BACKGROUND Managing Gustilo type ⅢB fractures in patients with type 2 diabetes is challenging due to delayed healing and elevated complication risks.This retro-spective study highlights the successful use of free-fla...BACKGROUND Managing Gustilo type ⅢB fractures in patients with type 2 diabetes is challenging due to delayed healing and elevated complication risks.This retro-spective study highlights the successful use of free-flap transfer combined with plate fixation,contributing insights into effective management strategies for these complex cases.AIM To evaluate free-flap transfer with plate fixation for managing Gustilo ⅢB fractures in diabetic patients,focusing on outcomes.METHODS A retrospective analysis of six cases was conducted with a minimum follow-up period of three years.Patients underwent free-flap transfer and plate fixation for fracture management.Outcomes assessed included bone union,flap viability,and complications requiring intervention or plate removal.The follow-up period ranged from three to four years.Persistent infections beneath the flap developed in two patients,necessitating daily wound care.RESULTS Bone healing occurred within 17 to 34 months,with plate removal required in three patients after fracture consolidation.Traumatic osteomyelitis was observed in at least one patient.Despite challenges such as sinus formation and variations in flap pedicle anatomy,successful bone union and flap viability were achieved in all cases.Freeflap transfer combined with plate fixation shows promise for treating Gustilo type ⅢB fractures in patients with diabetes.While infection and the need for plate removal surgeries were observed,consistent success in bone healing and flap viability highlights the potential of this approach.CONCLUSION Free-flap transfer with plate fixation effectively manages Gustilo ⅢB fractures in diabetics,achieving bone/flap healing despite infection risks.Careful patient selection and further validation are critical.展开更多
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 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 cortica...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.展开更多
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 scr...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.展开更多
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,...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.展开更多
Objective: to discuss the effect of minimally invasive percutaneous plate internal fixation and its influence on trauma control in the treatment of tibial fractures. Methods: 72 patients with tibial fracture who recei...Objective: to discuss the effect of minimally invasive percutaneous plate internal fixation and its influence on trauma control in the treatment of tibial fractures. Methods: 72 patients with tibial fracture who received surgical treatment in our hospital were divided into two groups by single and double number distribution method. The study group and routine group were treated with minimally invasive percutaneous plate internal fixation and open reduction and internal fixation respectively. The effects, satisfaction, surgical indexes, quality of life, complications and traumatic stress indexes of different groups of patients after different treatment methods were discussed. Results: by observing the effect and satisfaction degree of different groups of patients after different treatments, we know that the total effective rate and satisfaction degree of the patients in the study group were 94.45%, (95.65 ± 1.75) points, while the total effective rate of the patients in the routine group was 72.22%, (76.54 ± 0.65) points, and the data comparison was higher in the study group (P < 0.05);In the investigation of the quality of life of different groups of patients after different treatments, it was found that the quality of life of the patients in the study group was better (P < 0.05);In terms of the operative indexes and traumatic stress indexes of different groups of patients treated in different ways, the improvement effect of the operative indexes and traumatic stress indexes of the selected study group was better than that of the routine group (P < 0.05);Comparing the complications of different groups of patients after different ways of treatment, it shows that the probability of complications in the study group is lower than that in the routine group (P < 0.05). Conclusion: in order to improve the therapeutic effect, satisfaction and quality of life of patients with tibial fracture, reduce the probability of complications, and improve various indexes of operation and traumatic stress, minimally invasive percutaneous plate internal fixation is needed, and its application is very significant.展开更多
The purpose of this study was to observe the clinical efficacy of umbilical cord in the treatment of Jinri capsule and analyze its effect on postoperative injury and bone metabolism. Methods 90 cases of SAP tree fract...The purpose of this study was to observe the clinical efficacy of umbilical cord in the treatment of Jinri capsule and analyze its effect on postoperative injury and bone metabolism. Methods 90 cases of SAP tree fracture were randomly divided into two groups according to 1:1. In the control group, 45 patients were treated with MIPO, and 45 patients were treated with Jintian capsule based on MIPO for 6 weeks. Organic volume content (VOC), bone mass number (TB.n), elastic bone stress (ES) and calcium (BFP) were compared according to bone volume ratio (BV/TV) before and 6 weeks after operation. Six months postoperatively, bone protective function (OPG), tartrate phosphatase (TRAP), K collagen (KTH) and shoulder recovery were observed. Results Within 6 weeks after treatment, bone quality indexes such as TV were significantly lower than those in control group (P<0.05), and bone quality indexes such as VOC and TBC were significantly lower than those in control group (P<0.05). Significantly lower than control group (P<0.05). N was significantly higher than that of control group (P<0.05). The osteogenesis rates of BGP and OPG were higher than those of the control group (P<0.05), and the osteogenesis rates of TRAP and CTX were significantly lower than those of the control group (P<0.05). Were compared between the two groups before and 6 weeks after operation. Six months after surgery, the observation group had better function recovery, and the constant Murley score was significantly higher than that of the control group. Conclusion MIPO combined with Jintiange capsule can significantly improve the function recovery effect of shoulder joint, effectively stabilize bone mass index, promote the formation of bone structure, quickly recover bone metabolism function, and finally achieve fracture healing. It is worthy of clinical application.展开更多
Objective: to summarize the surgical treatment methods of comminuted calcaneal fracture and the effect differences of different surgical methods. Methods: patients with calcaneal fractures admitted to our hospital and...Objective: to summarize the surgical treatment methods of comminuted calcaneal fracture and the effect differences of different surgical methods. Methods: patients with calcaneal fractures admitted to our hospital and confirmed for surgical treatment were selected. All patients were comminuted fractures and met the requirements of surgical indications. The cases were selected from June 2018 to June 2020, and the conventional group took incision reduction surgery based on L-type incision. The experimental group performed minimally invasive plate internal fixation with plate screws according to the posterior heel or the tarsal sinus incision position. When observed after the operation, the items involved included the function of the heel, the recovery status of the calcaneus, the surgery-related indicators, and the complications occurring during and after the surgery. Results: the patients of the experimental group were significantly higher than the height. Bolher and Gissen angle were better than the conventional group in March and June, P <0.05;the time, bleeding volume, incision length, hospitalization time and related complications were significantly better than the conventional group, P <0.05. Conclusion: minimally invasive plate and screw internal fixation can effectively treat comminuted calcaneal fracture, which has a significant effect on the foot and ankle function, and obviously acts on the fracture site and function.展开更多
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 C3 type fracture usin...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 C3 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 C3 type fracture.It can provide more stable fixation to the bone and earlier functional exercises can be achieved.5 refs,3 figs,1 tab.展开更多
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...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.展开更多
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...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.展开更多
Objective:To evaluate the therapeutic effect of dynamic fixation with a hook plate-double loop plate internal fixation system for high-energy acromioclavicular joint complex dislocation(denoted as HACD,i.e.,Rockwood t...Objective:To evaluate the therapeutic effect of dynamic fixation with a hook plate-double loop plate internal fixation system for high-energy acromioclavicular joint complex dislocation(denoted as HACD,i.e.,Rockwood type III-V dislocation).Methods:Fifty-eight patients with HACD were selected and evenly divided by drawing lots.The experimental group underwent ligament reconstruction treatment,while the reference group received hook plate fixation treatment.The efficacy and other indicators were compared between the groups.Results:The overall effective rates between the groups were similar(P>0.05).The experimental group had a longer surgical duration,lower pain scores at 6 months postoperatively,higher shoulder joint function scores,and a lower complication rate,with P<0.05 when compared between groups.Conclusion:The effectiveness of the double loop plate internal fixation system ligament reconstruction treatment for patients with HACD is comparable to that of hook plate fixation treatment.Although the surgical duration is slightly longer,postoperative pain is milder,facilitating the recovery of shoulder joint function in patients and offering higher safety.展开更多
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 ou...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.展开更多
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 os...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.展开更多
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 difference...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.展开更多
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 s...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.展开更多
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 co...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.展开更多
文摘BACKGROUND Managing Gustilo type ⅢB fractures in patients with type 2 diabetes is challenging due to delayed healing and elevated complication risks.This retro-spective study highlights the successful use of free-flap transfer combined with plate fixation,contributing insights into effective management strategies for these complex cases.AIM To evaluate free-flap transfer with plate fixation for managing Gustilo ⅢB fractures in diabetic patients,focusing on outcomes.METHODS A retrospective analysis of six cases was conducted with a minimum follow-up period of three years.Patients underwent free-flap transfer and plate fixation for fracture management.Outcomes assessed included bone union,flap viability,and complications requiring intervention or plate removal.The follow-up period ranged from three to four years.Persistent infections beneath the flap developed in two patients,necessitating daily wound care.RESULTS Bone healing occurred within 17 to 34 months,with plate removal required in three patients after fracture consolidation.Traumatic osteomyelitis was observed in at least one patient.Despite challenges such as sinus formation and variations in flap pedicle anatomy,successful bone union and flap viability were achieved in all cases.Freeflap transfer combined with plate fixation shows promise for treating Gustilo type ⅢB fractures in patients with diabetes.While infection and the need for plate removal surgeries were observed,consistent success in bone healing and flap viability highlights the potential of this approach.CONCLUSION Free-flap transfer with plate fixation effectively manages Gustilo ⅢB fractures in diabetics,achieving bone/flap healing despite infection risks.Careful patient selection and further validation are critical.
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 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.
文摘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.
基金Special Project for Seedling Cultivation funded by Special Fund of Chinese Central Government for Basic Scientific Research Operations in Commonweal Research Institutes(No.ZZ11-084)。
文摘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.
文摘Objective: to discuss the effect of minimally invasive percutaneous plate internal fixation and its influence on trauma control in the treatment of tibial fractures. Methods: 72 patients with tibial fracture who received surgical treatment in our hospital were divided into two groups by single and double number distribution method. The study group and routine group were treated with minimally invasive percutaneous plate internal fixation and open reduction and internal fixation respectively. The effects, satisfaction, surgical indexes, quality of life, complications and traumatic stress indexes of different groups of patients after different treatment methods were discussed. Results: by observing the effect and satisfaction degree of different groups of patients after different treatments, we know that the total effective rate and satisfaction degree of the patients in the study group were 94.45%, (95.65 ± 1.75) points, while the total effective rate of the patients in the routine group was 72.22%, (76.54 ± 0.65) points, and the data comparison was higher in the study group (P < 0.05);In the investigation of the quality of life of different groups of patients after different treatments, it was found that the quality of life of the patients in the study group was better (P < 0.05);In terms of the operative indexes and traumatic stress indexes of different groups of patients treated in different ways, the improvement effect of the operative indexes and traumatic stress indexes of the selected study group was better than that of the routine group (P < 0.05);Comparing the complications of different groups of patients after different ways of treatment, it shows that the probability of complications in the study group is lower than that in the routine group (P < 0.05). Conclusion: in order to improve the therapeutic effect, satisfaction and quality of life of patients with tibial fracture, reduce the probability of complications, and improve various indexes of operation and traumatic stress, minimally invasive percutaneous plate internal fixation is needed, and its application is very significant.
文摘The purpose of this study was to observe the clinical efficacy of umbilical cord in the treatment of Jinri capsule and analyze its effect on postoperative injury and bone metabolism. Methods 90 cases of SAP tree fracture were randomly divided into two groups according to 1:1. In the control group, 45 patients were treated with MIPO, and 45 patients were treated with Jintian capsule based on MIPO for 6 weeks. Organic volume content (VOC), bone mass number (TB.n), elastic bone stress (ES) and calcium (BFP) were compared according to bone volume ratio (BV/TV) before and 6 weeks after operation. Six months postoperatively, bone protective function (OPG), tartrate phosphatase (TRAP), K collagen (KTH) and shoulder recovery were observed. Results Within 6 weeks after treatment, bone quality indexes such as TV were significantly lower than those in control group (P<0.05), and bone quality indexes such as VOC and TBC were significantly lower than those in control group (P<0.05). Significantly lower than control group (P<0.05). N was significantly higher than that of control group (P<0.05). The osteogenesis rates of BGP and OPG were higher than those of the control group (P<0.05), and the osteogenesis rates of TRAP and CTX were significantly lower than those of the control group (P<0.05). Were compared between the two groups before and 6 weeks after operation. Six months after surgery, the observation group had better function recovery, and the constant Murley score was significantly higher than that of the control group. Conclusion MIPO combined with Jintiange capsule can significantly improve the function recovery effect of shoulder joint, effectively stabilize bone mass index, promote the formation of bone structure, quickly recover bone metabolism function, and finally achieve fracture healing. It is worthy of clinical application.
文摘Objective: to summarize the surgical treatment methods of comminuted calcaneal fracture and the effect differences of different surgical methods. Methods: patients with calcaneal fractures admitted to our hospital and confirmed for surgical treatment were selected. All patients were comminuted fractures and met the requirements of surgical indications. The cases were selected from June 2018 to June 2020, and the conventional group took incision reduction surgery based on L-type incision. The experimental group performed minimally invasive plate internal fixation with plate screws according to the posterior heel or the tarsal sinus incision position. When observed after the operation, the items involved included the function of the heel, the recovery status of the calcaneus, the surgery-related indicators, and the complications occurring during and after the surgery. Results: the patients of the experimental group were significantly higher than the height. Bolher and Gissen angle were better than the conventional group in March and June, P <0.05;the time, bleeding volume, incision length, hospitalization time and related complications were significantly better than the conventional group, P <0.05. Conclusion: minimally invasive plate and screw internal fixation can effectively treat comminuted calcaneal fracture, which has a significant effect on the foot and ankle function, and obviously acts on the fracture site and function.
文摘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 C3 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 C3 type fracture.It can provide more stable fixation to the bone and earlier functional exercises can be achieved.5 refs,3 figs,1 tab.
文摘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.
文摘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.
文摘Objective:To evaluate the therapeutic effect of dynamic fixation with a hook plate-double loop plate internal fixation system for high-energy acromioclavicular joint complex dislocation(denoted as HACD,i.e.,Rockwood type III-V dislocation).Methods:Fifty-eight patients with HACD were selected and evenly divided by drawing lots.The experimental group underwent ligament reconstruction treatment,while the reference group received hook plate fixation treatment.The efficacy and other indicators were compared between the groups.Results:The overall effective rates between the groups were similar(P>0.05).The experimental group had a longer surgical duration,lower pain scores at 6 months postoperatively,higher shoulder joint function scores,and a lower complication rate,with P<0.05 when compared between groups.Conclusion:The effectiveness of the double loop plate internal fixation system ligament reconstruction treatment for patients with HACD is comparable to that of hook plate fixation treatment.Although the surgical duration is slightly longer,postoperative pain is milder,facilitating the recovery of shoulder joint function in patients and offering higher safety.
文摘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.
文摘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.
基金supported by the Shanghai Municipal Commission of Health and Family Planning(20144Y0250,20134Y207)the National Natural Science Foundation of China(11302154,11272273)The Hong Kong Research Grant Council GRF(PolyU152216/14E,PolyU5326/11E)
文摘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.
文摘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.
文摘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.
