Purpose： Soft tissue healing is of paramount importance in distal tibial fractures fora successful outcome. There is an increasing trend of using anterolateral plate due to an adequate soft tissue cover on ante- rola...Purpose： Soft tissue healing is of paramount importance in distal tibial fractures fora successful outcome. There is an increasing trend of using anterolateral plate due to an adequate soft tissue cover on ante- rolateral distal tibia. The aim of this study was to evaluate the results and complications of minimally invasive anterolateral locking plate in distal tibial fractures. Methods： This is a retrospective study of 42 patients with distal tibial fractures treated with minimally invasive anterolateral tibial plating. This study evaluates the hone and soft tissue healing along with emphasis on complications related to bone and soft tissue healing. Results： Full weight bearing was allowed in mean time period of 4.95 months （3-12 months）. A major local complication of a wound which required revision surgery was seen in one case. Minor complica- tions were identified in 9 cases which comprised 4 cases of marginal necrosis of the surgical wound, 1 case of superficial infection, I case of sensory disturbance over the anterolateral foot, 1 case of muscle hernia and 2 cases of delayed union. Mean distance between the posterolateral and anterolateral incision was 5.7 cm （4.5-8 cm）. Conclusion： The minimally invasive distal tibial fixation with anterolateral plating is a safe method of stabilization. Distance between anterolateral and posterolateral incision can be placed less than 7 cm apart deoending on fracture oattern with proper surgical timing and technique.展开更多
Purpose： The optimal surgical treatment of displaced type B and C fractures of the proximal humerus in the elderly remains controversial. Good clinical results have been reported by plating these fractures as well as...Purpose： The optimal surgical treatment of displaced type B and C fractures of the proximal humerus in the elderly remains controversial. Good clinical results have been reported by plating these fractures as well as a high rate of complications. Our retrospective study aims to evaluate clinical recovery and complications using the S3 locking plate in elderly patients. Methods： Fifty-one patients older than 65 years of age, with a complex proximal humeral fracture type B or C （AO classification system）, were included. Patients have been followed up for a minimum of 12 months. We assessed callus formation, radiological results, clinical outcome （according to the Constant Shoulder Score System） and complications. Any difference in the clinical recovery among the 2 types of fracture pattern （B and C） was investigated. Results： The mean time of fracture healing was 12.4 weeks. The mean Constant score at 3, 6 and 12 months was 68, 73 and 75 respectively. No statistically significant difference in the clinical outcome was observed between the 13 and C fracture patterns （p 〉 0.05）. We noticed an overall of 5 complications （9.8%）. There was no need to revision any of the implants. Conclusion： Anatomic reduction and proper plate positioning are essential for minimizing implant- related complications. In our experience the S3 angular stability system offers a proper osteosyntesis and a ~ood clinical recovery with a low rate of complications.展开更多
Objective： To assess the correlation between five anthropometric parameters and the distance from tibial tuberosity to medial malleolus in 100 volunteers. Methods： Six anthropometric parameters were measured in 50 m...Objective： To assess the correlation between five anthropometric parameters and the distance from tibial tuberosity to medial malleolus in 100 volunteers. Methods： Six anthropometric parameters were measured in 50 male and 50 female medical students using a metallic scale： medial knee joint line to ankle joint line （K-A）, medial knee joint line to medial malleolus （K-MM）, tibial tuberosity to ankle joint （TT-A）, tibial tuberosity to medial malleolus （TT- MM）, olecranon to 5th metacarpal head （O-MH） and body height （BH）. Nail size predicted based upon Tr-MM measurement was chosen as ideal nail size. A constant was derived for each of the six anthropometric parameters which was either added or subtracted to each measurement to derive nail size. A regression equation was applied to BH measurements. Nail sizes calculated were compared with that obtained from TI＇-MM measurement and accuracy was evaluated. Accuracy of O-MH and BH regression equations recommended by other authors were calculated in our data. Results： Adding 11 mm to Tr-A distance had highest accuracy （81%） and correlation （0.966） in predicting nails correctly. Subtracting 33 mm from K-MM measurement and 25 mm from K-A distance derived accurate sizes in 69% and 76% respectively. Adding 6 mm to O-MH distance had a poor accuracy of 51%. Nail size prediction based upon body height regression equation derived correct nail sizes in only 34% of the cases. Regression equation analysis by other authors based on O-MH and BH distances yielded correct sizes in 11% and 5% of the cases respectively. Conclusion： TT-A, K-A and K-MM measurements can be used simultaneously to increase accuracy of nail size prediction. This method would be helpful in determining nail size preoperatively especially when one anatomic landmark is difficult to palpate.展开更多
文摘Purpose： Soft tissue healing is of paramount importance in distal tibial fractures fora successful outcome. There is an increasing trend of using anterolateral plate due to an adequate soft tissue cover on ante- rolateral distal tibia. The aim of this study was to evaluate the results and complications of minimally invasive anterolateral locking plate in distal tibial fractures. Methods： This is a retrospective study of 42 patients with distal tibial fractures treated with minimally invasive anterolateral tibial plating. This study evaluates the hone and soft tissue healing along with emphasis on complications related to bone and soft tissue healing. Results： Full weight bearing was allowed in mean time period of 4.95 months （3-12 months）. A major local complication of a wound which required revision surgery was seen in one case. Minor complica- tions were identified in 9 cases which comprised 4 cases of marginal necrosis of the surgical wound, 1 case of superficial infection, I case of sensory disturbance over the anterolateral foot, 1 case of muscle hernia and 2 cases of delayed union. Mean distance between the posterolateral and anterolateral incision was 5.7 cm （4.5-8 cm）. Conclusion： The minimally invasive distal tibial fixation with anterolateral plating is a safe method of stabilization. Distance between anterolateral and posterolateral incision can be placed less than 7 cm apart deoending on fracture oattern with proper surgical timing and technique.
文摘Purpose： The optimal surgical treatment of displaced type B and C fractures of the proximal humerus in the elderly remains controversial. Good clinical results have been reported by plating these fractures as well as a high rate of complications. Our retrospective study aims to evaluate clinical recovery and complications using the S3 locking plate in elderly patients. Methods： Fifty-one patients older than 65 years of age, with a complex proximal humeral fracture type B or C （AO classification system）, were included. Patients have been followed up for a minimum of 12 months. We assessed callus formation, radiological results, clinical outcome （according to the Constant Shoulder Score System） and complications. Any difference in the clinical recovery among the 2 types of fracture pattern （B and C） was investigated. Results： The mean time of fracture healing was 12.4 weeks. The mean Constant score at 3, 6 and 12 months was 68, 73 and 75 respectively. No statistically significant difference in the clinical outcome was observed between the 13 and C fracture patterns （p 〉 0.05）. We noticed an overall of 5 complications （9.8%）. There was no need to revision any of the implants. Conclusion： Anatomic reduction and proper plate positioning are essential for minimizing implant- related complications. In our experience the S3 angular stability system offers a proper osteosyntesis and a ~ood clinical recovery with a low rate of complications.
文摘Objective： To assess the correlation between five anthropometric parameters and the distance from tibial tuberosity to medial malleolus in 100 volunteers. Methods： Six anthropometric parameters were measured in 50 male and 50 female medical students using a metallic scale： medial knee joint line to ankle joint line （K-A）, medial knee joint line to medial malleolus （K-MM）, tibial tuberosity to ankle joint （TT-A）, tibial tuberosity to medial malleolus （TT- MM）, olecranon to 5th metacarpal head （O-MH） and body height （BH）. Nail size predicted based upon Tr-MM measurement was chosen as ideal nail size. A constant was derived for each of the six anthropometric parameters which was either added or subtracted to each measurement to derive nail size. A regression equation was applied to BH measurements. Nail sizes calculated were compared with that obtained from TI＇-MM measurement and accuracy was evaluated. Accuracy of O-MH and BH regression equations recommended by other authors were calculated in our data. Results： Adding 11 mm to Tr-A distance had highest accuracy （81%） and correlation （0.966） in predicting nails correctly. Subtracting 33 mm from K-MM measurement and 25 mm from K-A distance derived accurate sizes in 69% and 76% respectively. Adding 6 mm to O-MH distance had a poor accuracy of 51%. Nail size prediction based upon body height regression equation derived correct nail sizes in only 34% of the cases. Regression equation analysis by other authors based on O-MH and BH distances yielded correct sizes in 11% and 5% of the cases respectively. Conclusion： TT-A, K-A and K-MM measurements can be used simultaneously to increase accuracy of nail size prediction. This method would be helpful in determining nail size preoperatively especially when one anatomic landmark is difficult to palpate.
