BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges f...BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.展开更多
This meta-analysis compared the therapeutic effect of cable pin system（CPS） with K-wire tension band（KTB） in the treatment of patella fractures among Chinese Han population. The databases of PubM ed, Cochrane libr...This meta-analysis compared the therapeutic effect of cable pin system（CPS） with K-wire tension band（KTB） in the treatment of patella fractures among Chinese Han population. The databases of PubM ed, Cochrane library, China National Knowledge Infrastructure（CNKI）, Chinese Wan Fang and Chinese VIP were searched for studies on CPS versus KTB in the treatment of patella fractures among Chinese Han population. Literatures were screened according to the inclusion and exclusion criteria. The quality of the studies was assessed, and meta-analysis was performed using the Cochrane Collaboration＇s REVMAN 5.3 software. A total of 932 patients from 15 studies were included in this meta-analysis（426 fractures treated with CPS and 506 fractures treated with KTB）. There were significant differences in duration of hospital stay [mean difference（MD）=–1.07; 95% confidence interval（CI）： –1.71 to –0.43], fracture healing time（MD=–1.23; 95% CI： –1.68 to –0.77）, flexion degree of knee joint at 6 th month after operation（MD=14.82; 95% CI： 10.93 to 18.71）, incidence of postoperative complication [risk ratio（RR）=0.16; 95% CI： 0.09 to 0.27] and excellent-good rate of B？stman score（RR=1.09; 95% CI： 1.03 to 1.16） between the CPS group and KTB group, while no significant difference was found in operative time between the two groups（MD=–4.52; 95% CI： –11.70 to 2.67）. For the treatment of patella fractures among Chinese Han population, limited evidence suggests that the CPS is more suitable than the KTB when considering the hospital stay, fracture healing time, flexion degree of knee at 6 th month after operation, incidence of postoperative complication and excellent-good rate of B？stman joint score. Due to the limitation of high quality evidence and sample size, more large-scale randomized controlled trials are needed to validate the findings in the future.展开更多
Routine postoperative radiographs after surgical fixation of pediatric distal-radius fractures have long been part of standard care.Yet growing evidence shows that these images rarely change management in stable cases...Routine postoperative radiographs after surgical fixation of pediatric distal-radius fractures have long been part of standard care.Yet growing evidence shows that these images rarely change management in stable cases,adding unnecessary cost,radiation exposure,and clinical burden.A recent study highlights this issue and questions whether routine imaging truly benefits patient outcomes.As orthopedic care shifts toward more patient-centered and value-driven models,there is increasing support for the judicious use of radiographs,reserving imaging for cases where clinical examination or patient symptoms suggest a potential problem.This shift would reflect a broader movement within orthopedic practice:Aligning tradition with necessity,and optimizing care based on evidence rather than habit.展开更多
目的掌指骨骨折是手外科常见创伤性疾病,掌指骨参与腕掌、掌指、指间关节的构成,治疗不当将严重影响患者的手的功能。文中探讨微型钢板、穿髓克氏针固定、牵引位石膏托3种不同治疗方法在掌指骨骨折治疗中的临床疗效。方法选取掌指骨骨...目的掌指骨骨折是手外科常见创伤性疾病,掌指骨参与腕掌、掌指、指间关节的构成,治疗不当将严重影响患者的手的功能。文中探讨微型钢板、穿髓克氏针固定、牵引位石膏托3种不同治疗方法在掌指骨骨折治疗中的临床疗效。方法选取掌指骨骨折患者60例共95个部位,分别平均进入微型钢板内固定、穿髓克氏针固定及牵引位石膏托3种不同治疗方法组,术后随访6～12个月,平均随访(8.1±1.5)个月,按照总主动屈曲度系统(total active flexion system,TAFS)评分评估3组临床疗效。结果微型钢板组内固定优良率为90.9%,穿髓克氏针内固定组优良率为71.4%,牵引位石膏保守治疗组优良率为55.6%,3组结果差异有显著统计学意义(P<0.05)。骨折愈合时间微型钢板组较其他2组短,差异有统计学意义(P<0.05)。切开复位感染率微型钢板内固定组为0.0%,穿髓克氏针组为15.4%(P<0.05)。结论微型钢板内固定治疗掌指骨骨折在术后关节功能恢复、骨折愈合时间、术后感染预防方面都具有明显优势,是首选的治疗方法。展开更多
基金approved by King Abdullah International Medical Research Center Ethics Committee(approval No.0000074524).
文摘BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.
文摘This meta-analysis compared the therapeutic effect of cable pin system（CPS） with K-wire tension band（KTB） in the treatment of patella fractures among Chinese Han population. The databases of PubM ed, Cochrane library, China National Knowledge Infrastructure（CNKI）, Chinese Wan Fang and Chinese VIP were searched for studies on CPS versus KTB in the treatment of patella fractures among Chinese Han population. Literatures were screened according to the inclusion and exclusion criteria. The quality of the studies was assessed, and meta-analysis was performed using the Cochrane Collaboration＇s REVMAN 5.3 software. A total of 932 patients from 15 studies were included in this meta-analysis（426 fractures treated with CPS and 506 fractures treated with KTB）. There were significant differences in duration of hospital stay [mean difference（MD）=–1.07; 95% confidence interval（CI）： –1.71 to –0.43], fracture healing time（MD=–1.23; 95% CI： –1.68 to –0.77）, flexion degree of knee joint at 6 th month after operation（MD=14.82; 95% CI： 10.93 to 18.71）, incidence of postoperative complication [risk ratio（RR）=0.16; 95% CI： 0.09 to 0.27] and excellent-good rate of B？stman score（RR=1.09; 95% CI： 1.03 to 1.16） between the CPS group and KTB group, while no significant difference was found in operative time between the two groups（MD=–4.52; 95% CI： –11.70 to 2.67）. For the treatment of patella fractures among Chinese Han population, limited evidence suggests that the CPS is more suitable than the KTB when considering the hospital stay, fracture healing time, flexion degree of knee at 6 th month after operation, incidence of postoperative complication and excellent-good rate of B？stman joint score. Due to the limitation of high quality evidence and sample size, more large-scale randomized controlled trials are needed to validate the findings in the future.
文摘Routine postoperative radiographs after surgical fixation of pediatric distal-radius fractures have long been part of standard care.Yet growing evidence shows that these images rarely change management in stable cases,adding unnecessary cost,radiation exposure,and clinical burden.A recent study highlights this issue and questions whether routine imaging truly benefits patient outcomes.As orthopedic care shifts toward more patient-centered and value-driven models,there is increasing support for the judicious use of radiographs,reserving imaging for cases where clinical examination or patient symptoms suggest a potential problem.This shift would reflect a broader movement within orthopedic practice:Aligning tradition with necessity,and optimizing care based on evidence rather than habit.
文摘目的掌指骨骨折是手外科常见创伤性疾病,掌指骨参与腕掌、掌指、指间关节的构成,治疗不当将严重影响患者的手的功能。文中探讨微型钢板、穿髓克氏针固定、牵引位石膏托3种不同治疗方法在掌指骨骨折治疗中的临床疗效。方法选取掌指骨骨折患者60例共95个部位,分别平均进入微型钢板内固定、穿髓克氏针固定及牵引位石膏托3种不同治疗方法组,术后随访6～12个月,平均随访(8.1±1.5)个月,按照总主动屈曲度系统(total active flexion system,TAFS)评分评估3组临床疗效。结果微型钢板组内固定优良率为90.9%,穿髓克氏针内固定组优良率为71.4%,牵引位石膏保守治疗组优良率为55.6%,3组结果差异有显著统计学意义(P<0.05)。骨折愈合时间微型钢板组较其他2组短,差异有统计学意义(P<0.05)。切开复位感染率微型钢板内固定组为0.0%,穿髓克氏针组为15.4%(P<0.05)。结论微型钢板内固定治疗掌指骨骨折在术后关节功能恢复、骨折愈合时间、术后感染预防方面都具有明显优势,是首选的治疗方法。
文摘[目的]用Meta分析定量评价克氏针与钢板固定桡骨远端骨折的疗效和安全性。[方法]计算机检索Pub Med、EMBASE、Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库、中国科技期刊全文数据库关于克氏针与钢板固定桡骨远端骨折的随机对照试验,由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险/方法学质量后,采用Rev Man 5.3软件进行Meta分析。[结果]共纳入8篇随机对照试验,Meta分析结果显示:钢板和克氏针治疗桡骨远端骨折术后3个月DASH评分[MD=-7.54,95%CI(-10.66,-4.42),P<0.001]、浅表部位感染发生率[OR=0.43,95%CI(0.23,0.79),P=0.007]、总并发症的发生率[OR=0.21,95%CI(0.15,0.29),P<0.001]方面差异有统计学意义。而在术后12个月DASH评分方面[MD=-2.87,95%CI(-6.48,0.73),P=0.12],两组差异无统计学意义。[结论]钢板内固定治疗桡骨远端骨折在DASH评分和降低术后并发症方面优于克氏针固定。
