BACKGROUND Reconstruction of the pelvic ring anatomy in unstable anterior pelvic ring injuries is a significant step to reduce the mortality rate associated with these injuries efficiently.There is a debate on using e...BACKGROUND Reconstruction of the pelvic ring anatomy in unstable anterior pelvic ring injuries is a significant step to reduce the mortality rate associated with these injuries efficiently.There is a debate on using either an anterior subcutaneous pelvis internal fixator(INFIX)or an anterior supra-acetabular external fixator(EXFIX)to manage an unstable anterior pelvic ring fracture.AIM To compare the functional and radiological outcomes and complications of INFIX vs EXFIX in managing unstable pelvic ring injuries.METHODS A prospective cohort study included 54 patients with unstable pelvic ring fractures.The patients were divided into two groups;the INFIX group,in which 30 cases were fixed by INFIX,and the EXFIX group,in which 24 patients were treated by EXFIX.The average age in the EXFIX group was 31.17 years(16-57 years),while in the INFIX group,it was 34.5 years(17-53 years).The study included 20(66.7%)males and 10(33.3%)females in the INFIX group and 10(41.7%)males and 14(58.3%)females in the EXFIX group.The radiological outcomes were evaluated using Matta and Tornetta's score,and the functional outcomes using the Majeed score.RESULTS The results revealed a statistically significant difference between both groups(P=0.013)regarding radiological outcomes,according to Matta and Tornetta's score in favor of the INFIX group.Sitting,standing,and walking abilities were measured at a 3-mo follow-up visit using Majeed score modules.It was significantly better among the INFIX group than the EXFIX group in all three modules.At the final follow-up,both groups had no statistically significant difference according to the Majeed score;92.35 in the INFIX group and 90.99 in the EXFIX group(P=0.513).A lower surgical site infection rate was noticed in the INFIX group(P=0.007).CONCLUSION Anterior subcutaneous pelvis INFIX is associated with better radiological outcomes and a lower infection rate than anterior supra-acetabular EXFIX in managing patients with unstable anterior pelvic ring fractures.展开更多
To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center...To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center retrospective comparative study included 50 adult patients with aseptic nonunion of femoral or tibial diaphyseal fractures treated at our institution between January 2015 and January 2025.Patients underwent either locking-plate(LP)fixation(n=25)or intramedullary nailing(IMN)(n=25).The primary outcome was radiographic union at 12 months postoperatively.Secondary outcomes included time to union,operative time,intraoperative blood loss,length of hospital stay,incidence of complications(superficial/deep infection,implant failure,malunion),and 12-month functional status assessed by the Lower Extremity Functional Scale(LEFS).Statistical comparisons used Welch t tests for continuous variables andχ²or Fisher exact tests for categorical variables.The protocol received institutional review board approval with waiver of informed consent.Results:Among 50 patients(LP=25;IMN=25),the 12-month union rate was 88.00%(22/25)in the LP group and 96.00%(24/25)in the IMN group(p=0.609).Time to union was shorter with IMN(6.20±1.83 vs 7.51±2.12 months;p=0.023).Operative time(110.52±25.23 vs 145.81±30.21 min;p<0.01)and intraoperative blood loss(250.41±80.64 vs 350.22±95.30 ml;p<0.01)favored IMN.Length of hospital stay was similar(6.24±1.83 vs 6.82±2.11 days;p=0.284).The incidence of superficial wound infection did not differ significantly(12.00%vs 4.00%;p=0.609).Twelve-month LEFS scores were comparable(65.44±10.21 vs 67.10±9.83;p=0.451).Conclusion:Both locking plate and intramedullary nail fixation are effective in the treatment of femoral and tibial nonunion,with high rates of union and good functional outcomes.Intramedullary nailing may be associated with a shorter time to union,reduced operative time and blood loss,and a lower risk of superficial wound infection compared to locking plate fixation.The choice of implant should be individualized based on fracture characteristics,patient factors,and surgeon preference.展开更多
Objective: To analyze the therapeutic effect of combining dental arch splint intermaxillary traction with rigid internal fixation for the treatment of facial comminuted fractures. Methods: Sixty patients with facial c...Objective: To analyze the therapeutic effect of combining dental arch splint intermaxillary traction with rigid internal fixation for the treatment of facial comminuted fractures. Methods: Sixty patients with facial comminuted fractures admitted for treatment between July 2023 and December 2024 were selected. Using a random number table method, 30 patients were assigned to the observation group, where moderate traction using a dental arch splint combined with rigid internal fixation was applied. Another 30 patients were assigned to the control group and only received dental arch splint traction treatment. The total effective rate, postoperative recovery indicators, periodontal status, complication rate, and quality of life scores were compared between the two groups. Results: The total effective rate in the observation group was higher than that in the control group. The postoperative recovery indicators and periodontal status in the observation group were superior to those in the control group. The complication rate and quality of life score were lower in the observation group compared to the control group, with P < 0.05. Conclusion: Combining dental arch splint intermaxillary traction with rigid internal fixation can improve the periodontal status and quality of life of patients with facial comminuted fractures, shorten postoperative recovery time, reduce various complications, and enhance surgical efficacy.展开更多
Objective： To investigate the efficacy of the locking internal fixator （LIF）, which includes the locking compression plate （LCP） and the less invasive stable system （LISS）, in the proximal and distal tibial fra...Objective： To investigate the efficacy of the locking internal fixator （LIF）, which includes the locking compression plate （LCP） and the less invasive stable system （LISS）, in the proximal and distal tibial fractures. Methods： We did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the opera- tion with LIF by the minimally invasive plate osteosynthe- sis （MIPO） technique. The data consisted of 43 proximal tibial fractures （type AO41 C3） and 55 distal tibial fractures （type AO43C3）. Results： No complications were observed in all patients after operation. The mean healing time was 8.4 months （range 5-14 months）. Only two cases of delayed union oc- curred at postoperative 10 months. No infections were re- ported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at post- operative 6 to 9 months and regained the normal functions of knee and ankle joints. Conclusion： Using LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing.展开更多
Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reducti...Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reduction,dynamic external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
BACKGROUND Proximal humerus fractures(PHFs)are common,especially in the elderly,and optimal surgical management remains debated.This study compares clinical,functional,and radiographic outcomes of deltoid split(DS)vs ...BACKGROUND Proximal humerus fractures(PHFs)are common,especially in the elderly,and optimal surgical management remains debated.This study compares clinical,functional,and radiographic outcomes of deltoid split(DS)vs deltopectoral(DP)approaches in PHFs treated with locking plates.AIM To evaluate and compare the clinical,functional,and radiographic outcomes-as well as postoperative complication rates-associated with the DS vs the DP surgical approach in the open reduction and internal fixation(ORIF)of PHFs using locking plate constructs.METHODS A multicenter retrospective study of 120 patients undergoing ORIF for closed Neer type II-IV PHFs between January 2023 and December 2023.Patients were grouped by surgical approach[DS(n=70),DP(n=50)].Outcome measures included Numeric Rating Scale(NRS)for pain,Quick-Disabilities in Arm,Shoulder,and Hand questionnaire(QuickDASH),Constant-Murley score,Short Form Health Survey-12v2,and radiographic alignment.Complication rates were recorded.Statistical significance was defined as P<0.05.RESULTS Early outcomes favored the DS group:(1)Lower NRS(3.1 vs 5.9);(2)Higher Constant-Murley(68.2 vs 50.5);and(3)Better QuickDASH(25.4 vs 37.1).Complication rate was lower in the DS group(1.66%vs 5.81%).Radiographic outcomes were comparable.Long-term results were similar between groups.CONCLUSION While both approaches yield satisfactory long-term outcomes,the DS approach is associated with faster early recovery and fewer complications,supporting its use in selected cases.展开更多
Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge ev...Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge even for the most experienced surgeon.In this study,we describe in detail a novel unlocking closed reduction technique(UCRT)frame that allows strong traction for bilateral posterior pelvic ring displacement and presents preliminary clinical outcomes.Methods We retrospectively reviewed 32 patients with bilateral displaced posterior pelvic ring disruptions(AO/OTA 61-C2 and C3)who were initially treated with this technique between July 2017 and July 2022.According to the AO/OTA clas-sification,there were 9 cases(28.12%)of 61-C2,and 23 cases(71.88%)of 61-C3.There were 11 males,21 females,with an average age of 38.1 years.The interval from injury to operation was 4-27 days,with a cut-off of 12.5 days(receiver operat-ing characteristic curve).Operative time,blood loss,and postoperative radiographic findings were recorded.The functional outcomes and complications were followed.Results A total of 30(93.8%)patients achieved successful closed reduction,whereas 2 required open reduction.The success-ful closed reduction rate was 95.5%(21/22)in patients whose injury-to-operation time was less than 12.5 days.The vertical displacement percent correction of the obviously displaced hemipelvis was 70.20%±16.79%on average.The average degree of pelvic deformity correction was 64.86%±17.71%.Thirty patients were followed up for at least 12 months(12-36 months),and no complications of nonunion or redisplacement were observed.The Matta-Tornetta scoring standard revealed that the excellent(25/30)and good(4/30)rate was 96.7%.The Majeed clinical efficacy score revealed that the overall excellent and good rate was 100%.One patient had INFIX-related infection,and 2 reported numbness in the lateral thigh.The numbness was improved after INFIX removal.Conclusions This study presents an updated technique for closed reduction using a UCRT frame for bilateral posterior pelvic ring disruption,which has been shown to be effective,as indicated by excellent surgical and functional outcomes.展开更多
Objective: To evaluate the effect of open reduction and internal fixation on radial head fracture and assess the post-operative function. Methods: This prospective observational study was conducted from June 2016 to J...Objective: To evaluate the effect of open reduction and internal fixation on radial head fracture and assess the post-operative function. Methods: This prospective observational study was conducted from June 2016 to July 2017 at Liaquat National Hospital and Medical College, Karachi. Altogether, 28 patients with radial head and neck fractures were enrolled in our study. These patients were admitted to the hospital and their fractures were fixed with open reduction and internal fixation. Baseline information of the patients was collected, and patient-rated elbow evaluation scores were calculated. Results: Out of the 28 patients, 21 were male and 7 were female. Besides, 16 fractures were on the right side and 12 were on the left side and 17 involving the dominant hands. In addition, 8 patients had Mason type Ⅱ fracture and 20 had Mason type Ⅲ fracture. The mean age of patients was (31.0 ± 8.0) years, and the mean follow-up is (1.2 ± 0.5) years. The mean average patient-rated elbow evaluation scores were (27.64 ± 1.60) at 1-year follow-up. Conclusions:The majority of the patients who had radial head fractures and treated by open reduction and internal fixation have attained an excellent range of motion postoperatively.展开更多
Objective: To compare the biomechanical basis of 3 different internal fixation methods: nitinol patellar concentrator (NT-PC), tension band and wire circle in treating patellar fractures. Methods: The epoxy resin thre...Objective: To compare the biomechanical basis of 3 different internal fixation methods: nitinol patellar concentrator (NT-PC), tension band and wire circle in treating patellar fractures. Methods: The epoxy resin three dimensional photoelasticity patellar models were made by precise moulding, and were fixated by nitinol patellar concentrator (NT-PC), tension band and wire circle respectively. The patellar models with frozen stress stripes were put into the polarized light field and the stress distributions were compared. As for the model fixated by NT-PC, by dividing layer, photographing and tracing, we used the iterative method to calculate the stress value of every internal node of the epoxy resin patellar model, and the character of stress was analyzed. Results: An overall stress field was yielded when the patellar model was fixated by NT-PC, and the stripes were more than that of tension band model and wire circle model, which have only few stress stripes in the fixated layers. Further analysis indicated that there were continuous fixated stresses in the facies articularis and distal pole of patella, and the character of stresses produced by NT-PC were mainly in longitudinal direction, then in transverse direction. The shearing stresses were small. Conclusion: The initiative and continuous memorial stress of NT-PC and its overall stress distribution character are the essence of NT-PC distinguished with tension band and wire circle in treating patellar fractures. The stress character produced by NT-PC is good for the stability of fracture site and prompts fracture healing.展开更多
BACKGROUND： With the development of internal fixation materials, simple operation with internal fixation has become a tendency. Ni-Ti shape memory alloy embracing fixator has such advantages as slight injury, easy op...BACKGROUND： With the development of internal fixation materials, simple operation with internal fixation has become a tendency. Ni-Ti shape memory alloy embracing fixator has such advantages as slight injury, easy operation, security, reliable fixation, and better histocompatibility. The present study was to explore curative effect and postoperative results of Ti-Ni shape memory alloy embracing ？ xator in patients with multiple fractured ribs and ？ ail chest.METHODS： The curative effect and long-term follow-up results were observed after internal ？ xation with a shape memory alloy embracing ？ xator in patients with multiple fractured ribs and ？ ail chest from January 2006 to December 2009.RESULTS： All patients were cured with an average hospital stay of 10.31±3.14 days. Post-operative pain was less severe than preoperative pain （P=0.02）.The rate of postoperative complications such as atelectasis, pulmonary infection, etc was 17.65%. There were fewer long-term complications and less in？ uence on daily work and life.CONCLUSIONS： It is practical to perform an operation for fracture of multiple ribs using a Ti-Ni shape memory alloy embracing ？ xator. The ？ xator, which is less traumatic, simple, safe, and reliable, has a good-histocompatibility and fewer postoperative complications.展开更多
To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus i...To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months （range 12-30 months）. The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation （P〈0. 01）, the total excellent and fine rate was 91.86%. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.展开更多
Objective: Acetabular fractures are common injuries in Iran. We assess the functional outcome of open reduction and internal fixation management of displaced Complex acetabular fractures. Materials and Methods: We ana...Objective: Acetabular fractures are common injuries in Iran. We assess the functional outcome of open reduction and internal fixation management of displaced Complex acetabular fractures. Materials and Methods: We analyzed a case series of patients with open reduction and internal fixation (ORIF) for complex acetabular fractures. Two hundred patients (132 men, 68 women) in four age groups including with a mean age of 43.39 ± 6.18 years (range 20 - 59 years) and a mean follow-up of 82.34 ± 12.48 months (range 18 - 109 months) met the inclusion criteria. Functional outcome at final follow-up was graded assessed according to Harris score. Factors affecting were defined. Results: Anatomic reduction was achieved in 192 hips, imperfect in 8 and poor in none. Radiological outcome revealed excellent results in 128 (64%) hips, good in eight, fair in five and none in poor. Harris score were excellent in 139 (69.5%) hips, good in 43 (21.5%) and fair in 18 (9%) and poor in none. The anatomical reduction results had a favorable final functional outcome. (0.003) However, BMI (P Conclusion: Optimal functional and radiological outcomes have been achieved with anatomic postoperative reduction. Also experience of specialist, on time surgery and good recovery lead to receiving excellent functional outcome with at least complications.展开更多
This is a study of 18 patients who had surgical treatment for spinal tuberculosis. All patients were admitted with the spinal tuberculosis and treated with a combination of anterior debridement and bone graft with po...This is a study of 18 patients who had surgical treatment for spinal tuberculosis. All patients were admitted with the spinal tuberculosis and treated with a combination of anterior debridement and bone graft with poterior internal fixaton using the Luque or Dick technique. The patients were able to walk within a few days postoperation. Three to seven years follow-ups show no recurrence. kyphosis and/or solid fusinon.展开更多
A high Mw of PLLA was synthesized, it intended to be used in the manufacture ofbioabsorbable screw applied in bone fracture internal fixation. The optical reactionconditions have been discussed.
Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children...Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.展开更多
<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>...<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>Methods: </strong>30 patients with spinal internal fixation autologous blood transfusion combined with controlled hypotension were selected as the subjects during the epidemic period from December 2019 to June 2020 in our hospital and during the operation, on the basis of routine blood pressure reduction, the American Haemonetice Corporation autologous blood continuous reinfusion system was used to infuse the blood recovered during the operation to the patient through filtration and other procedures. <strong>Results:</strong> 30 patients had no complications such as fever and hemolysis;And after the operation, the tube was dialed according to the drainage volume, the cervical thoracic and lumbar brace was customized, and the patient walked on the ground for one week;After no abnormalities, the patient was discharged. Intraoperative comparison of white blood cells (WBC), red blood cells (RBC), red blood cell pressure (HCT), hemoglobin (HGB), and coagulation time (PT) of patients with autologous blood before and after transfusion showed statistically significant differences before and after surgery (P < 0.001). <strong>Conclusion:</strong> During the new coronavirus pneumonia epidemic, the internal fixation of spinal surgery used a recovery machine to collect intraoperative blood for reinfusion. Intraoperative antihypertensive drugs were used to control blood pressure within a certain safe range. The postoperative clinical observation effect was significant and safe;especially at present the clinical significance during the epidemic was significant.展开更多
Wafer curvature method has been applied to determine the internal stress in the films using Stoney＇s equation.During the film deposition,the wafer fixation on the sample holder will restrict the deformation of the re...Wafer curvature method has been applied to determine the internal stress in the films using Stoney＇s equation.During the film deposition,the wafer fixation on the sample holder will restrict the deformation of the rectangle-shaped wafer,which may result in the stress datum difference along length and width direction.In this paper,the effect of wafer size and the wafer fixation on the TiN film internal stress measured by wafer curvature method was discussed.The rectangle-shaped wafers with different length/width ratios（L/W=1：1,2：1,3：1 and 4：1） were fixed as a cantilever beam.After the TiN films deposition,the profiles of the film/wafer were measured using a stylus profilometer and then the internal stress was calculated using the Stoney equation in the film.The results showed that the fixed end of the wafers limited to some degree the curvature of the wafers along the width direction.For film internal stress measured by wafer curvature method,the wafer profile should be scanned along the length direction and the scan distance should be greater than or equal to half of wafer length.When the length/width ratio of the wafer reached 3：1,the wafer curvature and the calculated stress were basically the same at different positions along the length direction.For film internal stress measured by wafer curvature method,it was recommended that the length/width ratio of wafer should be considered to be greater than or equal to 3：1,and the deformed profile was scanned along the length direction.展开更多
Objective:To evaluate the clinical effect of posterior internal fixation and fusion in the treatment of thoracolumbar fractures.Methods:36 patients with thoracolumbar fractures from January 2018 to December 2020 were ...Objective:To evaluate the clinical effect of posterior internal fixation and fusion in the treatment of thoracolumbar fractures.Methods:36 patients with thoracolumbar fractures from January 2018 to December 2020 were selected and divided into study group and control group according to the random number table model.The control group was treated with anterior internal fixation,while the study group was treated with posterior internal fixation and fusion.The indexes of the two groups were compared and analyzed.Results:Compared with the operation related indexes of the two groups,the study group had more advantages(P<0.05);The postoperative kyphosis Cobb angle,height of anterior and posterior vertebral body,wedge index of the two groups were better than those before operation(P<0.05),and there was no significant difference between the two groups(P>0.05);There was no significant difference between the two groups(P>0.05).Conclusion:The clinical effect of posterior internal fixation and fusion in the treatment of thoracolumbar fractures is significant,and the body damage is slight,which is worthy of comprehensive promotion.展开更多
BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patient...BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patients with medial knee osteoarthritis(OA).However,the process of choosing treatment for patients with both patellar fractures and anteromedial knee OA remains unclear.We present the case of a patient with a patellar fracture and anteromedial OA.CASE SUMMARY We present the case of a 72-year-old woman with a history of bilateral medial compartment OA of the knees and a right Oxford UKA.She also experienced a recent left patellar fracture.ORIF and Oxford UKA were performed in a single stage.The patient showed excellent postoperative clinical results.CONCLUSION ORIF and Oxford UKA can be performed simultaneously for patients with patellar fracture and anteromedial OA on the same knee.展开更多
文摘BACKGROUND Reconstruction of the pelvic ring anatomy in unstable anterior pelvic ring injuries is a significant step to reduce the mortality rate associated with these injuries efficiently.There is a debate on using either an anterior subcutaneous pelvis internal fixator(INFIX)or an anterior supra-acetabular external fixator(EXFIX)to manage an unstable anterior pelvic ring fracture.AIM To compare the functional and radiological outcomes and complications of INFIX vs EXFIX in managing unstable pelvic ring injuries.METHODS A prospective cohort study included 54 patients with unstable pelvic ring fractures.The patients were divided into two groups;the INFIX group,in which 30 cases were fixed by INFIX,and the EXFIX group,in which 24 patients were treated by EXFIX.The average age in the EXFIX group was 31.17 years(16-57 years),while in the INFIX group,it was 34.5 years(17-53 years).The study included 20(66.7%)males and 10(33.3%)females in the INFIX group and 10(41.7%)males and 14(58.3%)females in the EXFIX group.The radiological outcomes were evaluated using Matta and Tornetta's score,and the functional outcomes using the Majeed score.RESULTS The results revealed a statistically significant difference between both groups(P=0.013)regarding radiological outcomes,according to Matta and Tornetta's score in favor of the INFIX group.Sitting,standing,and walking abilities were measured at a 3-mo follow-up visit using Majeed score modules.It was significantly better among the INFIX group than the EXFIX group in all three modules.At the final follow-up,both groups had no statistically significant difference according to the Majeed score;92.35 in the INFIX group and 90.99 in the EXFIX group(P=0.513).A lower surgical site infection rate was noticed in the INFIX group(P=0.007).CONCLUSION Anterior subcutaneous pelvis INFIX is associated with better radiological outcomes and a lower infection rate than anterior supra-acetabular EXFIX in managing patients with unstable anterior pelvic ring fractures.
文摘To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center retrospective comparative study included 50 adult patients with aseptic nonunion of femoral or tibial diaphyseal fractures treated at our institution between January 2015 and January 2025.Patients underwent either locking-plate(LP)fixation(n=25)or intramedullary nailing(IMN)(n=25).The primary outcome was radiographic union at 12 months postoperatively.Secondary outcomes included time to union,operative time,intraoperative blood loss,length of hospital stay,incidence of complications(superficial/deep infection,implant failure,malunion),and 12-month functional status assessed by the Lower Extremity Functional Scale(LEFS).Statistical comparisons used Welch t tests for continuous variables andχ²or Fisher exact tests for categorical variables.The protocol received institutional review board approval with waiver of informed consent.Results:Among 50 patients(LP=25;IMN=25),the 12-month union rate was 88.00%(22/25)in the LP group and 96.00%(24/25)in the IMN group(p=0.609).Time to union was shorter with IMN(6.20±1.83 vs 7.51±2.12 months;p=0.023).Operative time(110.52±25.23 vs 145.81±30.21 min;p<0.01)and intraoperative blood loss(250.41±80.64 vs 350.22±95.30 ml;p<0.01)favored IMN.Length of hospital stay was similar(6.24±1.83 vs 6.82±2.11 days;p=0.284).The incidence of superficial wound infection did not differ significantly(12.00%vs 4.00%;p=0.609).Twelve-month LEFS scores were comparable(65.44±10.21 vs 67.10±9.83;p=0.451).Conclusion:Both locking plate and intramedullary nail fixation are effective in the treatment of femoral and tibial nonunion,with high rates of union and good functional outcomes.Intramedullary nailing may be associated with a shorter time to union,reduced operative time and blood loss,and a lower risk of superficial wound infection compared to locking plate fixation.The choice of implant should be individualized based on fracture characteristics,patient factors,and surgeon preference.
基金Special Support Program for Scientific and Technological Talent“Application and Impact of Dental Arch Splint Intermaxillary Traction Combined with Rigid Internal Fixation on Oral Health in Patients with Facial Fractures”(DX2023BR18)。
文摘Objective: To analyze the therapeutic effect of combining dental arch splint intermaxillary traction with rigid internal fixation for the treatment of facial comminuted fractures. Methods: Sixty patients with facial comminuted fractures admitted for treatment between July 2023 and December 2024 were selected. Using a random number table method, 30 patients were assigned to the observation group, where moderate traction using a dental arch splint combined with rigid internal fixation was applied. Another 30 patients were assigned to the control group and only received dental arch splint traction treatment. The total effective rate, postoperative recovery indicators, periodontal status, complication rate, and quality of life scores were compared between the two groups. Results: The total effective rate in the observation group was higher than that in the control group. The postoperative recovery indicators and periodontal status in the observation group were superior to those in the control group. The complication rate and quality of life score were lower in the observation group compared to the control group, with P < 0.05. Conclusion: Combining dental arch splint intermaxillary traction with rigid internal fixation can improve the periodontal status and quality of life of patients with facial comminuted fractures, shorten postoperative recovery time, reduce various complications, and enhance surgical efficacy.
文摘Objective： To investigate the efficacy of the locking internal fixator （LIF）, which includes the locking compression plate （LCP） and the less invasive stable system （LISS）, in the proximal and distal tibial fractures. Methods： We did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the opera- tion with LIF by the minimally invasive plate osteosynthe- sis （MIPO） technique. The data consisted of 43 proximal tibial fractures （type AO41 C3） and 55 distal tibial fractures （type AO43C3）. Results： No complications were observed in all patients after operation. The mean healing time was 8.4 months （range 5-14 months）. Only two cases of delayed union oc- curred at postoperative 10 months. No infections were re- ported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at post- operative 6 to 9 months and regained the normal functions of knee and ankle joints. Conclusion： Using LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing.
文摘Objective To evaluate effects of manipulative reduction,dynamic external fixator combined with limited internal fixation for the treatment of Pilon fractures.Methods From January 2007 to June 2009,manipulative reduction,dynamic external
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BACKGROUND Proximal humerus fractures(PHFs)are common,especially in the elderly,and optimal surgical management remains debated.This study compares clinical,functional,and radiographic outcomes of deltoid split(DS)vs deltopectoral(DP)approaches in PHFs treated with locking plates.AIM To evaluate and compare the clinical,functional,and radiographic outcomes-as well as postoperative complication rates-associated with the DS vs the DP surgical approach in the open reduction and internal fixation(ORIF)of PHFs using locking plate constructs.METHODS A multicenter retrospective study of 120 patients undergoing ORIF for closed Neer type II-IV PHFs between January 2023 and December 2023.Patients were grouped by surgical approach[DS(n=70),DP(n=50)].Outcome measures included Numeric Rating Scale(NRS)for pain,Quick-Disabilities in Arm,Shoulder,and Hand questionnaire(QuickDASH),Constant-Murley score,Short Form Health Survey-12v2,and radiographic alignment.Complication rates were recorded.Statistical significance was defined as P<0.05.RESULTS Early outcomes favored the DS group:(1)Lower NRS(3.1 vs 5.9);(2)Higher Constant-Murley(68.2 vs 50.5);and(3)Better QuickDASH(25.4 vs 37.1).Complication rate was lower in the DS group(1.66%vs 5.81%).Radiographic outcomes were comparable.Long-term results were similar between groups.CONCLUSION While both approaches yield satisfactory long-term outcomes,the DS approach is associated with faster early recovery and fewer complications,supporting its use in selected cases.
基金supported by the National Key Research and Development Program of China(2022YFC2504303)Innovation Foundation of National Clinical Research Center for Orthopaedics,Sports Medicine&Rehabilitation(2021-NCRC-CXJJ-ZH-24)Medical Innovation and Transformation Incubation Project of Tongji Hospital(2022ZHFY10).
文摘Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge even for the most experienced surgeon.In this study,we describe in detail a novel unlocking closed reduction technique(UCRT)frame that allows strong traction for bilateral posterior pelvic ring displacement and presents preliminary clinical outcomes.Methods We retrospectively reviewed 32 patients with bilateral displaced posterior pelvic ring disruptions(AO/OTA 61-C2 and C3)who were initially treated with this technique between July 2017 and July 2022.According to the AO/OTA clas-sification,there were 9 cases(28.12%)of 61-C2,and 23 cases(71.88%)of 61-C3.There were 11 males,21 females,with an average age of 38.1 years.The interval from injury to operation was 4-27 days,with a cut-off of 12.5 days(receiver operat-ing characteristic curve).Operative time,blood loss,and postoperative radiographic findings were recorded.The functional outcomes and complications were followed.Results A total of 30(93.8%)patients achieved successful closed reduction,whereas 2 required open reduction.The success-ful closed reduction rate was 95.5%(21/22)in patients whose injury-to-operation time was less than 12.5 days.The vertical displacement percent correction of the obviously displaced hemipelvis was 70.20%±16.79%on average.The average degree of pelvic deformity correction was 64.86%±17.71%.Thirty patients were followed up for at least 12 months(12-36 months),and no complications of nonunion or redisplacement were observed.The Matta-Tornetta scoring standard revealed that the excellent(25/30)and good(4/30)rate was 96.7%.The Majeed clinical efficacy score revealed that the overall excellent and good rate was 100%.One patient had INFIX-related infection,and 2 reported numbness in the lateral thigh.The numbness was improved after INFIX removal.Conclusions This study presents an updated technique for closed reduction using a UCRT frame for bilateral posterior pelvic ring disruption,which has been shown to be effective,as indicated by excellent surgical and functional outcomes.
文摘Objective: To evaluate the effect of open reduction and internal fixation on radial head fracture and assess the post-operative function. Methods: This prospective observational study was conducted from June 2016 to July 2017 at Liaquat National Hospital and Medical College, Karachi. Altogether, 28 patients with radial head and neck fractures were enrolled in our study. These patients were admitted to the hospital and their fractures were fixed with open reduction and internal fixation. Baseline information of the patients was collected, and patient-rated elbow evaluation scores were calculated. Results: Out of the 28 patients, 21 were male and 7 were female. Besides, 16 fractures were on the right side and 12 were on the left side and 17 involving the dominant hands. In addition, 8 patients had Mason type Ⅱ fracture and 20 had Mason type Ⅲ fracture. The mean age of patients was (31.0 ± 8.0) years, and the mean follow-up is (1.2 ± 0.5) years. The mean average patient-rated elbow evaluation scores were (27.64 ± 1.60) at 1-year follow-up. Conclusions:The majority of the patients who had radial head fractures and treated by open reduction and internal fixation have attained an excellent range of motion postoperatively.
文摘Objective: To compare the biomechanical basis of 3 different internal fixation methods: nitinol patellar concentrator (NT-PC), tension band and wire circle in treating patellar fractures. Methods: The epoxy resin three dimensional photoelasticity patellar models were made by precise moulding, and were fixated by nitinol patellar concentrator (NT-PC), tension band and wire circle respectively. The patellar models with frozen stress stripes were put into the polarized light field and the stress distributions were compared. As for the model fixated by NT-PC, by dividing layer, photographing and tracing, we used the iterative method to calculate the stress value of every internal node of the epoxy resin patellar model, and the character of stress was analyzed. Results: An overall stress field was yielded when the patellar model was fixated by NT-PC, and the stripes were more than that of tension band model and wire circle model, which have only few stress stripes in the fixated layers. Further analysis indicated that there were continuous fixated stresses in the facies articularis and distal pole of patella, and the character of stresses produced by NT-PC were mainly in longitudinal direction, then in transverse direction. The shearing stresses were small. Conclusion: The initiative and continuous memorial stress of NT-PC and its overall stress distribution character are the essence of NT-PC distinguished with tension band and wire circle in treating patellar fractures. The stress character produced by NT-PC is good for the stability of fracture site and prompts fracture healing.
文摘BACKGROUND： With the development of internal fixation materials, simple operation with internal fixation has become a tendency. Ni-Ti shape memory alloy embracing fixator has such advantages as slight injury, easy operation, security, reliable fixation, and better histocompatibility. The present study was to explore curative effect and postoperative results of Ti-Ni shape memory alloy embracing ？ xator in patients with multiple fractured ribs and ？ ail chest.METHODS： The curative effect and long-term follow-up results were observed after internal ？ xation with a shape memory alloy embracing ？ xator in patients with multiple fractured ribs and ？ ail chest from January 2006 to December 2009.RESULTS： All patients were cured with an average hospital stay of 10.31±3.14 days. Post-operative pain was less severe than preoperative pain （P=0.02）.The rate of postoperative complications such as atelectasis, pulmonary infection, etc was 17.65%. There were fewer long-term complications and less in？ uence on daily work and life.CONCLUSIONS： It is practical to perform an operation for fracture of multiple ribs using a Ti-Ni shape memory alloy embracing ？ xator. The ？ xator, which is less traumatic, simple, safe, and reliable, has a good-histocompatibility and fewer postoperative complications.
文摘To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months （range 12-30 months）. The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation （P〈0. 01）, the total excellent and fine rate was 91.86%. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.
文摘Objective: Acetabular fractures are common injuries in Iran. We assess the functional outcome of open reduction and internal fixation management of displaced Complex acetabular fractures. Materials and Methods: We analyzed a case series of patients with open reduction and internal fixation (ORIF) for complex acetabular fractures. Two hundred patients (132 men, 68 women) in four age groups including with a mean age of 43.39 ± 6.18 years (range 20 - 59 years) and a mean follow-up of 82.34 ± 12.48 months (range 18 - 109 months) met the inclusion criteria. Functional outcome at final follow-up was graded assessed according to Harris score. Factors affecting were defined. Results: Anatomic reduction was achieved in 192 hips, imperfect in 8 and poor in none. Radiological outcome revealed excellent results in 128 (64%) hips, good in eight, fair in five and none in poor. Harris score were excellent in 139 (69.5%) hips, good in 43 (21.5%) and fair in 18 (9%) and poor in none. The anatomical reduction results had a favorable final functional outcome. (0.003) However, BMI (P Conclusion: Optimal functional and radiological outcomes have been achieved with anatomic postoperative reduction. Also experience of specialist, on time surgery and good recovery lead to receiving excellent functional outcome with at least complications.
文摘This is a study of 18 patients who had surgical treatment for spinal tuberculosis. All patients were admitted with the spinal tuberculosis and treated with a combination of anterior debridement and bone graft with poterior internal fixaton using the Luque or Dick technique. The patients were able to walk within a few days postoperation. Three to seven years follow-ups show no recurrence. kyphosis and/or solid fusinon.
文摘A high Mw of PLLA was synthesized, it intended to be used in the manufacture ofbioabsorbable screw applied in bone fracture internal fixation. The optical reactionconditions have been discussed.
基金supported by Program of the National Natural Science Foundation of China(No.82074233)Scientific Research Foundation for Advanced Talents,Xiang’an Hospital of Xiamen University(No.PM201809170009).
文摘Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.
文摘<strong>Objective: </strong>To explore the therapeutic effect of autologous blood reinfusion combined with controlled hypotension in surgical spinal fixation during the outbreak of COVID-19. <strong>Methods: </strong>30 patients with spinal internal fixation autologous blood transfusion combined with controlled hypotension were selected as the subjects during the epidemic period from December 2019 to June 2020 in our hospital and during the operation, on the basis of routine blood pressure reduction, the American Haemonetice Corporation autologous blood continuous reinfusion system was used to infuse the blood recovered during the operation to the patient through filtration and other procedures. <strong>Results:</strong> 30 patients had no complications such as fever and hemolysis;And after the operation, the tube was dialed according to the drainage volume, the cervical thoracic and lumbar brace was customized, and the patient walked on the ground for one week;After no abnormalities, the patient was discharged. Intraoperative comparison of white blood cells (WBC), red blood cells (RBC), red blood cell pressure (HCT), hemoglobin (HGB), and coagulation time (PT) of patients with autologous blood before and after transfusion showed statistically significant differences before and after surgery (P < 0.001). <strong>Conclusion:</strong> During the new coronavirus pneumonia epidemic, the internal fixation of spinal surgery used a recovery machine to collect intraoperative blood for reinfusion. Intraoperative antihypertensive drugs were used to control blood pressure within a certain safe range. The postoperative clinical observation effect was significant and safe;especially at present the clinical significance during the epidemic was significant.
基金Funded by National Scholastic Athletics Foundotion(NSAF)(No.U1330113)National Natural Science Foundation of China(No.81271953)
文摘Wafer curvature method has been applied to determine the internal stress in the films using Stoney＇s equation.During the film deposition,the wafer fixation on the sample holder will restrict the deformation of the rectangle-shaped wafer,which may result in the stress datum difference along length and width direction.In this paper,the effect of wafer size and the wafer fixation on the TiN film internal stress measured by wafer curvature method was discussed.The rectangle-shaped wafers with different length/width ratios（L/W=1：1,2：1,3：1 and 4：1） were fixed as a cantilever beam.After the TiN films deposition,the profiles of the film/wafer were measured using a stylus profilometer and then the internal stress was calculated using the Stoney equation in the film.The results showed that the fixed end of the wafers limited to some degree the curvature of the wafers along the width direction.For film internal stress measured by wafer curvature method,the wafer profile should be scanned along the length direction and the scan distance should be greater than or equal to half of wafer length.When the length/width ratio of the wafer reached 3：1,the wafer curvature and the calculated stress were basically the same at different positions along the length direction.For film internal stress measured by wafer curvature method,it was recommended that the length/width ratio of wafer should be considered to be greater than or equal to 3：1,and the deformed profile was scanned along the length direction.
文摘Objective:To evaluate the clinical effect of posterior internal fixation and fusion in the treatment of thoracolumbar fractures.Methods:36 patients with thoracolumbar fractures from January 2018 to December 2020 were selected and divided into study group and control group according to the random number table model.The control group was treated with anterior internal fixation,while the study group was treated with posterior internal fixation and fusion.The indexes of the two groups were compared and analyzed.Results:Compared with the operation related indexes of the two groups,the study group had more advantages(P<0.05);The postoperative kyphosis Cobb angle,height of anterior and posterior vertebral body,wedge index of the two groups were better than those before operation(P<0.05),and there was no significant difference between the two groups(P>0.05);There was no significant difference between the two groups(P>0.05).Conclusion:The clinical effect of posterior internal fixation and fusion in the treatment of thoracolumbar fractures is significant,and the body damage is slight,which is worthy of comprehensive promotion.
文摘BACKGROUND Open reduction and internal fixation(ORIF)is the traditional surgical treatment for patellar fractures,and unicompartmental knee arthroplasty(UKA),especially Oxford UKA,has been increasingly used in patients with medial knee osteoarthritis(OA).However,the process of choosing treatment for patients with both patellar fractures and anteromedial knee OA remains unclear.We present the case of a patient with a patellar fracture and anteromedial OA.CASE SUMMARY We present the case of a 72-year-old woman with a history of bilateral medial compartment OA of the knees and a right Oxford UKA.She also experienced a recent left patellar fracture.ORIF and Oxford UKA were performed in a single stage.The patient showed excellent postoperative clinical results.CONCLUSION ORIF and Oxford UKA can be performed simultaneously for patients with patellar fracture and anteromedial OA on the same knee.
