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
Objective: to compare the therapeutic effects of minimally invasive tension band and hook plate in the treatment of acromioclavicular joint dislocation. Methods: a retrospective analysis of 29 patients with acromiocla...Objective: to compare the therapeutic effects of minimally invasive tension band and hook plate in the treatment of acromioclavicular joint dislocation. Methods: a retrospective analysis of 29 patients with acromioclavicular joint dislocation admitted to Beijing Fengtai Hospital from March 2017 to September 2018 was performed. The patients were divided into two groups: 14 patients underwent internal fixation with hook plate and 15 patients underwent modified minimally invasive tension band. The operation conditions and complications of the two groups were compared, and the joint function was evaluated by Constant-Mudey score. Results: the operation time of hook plate group was slightly shorter than that of minimally invasive tension band group, and there was no significant difference in clinical efficacy between the two groups. Conclusion: the improved minimally invasive tension band technique can make up for the deficiency of traditional tension band, and is also a reliable surgical method compared with hook plate.展开更多
Objective: to compare the efficacy of clavicle hook plate and tight-rope model in the treatment of acute acromioclavicular joint dislocation. Methods: a total of 68 patients with acute acromioclavicular dislocation fr...Objective: to compare the efficacy of clavicle hook plate and tight-rope model in the treatment of acute acromioclavicular joint dislocation. Methods: a total of 68 patients with acute acromioclavicular dislocation from March 2018 to April 2020 were analyzed for the efficacy of clavicular hook plate and tight-rope mode. Results: the test group (χ2 = 10.2043, P < 0.001) had high curative effect. The operation time in the test group was long (t = 32.032, P < 0.001). The amount of blood loss and length of hospital stay (t = 15.181, P < 0.001) and (t = 23.135, P < 0.001) were both low (P < 0.05). Six months and one year after the operation: in the test group, flexion (t = 24.521, P < 0.001), (t = 18.852, P < 0.001), abduction (t = 16.524, P < 0.001), (t = 15.541, P < 0.001) were all high, P < 0.05. Constant score (t = 7.524, P < 0.001) and (t = 28.524, P < 0.001) were high. UCLA shoulder score (t = 11.578, P < 0.001), (t = 18.635, P < 0.001) high. VAS score (t = 6.857, P < 0.001) and (t=8.587, P < 0.001) were low. Conclusion: tight -rope mode is effective for patients with acute acromioclavicular dislocation, which can improve shoulder function, has the advantages of fewer complications and less trauma, and can promote the rapid recovery of patients.展开更多
Objective:To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods:80 patients with TOSSY...Objective:To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods:80 patients with TOSSY type III acromioclavicular joint dislocation who were admitted to our hospital from January 2014 to January 2019 were selected.They were randomly divided into the control group(n=39,treated with clavicular hook plate)and the observation group(n=41,treated with clavicular hook plate combined with coracoclavicular ligament repair)by the random number table method.The clinical efficacy in 12 months after operation,related clinical indicators,12-month postoperative recovery and postoperative complications were compared between the two groups.Results:The excellent and good rate was 92.68%(38/41)in 12 months after operation in the observation group,which was higher than that(76.92%,30/39)in the control group(p<.05).There were no significant differences in the duration of surgery,intraoperative blood loss and HLOS between the observation group and the control group(p>.05).In 12 months after operation,abduction activity and forward flexion activity of the observation group were higher than those of the control group,and visual analogue score(VAS)was lower than that of the control group(p<.05).The incidence of complications in the observation group was slightly lower than that in the control group,but there was no statistically significant difference between the two groups(p>.05).Conclusions:For TOSSY type III acromioclavicular joint dislocation,clavicular hook plate combined with coracoclavicular ligament repair has a good clinical efficacy.It can improve shoulder joint function,alleviate shoulder pain and have fewer complications.It can provide a reference for clinical treatment of this type of acromioclavicular joint dislocation.展开更多
Purpose: Acromioclavicular (AC) joint dislocation is commonly treated using a clavicle hook plate (HP). However, previous reports have indicated that acromial fractures may occur after HP fixation. The purpose of this...Purpose: Acromioclavicular (AC) joint dislocation is commonly treated using a clavicle hook plate (HP). However, previous reports have indicated that acromial fractures may occur after HP fixation. The purpose of this study was to identify risk factors for acromial fractures. Methods: A retrospective study was conducted on 39 patients with AC joint dislocation who were treated using clavicle HP fixation in our hospital between 2006 and 2017. Related parameters, including Rockwood classification, hook angle, the degree of reduction, the coverage of the hook under the acromion, and the anteroposterior position of the hook under the acromion, were evaluated to identify risk factors for acromial fractures. Results: The mean age of the participants was 51.7 (range 19 - 81) years;34 were men and 5 were women. Injury occurred on the right side in 18 patients and on the left side in 21. Injuries were categorized as follows: 24 were Rockwood type III, one was type IV, and 14 were type V. Four of the 39 patients (10%) experienced acromial fractures. Statistical analyses indicated that the degree of reduction at the final follow-up was moderately correlated with the Constant score. Posterior positioning of the hook was the only identified risk factor for acromial fractures. Hook angle and the degree of reduction at the time of surgery were not significantly associated with acromial fractures. Conclusions: Postoperative shoulder function was associated with the degree of reduction at the final follow-up, suggesting that anatomical reduction is recommended for AC joint dislocation. Posterior positioning of the hook is a risk factor for acromial fractures;however, clavicle HP fixation provides a positive outcome for AC joint dislocation. Therefore, careful positioning of the hook is required for preventing acromial fractures.展开更多
Purpose:Surgical management of the lateral end of clavicle fractures has been a challenge for orthopedicsurgeons considering the high rate of non-union.There has been no right and wrong answer to thesetypes of fractur...Purpose:Surgical management of the lateral end of clavicle fractures has been a challenge for orthopedicsurgeons considering the high rate of non-union.There has been no right and wrong answer to thesetypes of fractures and many methods discussed in the literature,but the 2 most used bony proceduresare hook plate and locking plate with or without the use of supplementary soft tissue procedures.Theavailable evidence,in this case,is scarce with questionable reliability.The idea of this systemic review isto promote evidence-based practice when choosing between the 2 implants for this fracture.This studyaims to review the results by performing a systemic review of the literature comparing the results oflocking plate vs.hook plate for the lateral end of clavicle fracturefixation with an emphasis on outcomeand associated complications.Methods:A search of the literature was made with the keyword“clavicle”in PubMed/Ovid Medline/Embase and University of Edinburgh online library“discover Ed”.A total of 4063 articles were identifiedincluding case series(with at least 3 cases)and review articles focusing on locking plate alone,com-parisons of locking plate and hook plate,or hook plate alone.Articles were excluded if they were notpublished in English,focused on pediatric studies,or consisted only of book chapters.Studies examiningtension band wiring,soft tissue procedures for fracturefixation,arthroscopic-assisted procedures,additional soft tissue procedures along with platefixation,and fracture dislocation of the lateral end ofthe clavicle were also excluded.The search was then narrowed down to 21 articles after consideration ofinclusion and exclusion criteria.A detailed review of the surgical methodology further excluded addi-tional soft tissue procedures,resulting in afinal selection of 15 studies.The quality of the studies wasassessed using the Modified Coleman Score by the authors.Results:A total of 15 studies related to Neer type II fracture met the inclusion criteria.However,2 otherstudies also included type V fracture as well.The mean age of patients in these studies was 32 years.Themean follow-up period was 24.3 months(ranging from 6 to 65 months).The time of radiological unionwas documented from 2 to 4.5 months.Constant and disabilities of arm,shoulder,and hand scores weremost used as the criteria for patient outcomes.The size of the lateral fragment that can accommodate/provide bicortical fracture was documented in only 3 studies.The mean incidence of removal of hookplate was 86.9%.In contrast,the mean incidence of removal of locking plate was 27.0%.Superficial woundinfection was documented in 5 studies and deep wound infection was seen in 1 study.The mean unionrate for hook plate was 97.0%compared to 100%for locking plate.Complications associated with hookplate have been documented in 11 studies.The most commonly reported incidence of complication wasacromial osteolysis.The quality of studies was assessed using modified Coleman score.Other than 2studies that were considered for the study that met the“fair”standard all of them were considered“poor”based on the modified Coleman score.Conclusion:Both hook plate and locking plate provide acceptable operative treatment options for thelateral end of clavicle fracture.However,a consideration of surgeons’experience,the likelihood of a second operation,and the size of the lateral fragment should be considered when choosing between the 2types of implants.展开更多
Background: Clavicular hook plates are effective fixation devices for lateral end clavicle fractures and acromioclavicular joint dislocations and have been extensively used in the last decade. Although this plate achi...Background: Clavicular hook plates are effective fixation devices for lateral end clavicle fractures and acromioclavicular joint dislocations and have been extensively used in the last decade. Although this plate achieves a high percentage of union, there are concerns about sub-acromial osteolysis and impingement of supraspinatus tendon. Objective: To show that impingement of supraspinatus tendon can be prevented by measuring the depth between acromion and supraspinatus tendon posteriorly and using hook plates of appropriate depth. Materials and Methods: We performed a prospective study on 25 patients with lateral end clavicle fractures and acromio clavicular joint disruptions by measuring the depth between posterior border of acromion and the superior border of supraspinatus at the point of application of hook plate. Fixation is then done by appropriate sized hook plate. Results: None of the patients had impingement of supraspinatus tendon. Five patients developed subacromial osteolysis which did not have any impact on shoulder function. Conclusion: There is a variation in anatomy of the acromion in different ethnic groups. Hence uniform sized hook plate will be inappropriate. A smaller hook depth is needed in south Asian population to prevent impingement.展开更多
The paper is devoted to dynamic design of thick orthotropic cantilever plates by applying the bimoment theory of plates, which takes into account the forces, moments and bimoments;and the theory takes into account non...The paper is devoted to dynamic design of thick orthotropic cantilever plates by applying the bimoment theory of plates, which takes into account the forces, moments and bimoments;and the theory takes into account nonlinear law of displacements distribution in cross section of the plate. The methods for constructing bimoment theory are based on Hooke’s Law, three-dimensional equations of the theory of dynamic elasticity and the method of displacements expansion into Maclaurin series. The article gives the expressions to determine the forces, moments and bimoments. Bimoment theory of plates is described by two unrelated two-dimensional systems with nine equations in each. On each edge of the plate, depending on the type of fastening, nine boundary conditions are given. As an example, the solution of the problem of dynamic bending of thick isotropic and orthotropic plate under the influence of transverse dynamic loads in the form of the Heaviside function is given. The equations of motion of the plate are solved by numerical method of finite differences. The numerical results are obtained for isotropic and orthotropic plate. The graphs of changes of displacements and stresses of faces surfaces of the plate are presented. Maximum values of these displacements are found and analyzed. It is shown that by Timoshenko theory numerical values of stresses are much smaller compared to the ones obtained by bimoment theory of plates. Maximum numerical values of generalized displacements, forces, moments, and bimoments are obtained and presented in tabular form. The analysis of numerical results is done and the conclusions are drawn.展开更多
[目的]比较Tight-rope联合经皮螺钉与锁骨钩钢板治疗老年Cho IIC型锁骨远端骨折的临床疗效。[方法]回顾性分析2015年1月—2023年1月在本科接受手术治疗的老年Cho IIC型锁骨远端骨折63例患者的临床资料。根据医患沟通结果,31例采用Tight-...[目的]比较Tight-rope联合经皮螺钉与锁骨钩钢板治疗老年Cho IIC型锁骨远端骨折的临床疗效。[方法]回顾性分析2015年1月—2023年1月在本科接受手术治疗的老年Cho IIC型锁骨远端骨折63例患者的临床资料。根据医患沟通结果,31例采用Tight-rope联合经皮螺钉固定(袢钉组),32例采用锁骨钩钢板技术(钩板组)。比较两组围手术期、随访和影像资料。[结果]袢钉组手术时间[(65.8±16.7) min vs (83.1±20.8) min,P<0.001]、切口长度[(1.9±0.7) cm vs (9.5±1.9) cm,P<0.001]、术中出血量[(21.5±9.9) m L vs (97.5±55.8) mL,P<0.001]、住院时间[(8.4±2.2) d vs (13.3±5.6) d,P<0.001]均显著优于钩板组。所有患者均获得12个月以上随访。随时间推移,两组VAS评分、Constant-Murley评分及前屈上举ROM、外展上举ROM均显著改善(P<0.05)。术后3个月、末次随访时袢钉组的VAS评分[(1.7±0.6) vs (2.6±1.1),P<0.001;(0.6±0.5) vs (1.5±0.9),P<0.001]、ConstantMurley评分[(85.0±4.0) vs (80.0±4.6),P<0.001;(91.9±3.9) vs (88.5±4.8),P<0.001]及肩前屈上举ROM [(127.3±11.1)°vs (118.2±14.7)°,P=0.008;(155.3±10.9)°vs (144.7±13.5)°,P<0.001]、肩外展上举ROM [(116.5±10.0)°vs (108.1±12.9)°,P<0.001;(148.9±13.0)°vs(127.7±17.9)°,P<0.001]均优于钩板组。影像方面,两组骨折复位质量的差异无统计学意义(P>0.05)。两组术后喙锁距离(coracoclavicular distance,CC)均显著改善(P<0.05),相应时间点,两组CC的差异均无统计学意义(P>0.05)。[结论]两种手术方式治疗老年骨质疏松性Cho IIC型锁骨远端骨折均可获得良好临床疗效,其中经皮螺钉联合改良Tight-rope技术具有切口小、创伤少的特点,可以更好地改善术后早期疼痛,利于肩关节功能恢复。展开更多
BACKGROUND Clavicle fractures are a common type of fracture that often occurs after high-energy trauma.The treatment methods for clavicle fractures remain controversial.Both locking compression and hook plates are rec...BACKGROUND Clavicle fractures are a common type of fracture that often occurs after high-energy trauma.The treatment methods for clavicle fractures remain controversial.Both locking compression and hook plates are recommended.CASE SUMMARY A 44-year-old male suffered an injury during skiing.Radiography revealed a right-sided distal clavicular fracture.The fracture was treated using a hook plate due to its small size.During the surgical procedure,Kirschner wires were used to drill holes in the acromion.The end of the hook plate was inserted into the hole rather than below the edge of the acromion.CONCLUSION One year later,imaging revealed complete healing of the fracture,and the hook plate was removed.The patient was satisfied with the course and treatment results.Additionally,a new classification system was proposed based on the degree of injury to the distal clavicle joint surface.The incidence of postoperative complications associated with the use of hook plates for clavicular fracture treatment is relatively high.Complications can be reduced by changing the hook plate placement.展开更多
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Objective: to compare the therapeutic effects of minimally invasive tension band and hook plate in the treatment of acromioclavicular joint dislocation. Methods: a retrospective analysis of 29 patients with acromioclavicular joint dislocation admitted to Beijing Fengtai Hospital from March 2017 to September 2018 was performed. The patients were divided into two groups: 14 patients underwent internal fixation with hook plate and 15 patients underwent modified minimally invasive tension band. The operation conditions and complications of the two groups were compared, and the joint function was evaluated by Constant-Mudey score. Results: the operation time of hook plate group was slightly shorter than that of minimally invasive tension band group, and there was no significant difference in clinical efficacy between the two groups. Conclusion: the improved minimally invasive tension band technique can make up for the deficiency of traditional tension band, and is also a reliable surgical method compared with hook plate.
文摘Objective: to compare the efficacy of clavicle hook plate and tight-rope model in the treatment of acute acromioclavicular joint dislocation. Methods: a total of 68 patients with acute acromioclavicular dislocation from March 2018 to April 2020 were analyzed for the efficacy of clavicular hook plate and tight-rope mode. Results: the test group (χ2 = 10.2043, P < 0.001) had high curative effect. The operation time in the test group was long (t = 32.032, P < 0.001). The amount of blood loss and length of hospital stay (t = 15.181, P < 0.001) and (t = 23.135, P < 0.001) were both low (P < 0.05). Six months and one year after the operation: in the test group, flexion (t = 24.521, P < 0.001), (t = 18.852, P < 0.001), abduction (t = 16.524, P < 0.001), (t = 15.541, P < 0.001) were all high, P < 0.05. Constant score (t = 7.524, P < 0.001) and (t = 28.524, P < 0.001) were high. UCLA shoulder score (t = 11.578, P < 0.001), (t = 18.635, P < 0.001) high. VAS score (t = 6.857, P < 0.001) and (t=8.587, P < 0.001) were low. Conclusion: tight -rope mode is effective for patients with acute acromioclavicular dislocation, which can improve shoulder function, has the advantages of fewer complications and less trauma, and can promote the rapid recovery of patients.
基金Natural Science Foundation of Inner Mongolia Autonomous Region(2019MS08045).
文摘Objective:To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods:80 patients with TOSSY type III acromioclavicular joint dislocation who were admitted to our hospital from January 2014 to January 2019 were selected.They were randomly divided into the control group(n=39,treated with clavicular hook plate)and the observation group(n=41,treated with clavicular hook plate combined with coracoclavicular ligament repair)by the random number table method.The clinical efficacy in 12 months after operation,related clinical indicators,12-month postoperative recovery and postoperative complications were compared between the two groups.Results:The excellent and good rate was 92.68%(38/41)in 12 months after operation in the observation group,which was higher than that(76.92%,30/39)in the control group(p<.05).There were no significant differences in the duration of surgery,intraoperative blood loss and HLOS between the observation group and the control group(p>.05).In 12 months after operation,abduction activity and forward flexion activity of the observation group were higher than those of the control group,and visual analogue score(VAS)was lower than that of the control group(p<.05).The incidence of complications in the observation group was slightly lower than that in the control group,but there was no statistically significant difference between the two groups(p>.05).Conclusions:For TOSSY type III acromioclavicular joint dislocation,clavicular hook plate combined with coracoclavicular ligament repair has a good clinical efficacy.It can improve shoulder joint function,alleviate shoulder pain and have fewer complications.It can provide a reference for clinical treatment of this type of acromioclavicular joint dislocation.
文摘Purpose: Acromioclavicular (AC) joint dislocation is commonly treated using a clavicle hook plate (HP). However, previous reports have indicated that acromial fractures may occur after HP fixation. The purpose of this study was to identify risk factors for acromial fractures. Methods: A retrospective study was conducted on 39 patients with AC joint dislocation who were treated using clavicle HP fixation in our hospital between 2006 and 2017. Related parameters, including Rockwood classification, hook angle, the degree of reduction, the coverage of the hook under the acromion, and the anteroposterior position of the hook under the acromion, were evaluated to identify risk factors for acromial fractures. Results: The mean age of the participants was 51.7 (range 19 - 81) years;34 were men and 5 were women. Injury occurred on the right side in 18 patients and on the left side in 21. Injuries were categorized as follows: 24 were Rockwood type III, one was type IV, and 14 were type V. Four of the 39 patients (10%) experienced acromial fractures. Statistical analyses indicated that the degree of reduction at the final follow-up was moderately correlated with the Constant score. Posterior positioning of the hook was the only identified risk factor for acromial fractures. Hook angle and the degree of reduction at the time of surgery were not significantly associated with acromial fractures. Conclusions: Postoperative shoulder function was associated with the degree of reduction at the final follow-up, suggesting that anatomical reduction is recommended for AC joint dislocation. Posterior positioning of the hook is a risk factor for acromial fractures;however, clavicle HP fixation provides a positive outcome for AC joint dislocation. Therefore, careful positioning of the hook is required for preventing acromial fractures.
文摘Purpose:Surgical management of the lateral end of clavicle fractures has been a challenge for orthopedicsurgeons considering the high rate of non-union.There has been no right and wrong answer to thesetypes of fractures and many methods discussed in the literature,but the 2 most used bony proceduresare hook plate and locking plate with or without the use of supplementary soft tissue procedures.Theavailable evidence,in this case,is scarce with questionable reliability.The idea of this systemic review isto promote evidence-based practice when choosing between the 2 implants for this fracture.This studyaims to review the results by performing a systemic review of the literature comparing the results oflocking plate vs.hook plate for the lateral end of clavicle fracturefixation with an emphasis on outcomeand associated complications.Methods:A search of the literature was made with the keyword“clavicle”in PubMed/Ovid Medline/Embase and University of Edinburgh online library“discover Ed”.A total of 4063 articles were identifiedincluding case series(with at least 3 cases)and review articles focusing on locking plate alone,com-parisons of locking plate and hook plate,or hook plate alone.Articles were excluded if they were notpublished in English,focused on pediatric studies,or consisted only of book chapters.Studies examiningtension band wiring,soft tissue procedures for fracturefixation,arthroscopic-assisted procedures,additional soft tissue procedures along with platefixation,and fracture dislocation of the lateral end ofthe clavicle were also excluded.The search was then narrowed down to 21 articles after consideration ofinclusion and exclusion criteria.A detailed review of the surgical methodology further excluded addi-tional soft tissue procedures,resulting in afinal selection of 15 studies.The quality of the studies wasassessed using the Modified Coleman Score by the authors.Results:A total of 15 studies related to Neer type II fracture met the inclusion criteria.However,2 otherstudies also included type V fracture as well.The mean age of patients in these studies was 32 years.Themean follow-up period was 24.3 months(ranging from 6 to 65 months).The time of radiological unionwas documented from 2 to 4.5 months.Constant and disabilities of arm,shoulder,and hand scores weremost used as the criteria for patient outcomes.The size of the lateral fragment that can accommodate/provide bicortical fracture was documented in only 3 studies.The mean incidence of removal of hookplate was 86.9%.In contrast,the mean incidence of removal of locking plate was 27.0%.Superficial woundinfection was documented in 5 studies and deep wound infection was seen in 1 study.The mean unionrate for hook plate was 97.0%compared to 100%for locking plate.Complications associated with hookplate have been documented in 11 studies.The most commonly reported incidence of complication wasacromial osteolysis.The quality of studies was assessed using modified Coleman score.Other than 2studies that were considered for the study that met the“fair”standard all of them were considered“poor”based on the modified Coleman score.Conclusion:Both hook plate and locking plate provide acceptable operative treatment options for thelateral end of clavicle fracture.However,a consideration of surgeons’experience,the likelihood of a second operation,and the size of the lateral fragment should be considered when choosing between the 2types of implants.
文摘Background: Clavicular hook plates are effective fixation devices for lateral end clavicle fractures and acromioclavicular joint dislocations and have been extensively used in the last decade. Although this plate achieves a high percentage of union, there are concerns about sub-acromial osteolysis and impingement of supraspinatus tendon. Objective: To show that impingement of supraspinatus tendon can be prevented by measuring the depth between acromion and supraspinatus tendon posteriorly and using hook plates of appropriate depth. Materials and Methods: We performed a prospective study on 25 patients with lateral end clavicle fractures and acromio clavicular joint disruptions by measuring the depth between posterior border of acromion and the superior border of supraspinatus at the point of application of hook plate. Fixation is then done by appropriate sized hook plate. Results: None of the patients had impingement of supraspinatus tendon. Five patients developed subacromial osteolysis which did not have any impact on shoulder function. Conclusion: There is a variation in anatomy of the acromion in different ethnic groups. Hence uniform sized hook plate will be inappropriate. A smaller hook depth is needed in south Asian population to prevent impingement.
文摘The paper is devoted to dynamic design of thick orthotropic cantilever plates by applying the bimoment theory of plates, which takes into account the forces, moments and bimoments;and the theory takes into account nonlinear law of displacements distribution in cross section of the plate. The methods for constructing bimoment theory are based on Hooke’s Law, three-dimensional equations of the theory of dynamic elasticity and the method of displacements expansion into Maclaurin series. The article gives the expressions to determine the forces, moments and bimoments. Bimoment theory of plates is described by two unrelated two-dimensional systems with nine equations in each. On each edge of the plate, depending on the type of fastening, nine boundary conditions are given. As an example, the solution of the problem of dynamic bending of thick isotropic and orthotropic plate under the influence of transverse dynamic loads in the form of the Heaviside function is given. The equations of motion of the plate are solved by numerical method of finite differences. The numerical results are obtained for isotropic and orthotropic plate. The graphs of changes of displacements and stresses of faces surfaces of the plate are presented. Maximum values of these displacements are found and analyzed. It is shown that by Timoshenko theory numerical values of stresses are much smaller compared to the ones obtained by bimoment theory of plates. Maximum numerical values of generalized displacements, forces, moments, and bimoments are obtained and presented in tabular form. The analysis of numerical results is done and the conclusions are drawn.
文摘[目的]比较Tight-rope联合经皮螺钉与锁骨钩钢板治疗老年Cho IIC型锁骨远端骨折的临床疗效。[方法]回顾性分析2015年1月—2023年1月在本科接受手术治疗的老年Cho IIC型锁骨远端骨折63例患者的临床资料。根据医患沟通结果,31例采用Tight-rope联合经皮螺钉固定(袢钉组),32例采用锁骨钩钢板技术(钩板组)。比较两组围手术期、随访和影像资料。[结果]袢钉组手术时间[(65.8±16.7) min vs (83.1±20.8) min,P<0.001]、切口长度[(1.9±0.7) cm vs (9.5±1.9) cm,P<0.001]、术中出血量[(21.5±9.9) m L vs (97.5±55.8) mL,P<0.001]、住院时间[(8.4±2.2) d vs (13.3±5.6) d,P<0.001]均显著优于钩板组。所有患者均获得12个月以上随访。随时间推移,两组VAS评分、Constant-Murley评分及前屈上举ROM、外展上举ROM均显著改善(P<0.05)。术后3个月、末次随访时袢钉组的VAS评分[(1.7±0.6) vs (2.6±1.1),P<0.001;(0.6±0.5) vs (1.5±0.9),P<0.001]、ConstantMurley评分[(85.0±4.0) vs (80.0±4.6),P<0.001;(91.9±3.9) vs (88.5±4.8),P<0.001]及肩前屈上举ROM [(127.3±11.1)°vs (118.2±14.7)°,P=0.008;(155.3±10.9)°vs (144.7±13.5)°,P<0.001]、肩外展上举ROM [(116.5±10.0)°vs (108.1±12.9)°,P<0.001;(148.9±13.0)°vs(127.7±17.9)°,P<0.001]均优于钩板组。影像方面,两组骨折复位质量的差异无统计学意义(P>0.05)。两组术后喙锁距离(coracoclavicular distance,CC)均显著改善(P<0.05),相应时间点,两组CC的差异均无统计学意义(P>0.05)。[结论]两种手术方式治疗老年骨质疏松性Cho IIC型锁骨远端骨折均可获得良好临床疗效,其中经皮螺钉联合改良Tight-rope技术具有切口小、创伤少的特点,可以更好地改善术后早期疼痛,利于肩关节功能恢复。
文摘BACKGROUND Clavicle fractures are a common type of fracture that often occurs after high-energy trauma.The treatment methods for clavicle fractures remain controversial.Both locking compression and hook plates are recommended.CASE SUMMARY A 44-year-old male suffered an injury during skiing.Radiography revealed a right-sided distal clavicular fracture.The fracture was treated using a hook plate due to its small size.During the surgical procedure,Kirschner wires were used to drill holes in the acromion.The end of the hook plate was inserted into the hole rather than below the edge of the acromion.CONCLUSION One year later,imaging revealed complete healing of the fracture,and the hook plate was removed.The patient was satisfied with the course and treatment results.Additionally,a new classification system was proposed based on the degree of injury to the distal clavicle joint surface.The incidence of postoperative complications associated with the use of hook plates for clavicular fracture treatment is relatively high.Complications can be reduced by changing the hook plate placement.
