared with pain levels,active range of trapeziometacarpal motion,grip strength and pinch strength,arthritic changes,and adduction deformity.Results Based on primary closed reduction maintained,the rate of anatomic reduction is 63.6％.Radiographic fracture union was achieved in all patients at a mean time of 5 weeks.At the final follow-up,there was no difference between the two groups in mean union time and pain levels （P=-0.2）.There was also no difference between the two groups regarding the active range of trapeziometacarpal motion （P=0.3）,grip stength （P=0.6）,pinch strength （P=0.2）,arthritic change and loss of reduction （P=0.2）.There was a significant correlation between adduction deformity and the development of arthritis （P=0.02）.Conclusion Closed reduction mini-external fixator fixation should be first tried to apply in the treatment of Bennett＇s fracture dislocation,and open reduction internal fixation should only be performed for irreducible fractures.展开更多
目的观察并探讨外固定架（External fixation，EF）联合抗感染活性骨（Anti-infective reconstituted bone xenograft，ARBX）对四肢创伤性骨髓炎的治疗效果。方法选择2012年3月～2014年12月在医院接受手术治疗的四肢创伤性骨髓炎患者6...目的观察并探讨外固定架（External fixation，EF）联合抗感染活性骨（Anti-infective reconstituted bone xenograft，ARBX）对四肢创伤性骨髓炎的治疗效果。方法选择2012年3月～2014年12月在医院接受手术治疗的四肢创伤性骨髓炎患者60例，随机将患者分为观察组和对照组两组，各30例。观察组接受EF联合ARBX治疗；而对照组接受ARBX治疗。统计两组患者的抗生素疗程、骨折骨性愈合时间、伤口愈合时间，评价两组疗效并统计并发症发生情况。结果观察组抗生素疗程、骨折骨性愈合时间、伤口愈合时间分别为（3．2±1．7）周、（7．2±2．2）月和（125．3±23．6）天，对照组为（4．6±1．8）周、（8．5±1．8）月和（157．2±27．4）天，观察组抗生素疗程、骨折骨性愈合时间、伤口愈合时间均明显短于对照组（P〈O．05）；观察组总有效率96．7％（29／30），对照组为76．7％（23／30），观察组总有效率明显高于对照组（P〈0．05）；观察组并发症率为6．7％（2／30），对照组为30．O％（9／30），观察组并发症率明显低于对照组（P〈0．05）。结论EF联合ARBX四肢创伤性骨髓炎疗效显著，缩短了骨折愈合时间，且有效降低了术后并发症，是治疗四肢创伤性骨髓炎的有效方案。展开更多
文摘Background The Bennett fracture is either a common or a challenging problem to hand surgeons.It is still debated whether closed or open reduction gives optimal results.This study aimed to describe and assess a closed reduction and mini-external fixator fixation technique for the treatment of Bennett＇s fracture dislocation and to compare this technique versus open reduction and internal fixation.Methods From October 2002 to December 2012,56 patients with Bennett＇s fracture dislocation were treated by closed reduction and mini-external fixator fixation and 32 patients were treated by open reduction and internal fixation in Jishuitan Hospital.Patients with an articular step-off of more than 1 mm were excluded.All patients were assessed at a mean followup of 7 years （range 2-10 years） and the two groups were compared with pain levels,active range of trapeziometacarpal motion,grip strength and pinch strength,arthritic changes,and adduction deformity.Results Based on primary closed reduction maintained,the rate of anatomic reduction is 63.6％.Radiographic fracture union was achieved in all patients at a mean time of 5 weeks.At the final follow-up,there was no difference between the two groups in mean union time and pain levels （P=-0.2）.There was also no difference between the two groups regarding the active range of trapeziometacarpal motion （P=0.3）,grip stength （P=0.6）,pinch strength （P=0.2）,arthritic change and loss of reduction （P=0.2）.There was a significant correlation between adduction deformity and the development of arthritis （P=0.02）.Conclusion Closed reduction mini-external fixator fixation should be first tried to apply in the treatment of Bennett＇s fracture dislocation,and open reduction internal fixation should only be performed for irreducible fractures.
文摘目的观察并探讨外固定架（External fixation，EF）联合抗感染活性骨（Anti-infective reconstituted bone xenograft，ARBX）对四肢创伤性骨髓炎的治疗效果。方法选择2012年3月～2014年12月在医院接受手术治疗的四肢创伤性骨髓炎患者60例，随机将患者分为观察组和对照组两组，各30例。观察组接受EF联合ARBX治疗；而对照组接受ARBX治疗。统计两组患者的抗生素疗程、骨折骨性愈合时间、伤口愈合时间，评价两组疗效并统计并发症发生情况。结果观察组抗生素疗程、骨折骨性愈合时间、伤口愈合时间分别为（3．2±1．7）周、（7．2±2．2）月和（125．3±23．6）天，对照组为（4．6±1．8）周、（8．5±1．8）月和（157．2±27．4）天，观察组抗生素疗程、骨折骨性愈合时间、伤口愈合时间均明显短于对照组（P〈O．05）；观察组总有效率96．7％（29／30），对照组为76．7％（23／30），观察组总有效率明显高于对照组（P〈0．05）；观察组并发症率为6．7％（2／30），对照组为30．O％（9／30），观察组并发症率明显低于对照组（P〈0．05）。结论EF联合ARBX四肢创伤性骨髓炎疗效显著，缩短了骨折愈合时间，且有效降低了术后并发症，是治疗四肢创伤性骨髓炎的有效方案。
