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 and χ^(2) or 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 evaluate the treatment regimen and efficacy for limb fractures combined with traumatic shock(TS).Methods:A total of 88 patients with limb fractures combined with TS,admitted between January 2021 and Decem...Objective:To evaluate the treatment regimen and efficacy for limb fractures combined with traumatic shock(TS).Methods:A total of 88 patients with limb fractures combined with TS,admitted between January 2021 and December 2023,were selected.Patients were divided randomly using a numerical grouping method.The observation group underwent restricted fluid resuscitation combined with comprehensive treatment,while the reference group received conventional fluid resuscitation combined with comprehensive treatment.Recovery time,fracture prognosis,complications,severity of the condition,and post-fracture joint function were compared between the two groups.Results:The observation group showed shorter symptom recovery times,a higher rate of anatomical fracture reduction,and a lower complication rate compared to the reference group(P<0.05).After one week of treatment,the severity score of the condition in the observation group was lower than that of the reference group,and all joint function scores were higher in the observation group(P<0.05).Conclusion:Restricted fluid resuscitation combined with comprehensive treatment for limb fractures with TS can alleviate symptoms,improve fracture prognosis,reduce related complications,decrease the severity of trauma,and enhance joint function.The therapeutic effect is excellent.展开更多
Objectives To study the effects of applying locking compression plates in the treatment of patients with limb fractures on postoperative fracture healing.Methods:115 patients with limb fractures who were treated in ou...Objectives To study the effects of applying locking compression plates in the treatment of patients with limb fractures on postoperative fracture healing.Methods:115 patients with limb fractures who were treated in our hospital from November 2019 to November 2020 were selected.In order to study the effective treatment method,the random-number table method was used in this study to divide the patients into two groups,namely the experimental group and the control group,and the locking compression plate treatment method and the pure plate and screw internal fixation treatment method were administered respectively to study their clinical application effects.Results:Compared with the control group,patients in the experimental group had a lower incidence of complications,shorter hospitalizations and shorter recovery time.Meanwhile,the experimental group had a better quality of recovery,and all data were significantly different from those of the control group,P<0.05,the intervention effect of the experimental group was better.Conclusion:The application of the locking compression plate in the treatment of patients with limb fractures is more conducive to promoting the postoperative healing of the patients'fractures,reducing the incidence of postoperative complications,and promoting the rapid recovery of patients,which has positive significance for clinical development.展开更多
Objective: to study the effect of structural nursing on psychological status, survival quality and complications of patients. Methods: 60 patients with limb fractures admitted from October 2019 to February 2021 were i...Objective: to study the effect of structural nursing on psychological status, survival quality and complications of patients. Methods: 60 patients with limb fractures admitted from October 2019 to February 2021 were included. The random number table were divided into study group and control group, and the psychological status, survival quality and complications of the two groups. Results: the incidence of psychological and behavioral response, including preoperative control loss, pain response and separation anxiety, was lower than that of the control group, the SF-36 scale was higher than that of the control group, and the perioperative complication rate was lower than that of the control group, which was statistically significant (P 0.05).Conclusion: structural nursing can effectively improve the preoperative psychological state, improve the early postoperative survival quality, and reduce the risk of perioperative complications.展开更多
Objective:To explore the anesthesia effect of ultrasound-guided nerve block in elderly patients with lower limb fractures.Methods:From November 2017 to November 2020,50 elderly patients with lower limb fractures in ou...Objective:To explore the anesthesia effect of ultrasound-guided nerve block in elderly patients with lower limb fractures.Methods:From November 2017 to November 2020,50 elderly patients with lower limb fractures in our hospital were divided into experimental group(25 cases,general anesthesia+femoral nerve and sciatic nerve block)and control group(25 cases,general body anesthesia).Compare the MAP,HR,anesthesia effect,and adverse reactions between the two groups at each time period.Results:Before induction,the difference in MAP and HR between the two groups of patients did not form,p>0.05;the MAP and HR of the experimental group were compared with the control group at the time of skin incision,1 hour during the operation,and removal of the laryngeal mask,P<0.05;the time of extubation in the experimental group(14.28±3.18)min,awake time(5.57±1.32)min,orientation recovery time(11.89±2.23)min,propofol dosage(191.36±22.48)mg,remifentanil dosage(0.23±0.04)mg,Compared with the control group,P<0.05;the adverse reaction rate of the experimental group(8%,2/25)was lower than that of the control group(32%,8/25),P<0.05.Conclusion:The use of ultrasound-guided femoral nerve and sciatic nerve block for elderly patients with lower limb fractures can enhance the effect of anesthesia,effectively reduce the use of anesthetics,and have fewer adverse reactions.It is worthy of promotion.展开更多
Objective: to analyze the clinical effect of locking compression plate on limb fractures. Methods: 130 patients with limb fractures received in our hospital from June 2021 to July 2022 were selected for the study. The...Objective: to analyze the clinical effect of locking compression plate on limb fractures. Methods: 130 patients with limb fractures received in our hospital from June 2021 to July 2022 were selected for the study. They were randomly divided into the control group (ordinary plate and screw internal fixation) and the observation group (locking compression plate treatment), 65 patients in each group. The clinical effects were compared. Results: the clinical effective rate of the observation group was significantly better than that of the control group (P < 0.05);the operation time, fracture healing time, X-ray callus score, VAS score and complication rate in the observation group were significantly lower than those in the control group (P < 0.05). Conclusion: the clinical effect of locking compression plate for limb fracture is significant, which can promote patients to obtain better treatment effect, significantly shorten the operation time of patients, promote fracture healing, further reduce the body pain of patients, reduce the pain of patients, and the probability of adverse reactions of patients is relatively low, which has high safety in clinical application. It also shows that this treatment method has a better significance of popularization and application.展开更多
Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fract...Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fractures of the bilateral lower limbs due to this reason. A child fell from a height of around 15 feet after toppling from a balcony. He developed multiple fractures involving the right femoral shaft, right distal femoral epiphysis (Salter Harris type 2), right distal metaphysis of the tibia and fibula, and undisplaced Salter Harris type 2 epiphyseal injury of the left distal tibia. There were no head, abdominal or spinal injuries. The patient was taken into emergency operation theatre after initial management which consisted of intravenous fluids, blood transfusion, and splintage of both lower limbs. Fracture of the femoral shaft was treated by closed reduction and fixation using two titanium elastic nails. Distal femoral physeal injury required open reduction and fixation with K wires. Distal tibia fractures were closely reduced and managed nonoperatively in both the lower limbs. All the fractures united in four weeks. At the last follow-up, the child had no disability and was able to perform daily activities comfortably. We also proposed the unique mechanism of injury in this report.展开更多
OBJECTIVE: To investigate the combined effect of Traditional Chinese Medicine(TCM) decoction and low-molecular-weight heparin calcium on deep vein thrombosis(DVT) induced by surgery in patients with lower limb fractur...OBJECTIVE: To investigate the combined effect of Traditional Chinese Medicine(TCM) decoction and low-molecular-weight heparin calcium on deep vein thrombosis(DVT) induced by surgery in patients with lower limb fracture.METHODS: Totally 86 hospitalized patients with DVT after surgery of lower limb fracture between September 2012 and January 2015 were recruited and randomly divided into control group and observation group, 43 cases in each group. The patients in the control group were treated with subcutaneous injection of low-molecular-weight heparin calcium, and those in the observation group were additionally given Danshen Injection and TCM decoction. The differences between two groups in occurrence rate, medication time, therapeutic effects,recurrence rate of thrombosis, activated partial thromboplastin time(APTT), and prothrombin time(PT) were compared.RESULTS: The occurrence rate of DVT in observation group(4.65%, 2/43) was lower than that in control group(27.91%,12/43)(P<0.05). The medication time of observation group was(6.15±2.94) d, shorter than(9.76±3.12) d in the control group(P<0.05). In observation group, 2 cases of DVT were cured(2/2); in the control group, 9 cases presented therapeutic effects and the total effective rate was 75.00%(9/12). The improvement of APTT and PT in the observation group was better than that in the control group(P<0.05).CONCLUSION: Integrative TCM decoction plus low-molecularweight heparin calcium is superior to applicaton of low-molecularweight heparin calcium alone in reducing and treating DVT in the postoperative patients with lower limb fracture.展开更多
Heterotopic ossification(HO)is a consequence of traumatic bone and tissue damage,which occurs in 65%of military casualties with blast-associated amputations.However,the mechanisms behind blast-induced HO remain unclea...Heterotopic ossification(HO)is a consequence of traumatic bone and tissue damage,which occurs in 65%of military casualties with blast-associated amputations.However,the mechanisms behind blast-induced HO remain unclear.Animal models are used to study blast-induced HO,but developing such models is challenging,particularly in how to use a pure blast wave(primary blast)to induce limb fracture that then requires an amputation.Several studies,including our recent study,have developed platforms to induce limb fractures in rats with blast loading or a mixture of blast and impact loading.However,these models are limited by the survivability of the animal and repeatability of the model.In this study,we developed an improved platform,aiming to improve the animal's survivability and injury repeatability as well as focusing on primary blast only.The platform exposed only one limb of the rat to a blast wave while providing proper protection to the rest of the rat's body.We obtained very consistent fracture outcome in the tibia(location and pattern)in cadaveric rats with a large range of size and weight.Importantly,the rats did not obviously move during the test,where movement is a potential cause of uncontrolled injury.We further conducted parametric studies by varying the features of the design of the platform.These factors,such as how the limb is fixed and how the cavity through which the limb is placed is sealed,significantly affect the resulting injury.This platform and test setups enable well-controlled limb fracture induced directly by pure blast wave,which is the fundamental step towards a complete in vivo animal model for blast-induced HO induced by primary blast alone,excluding secondary and tertiary blast injury.In addition,the platform design and the findings presented here,particularly regarding the proper protection of the animal,have implications for future studies investigating localized blast injuries,such as blast induced brain and lung injuries.展开更多
Objective:To analyze the effect of locking compression plate on the success rate of operation and the time of postoperative recovery.Methods:120 patients with limb fractures from March 2018 to March 2020 were randomly...Objective:To analyze the effect of locking compression plate on the success rate of operation and the time of postoperative recovery.Methods:120 patients with limb fractures from March 2018 to March 2020 were randomly divided into control group(60 cases)and observation group(60 cases).The control group was treated with plate screw internal fixation,The observation group used locking compression plate internal fixation,Compare the effect of treatment,the success rate of operation and the time of postoperative recovery.results:compared the effective rate of the two groups,the observation group(93.33%)was significantly higher than the control group(75.00%).Compared with the two groups,the success rate of operation and the time of postoperative recovery,the observed composition power was higher than that of the control group,and the postoperative recovery time was lower than that of the control group,P<0.05.Conclusion:The use of locking compression plate for the treatment of limb fracture can significantly increase the probability of successful operation,shorten the recovery time after operation,the overall curative effect is ideal,and the clinical popularization value is high.展开更多
Objective: to analyze the effect of high quality nursing on functional recovery and quality of life of patients with limb fracture. Methods: 40 patients with limb fracture admitted to our hospital from September 2019 ...Objective: to analyze the effect of high quality nursing on functional recovery and quality of life of patients with limb fracture. Methods: 40 patients with limb fracture admitted to our hospital from September 2019 to September 2021 were included. They were divided into study group and control group by random number table method, with 20 cases in each group. Quality nursing and routine nursing were carried out respectively, and functional recovery and quality of life were evaluated and compared between groups. Results: after 2 weeks of nursing, fim score and whoqolbref score in the study group were higher than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion: quality nursing services for patients with limb fracture can promote functional recovery and improve the quality of life of patients.展开更多
Objective: to analyze the effect of humanistic nursing intervention on elderly patients with lower limb fracture after operation. Methods: a comparative study was carried out in this paper with 100 cases. It is mainly...Objective: to analyze the effect of humanistic nursing intervention on elderly patients with lower limb fracture after operation. Methods: a comparative study was carried out in this paper with 100 cases. It is mainly the elderly patients with lower limb fractures collected in our hospital in recent years. They are randomly divided into 50 cases in each group. During the operation, the corresponding intervention conditions were set as the control group, and the differences between the two groups were analyzed. Results: it can be found that the psychological, life and nursing satisfaction of the two groups of patients are evaluated and scored respectively, and it can be found that the experimental group has obvious advantages, the result is less than zero, P<0.05 has statistical significance. Conclusion: for elderly patients with lower limb fractures, in the process of humanistic intervention and nursing, improving the patients' survival satisfaction is beneficial to the patients' early recovery and improving the patients' living standard.展开更多
Objective: To analyze the clinical effect of rehabilitation nursing on knee joint stiffness after lower extremity trauma fracture. Methods: A total of 82 patients with knee stiffness after lower extremity trauma fract...Objective: To analyze the clinical effect of rehabilitation nursing on knee joint stiffness after lower extremity trauma fracture. Methods: A total of 82 patients with knee stiffness after lower extremity trauma fracture surgery were selected by random number table method. The results were divided into the experimental group (n41) and the control group (n41), who were given rehabilitation nursing and routine nursing respectively. Results: Before nursing implementation, there was no significant difference in muscle strength and flexion and extension of patients with knee stiffness after lower limb trauma fracture surgery between the two groups. After nursing implementation, the muscle strength and flexion and extension of patients in the experimental group were (8.85±0.86) kg and (85.48±5.68). The muscle strength and flexion and extension of the control group were (5.95±0.89) kg and (63.53±6.71), respectively. The improvement effect of the muscle strength and flexion and extension of the experimental group was better than that of the control group, P < 0.05. The improvement effect of knee stiffness in patients with lower extremity trauma fracture after surgery was compared between the two groups, and the experimental group was better than the control group, P < 0.05;After the implementation of nursing care, the quality of life score of patients in the experimental group was higher than that in the control group, P < 0.05;After the implementation of nursing care, the experimental group was higher than the control group, P < 0.05;The complication rate of the experimental group was better than that of the control group (P < 0.05). Conclusion: In view of the symptoms of knee stiffness in patients with lower extremity trauma fracture after surgery, rehabilitation nursing is helpful to improve the function of knee stiffness.展开更多
Objective To observe the changes of thrombelastography (TEG) and color Doppler flow imaging (CDFI) in the perioperative period after closed lower limb fracture.Methods Fasting venous blood samples in the morning from ...Objective To observe the changes of thrombelastography (TEG) and color Doppler flow imaging (CDFI) in the perioperative period after closed lower limb fracture.Methods Fasting venous blood samples in the morning from 11 healthy adults were used展开更多
Objective: to explore the preventive effect of evidence-based nursing intervention on venous thrombosis of lower limbs and the effect on wound healing time for patients with lower limb fractures admitted to the clinic...Objective: to explore the preventive effect of evidence-based nursing intervention on venous thrombosis of lower limbs and the effect on wound healing time for patients with lower limb fractures admitted to the clinic. Methods: from September 2018 to May 2020 as the research time range, 60 patients with clinical lower limb fractures in our hospital were selected and randomly divided into control group (30 cases) and observation group (30 cases) respectively. The venous thrombosis rate and wound healing time of lower limb were compared. Results: compared with the control group, the incidence of venous thrombosis in the observation group was lower (P < 0.05). Compared with the control group, the wound healing time and average hospitalization time in the observation group were shorter (P < 0.05). Conclusion: for patients with lower limb fractures, the application of evidence-based nursing model can effectively reduce the rate of lower limb venous thrombosis and shorten the healing time of patients with fracture. It has significant nursing effect and is worthy of clinical recommendation and use.展开更多
Purpose： Bear maul injuries are the most common wild animal inflicted injuries in India. More than 300 bear maul injuries report to our hospital per year. Methods： Twenty-one consecutive patients over a period of 1 ...Purpose： Bear maul injuries are the most common wild animal inflicted injuries in India. More than 300 bear maul injuries report to our hospital per year. Methods： Twenty-one consecutive patients over a period of 1 year reported to our department for orthopaedic management of bear maul injuries. All the patients were referred either from peripheral hospitals or from other surgical departments of our hospital. Results： All the patients had facial[scalp injuries of variable severity. In all the patients the severity of limb and facial trauma was inversely proportional to each other. Pattern of upper limb trauma in most of the patients was similar. Fifteen patients had either fractures of distal humerus or mid shaft/proximal forearm bone fracture. Two had distal forearm bone fracture, 2 had carpal/metacarpal fractures and I had clavicle fracture. Only I had lower limb fracture. Thirteen out of 21 patients had associated neurovascular injury of the involved limb. The characteristic feature was extensive soft tissue involvement of the affected limb. Conclusion： Upper limb injuries in bear maul patients usually have similar pattern. The severity of upper limb and facial/scalp trauma is inversely proportional to each other. Multistage orthopaedic surgeries are needed for such comolex limb injuries.展开更多
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 and χ^(2) or 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2023 Zhenjiang Science and Technology Innovation Fund(Key R&D Program-Social Development)Project“Study on the Role of Early Intervention Triggered by MT Prediction Model in Reducing the Incidence and Mortality of TIC in Patients with Multiple Injuries”(Project No.SH2023088)。
文摘Objective:To evaluate the treatment regimen and efficacy for limb fractures combined with traumatic shock(TS).Methods:A total of 88 patients with limb fractures combined with TS,admitted between January 2021 and December 2023,were selected.Patients were divided randomly using a numerical grouping method.The observation group underwent restricted fluid resuscitation combined with comprehensive treatment,while the reference group received conventional fluid resuscitation combined with comprehensive treatment.Recovery time,fracture prognosis,complications,severity of the condition,and post-fracture joint function were compared between the two groups.Results:The observation group showed shorter symptom recovery times,a higher rate of anatomical fracture reduction,and a lower complication rate compared to the reference group(P<0.05).After one week of treatment,the severity score of the condition in the observation group was lower than that of the reference group,and all joint function scores were higher in the observation group(P<0.05).Conclusion:Restricted fluid resuscitation combined with comprehensive treatment for limb fractures with TS can alleviate symptoms,improve fracture prognosis,reduce related complications,decrease the severity of trauma,and enhance joint function.The therapeutic effect is excellent.
文摘Objectives To study the effects of applying locking compression plates in the treatment of patients with limb fractures on postoperative fracture healing.Methods:115 patients with limb fractures who were treated in our hospital from November 2019 to November 2020 were selected.In order to study the effective treatment method,the random-number table method was used in this study to divide the patients into two groups,namely the experimental group and the control group,and the locking compression plate treatment method and the pure plate and screw internal fixation treatment method were administered respectively to study their clinical application effects.Results:Compared with the control group,patients in the experimental group had a lower incidence of complications,shorter hospitalizations and shorter recovery time.Meanwhile,the experimental group had a better quality of recovery,and all data were significantly different from those of the control group,P<0.05,the intervention effect of the experimental group was better.Conclusion:The application of the locking compression plate in the treatment of patients with limb fractures is more conducive to promoting the postoperative healing of the patients'fractures,reducing the incidence of postoperative complications,and promoting the rapid recovery of patients,which has positive significance for clinical development.
文摘Objective: to study the effect of structural nursing on psychological status, survival quality and complications of patients. Methods: 60 patients with limb fractures admitted from October 2019 to February 2021 were included. The random number table were divided into study group and control group, and the psychological status, survival quality and complications of the two groups. Results: the incidence of psychological and behavioral response, including preoperative control loss, pain response and separation anxiety, was lower than that of the control group, the SF-36 scale was higher than that of the control group, and the perioperative complication rate was lower than that of the control group, which was statistically significant (P 0.05).Conclusion: structural nursing can effectively improve the preoperative psychological state, improve the early postoperative survival quality, and reduce the risk of perioperative complications.
文摘Objective:To explore the anesthesia effect of ultrasound-guided nerve block in elderly patients with lower limb fractures.Methods:From November 2017 to November 2020,50 elderly patients with lower limb fractures in our hospital were divided into experimental group(25 cases,general anesthesia+femoral nerve and sciatic nerve block)and control group(25 cases,general body anesthesia).Compare the MAP,HR,anesthesia effect,and adverse reactions between the two groups at each time period.Results:Before induction,the difference in MAP and HR between the two groups of patients did not form,p>0.05;the MAP and HR of the experimental group were compared with the control group at the time of skin incision,1 hour during the operation,and removal of the laryngeal mask,P<0.05;the time of extubation in the experimental group(14.28±3.18)min,awake time(5.57±1.32)min,orientation recovery time(11.89±2.23)min,propofol dosage(191.36±22.48)mg,remifentanil dosage(0.23±0.04)mg,Compared with the control group,P<0.05;the adverse reaction rate of the experimental group(8%,2/25)was lower than that of the control group(32%,8/25),P<0.05.Conclusion:The use of ultrasound-guided femoral nerve and sciatic nerve block for elderly patients with lower limb fractures can enhance the effect of anesthesia,effectively reduce the use of anesthetics,and have fewer adverse reactions.It is worthy of promotion.
文摘Objective: to analyze the clinical effect of locking compression plate on limb fractures. Methods: 130 patients with limb fractures received in our hospital from June 2021 to July 2022 were selected for the study. They were randomly divided into the control group (ordinary plate and screw internal fixation) and the observation group (locking compression plate treatment), 65 patients in each group. The clinical effects were compared. Results: the clinical effective rate of the observation group was significantly better than that of the control group (P < 0.05);the operation time, fracture healing time, X-ray callus score, VAS score and complication rate in the observation group were significantly lower than those in the control group (P < 0.05). Conclusion: the clinical effect of locking compression plate for limb fracture is significant, which can promote patients to obtain better treatment effect, significantly shorten the operation time of patients, promote fracture healing, further reduce the body pain of patients, reduce the pain of patients, and the probability of adverse reactions of patients is relatively low, which has high safety in clinical application. It also shows that this treatment method has a better significance of popularization and application.
文摘Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fractures of the bilateral lower limbs due to this reason. A child fell from a height of around 15 feet after toppling from a balcony. He developed multiple fractures involving the right femoral shaft, right distal femoral epiphysis (Salter Harris type 2), right distal metaphysis of the tibia and fibula, and undisplaced Salter Harris type 2 epiphyseal injury of the left distal tibia. There were no head, abdominal or spinal injuries. The patient was taken into emergency operation theatre after initial management which consisted of intravenous fluids, blood transfusion, and splintage of both lower limbs. Fracture of the femoral shaft was treated by closed reduction and fixation using two titanium elastic nails. Distal femoral physeal injury required open reduction and fixation with K wires. Distal tibia fractures were closely reduced and managed nonoperatively in both the lower limbs. All the fractures united in four weeks. At the last follow-up, the child had no disability and was able to perform daily activities comfortably. We also proposed the unique mechanism of injury in this report.
基金2012 Science and Technology Program of Shenzhen(Grant No.:201203283)
文摘OBJECTIVE: To investigate the combined effect of Traditional Chinese Medicine(TCM) decoction and low-molecular-weight heparin calcium on deep vein thrombosis(DVT) induced by surgery in patients with lower limb fracture.METHODS: Totally 86 hospitalized patients with DVT after surgery of lower limb fracture between September 2012 and January 2015 were recruited and randomly divided into control group and observation group, 43 cases in each group. The patients in the control group were treated with subcutaneous injection of low-molecular-weight heparin calcium, and those in the observation group were additionally given Danshen Injection and TCM decoction. The differences between two groups in occurrence rate, medication time, therapeutic effects,recurrence rate of thrombosis, activated partial thromboplastin time(APTT), and prothrombin time(PT) were compared.RESULTS: The occurrence rate of DVT in observation group(4.65%, 2/43) was lower than that in control group(27.91%,12/43)(P<0.05). The medication time of observation group was(6.15±2.94) d, shorter than(9.76±3.12) d in the control group(P<0.05). In observation group, 2 cases of DVT were cured(2/2); in the control group, 9 cases presented therapeutic effects and the total effective rate was 75.00%(9/12). The improvement of APTT and PT in the observation group was better than that in the control group(P<0.05).CONCLUSION: Integrative TCM decoction plus low-molecularweight heparin calcium is superior to applicaton of low-molecularweight heparin calcium alone in reducing and treating DVT in the postoperative patients with lower limb fracture.
基金the auspices of the Royal British Legion Centre for Blast Injury Studies at Imperial College Londonthe financial support of the Royal British Legion。
文摘Heterotopic ossification(HO)is a consequence of traumatic bone and tissue damage,which occurs in 65%of military casualties with blast-associated amputations.However,the mechanisms behind blast-induced HO remain unclear.Animal models are used to study blast-induced HO,but developing such models is challenging,particularly in how to use a pure blast wave(primary blast)to induce limb fracture that then requires an amputation.Several studies,including our recent study,have developed platforms to induce limb fractures in rats with blast loading or a mixture of blast and impact loading.However,these models are limited by the survivability of the animal and repeatability of the model.In this study,we developed an improved platform,aiming to improve the animal's survivability and injury repeatability as well as focusing on primary blast only.The platform exposed only one limb of the rat to a blast wave while providing proper protection to the rest of the rat's body.We obtained very consistent fracture outcome in the tibia(location and pattern)in cadaveric rats with a large range of size and weight.Importantly,the rats did not obviously move during the test,where movement is a potential cause of uncontrolled injury.We further conducted parametric studies by varying the features of the design of the platform.These factors,such as how the limb is fixed and how the cavity through which the limb is placed is sealed,significantly affect the resulting injury.This platform and test setups enable well-controlled limb fracture induced directly by pure blast wave,which is the fundamental step towards a complete in vivo animal model for blast-induced HO induced by primary blast alone,excluding secondary and tertiary blast injury.In addition,the platform design and the findings presented here,particularly regarding the proper protection of the animal,have implications for future studies investigating localized blast injuries,such as blast induced brain and lung injuries.
文摘Objective:To analyze the effect of locking compression plate on the success rate of operation and the time of postoperative recovery.Methods:120 patients with limb fractures from March 2018 to March 2020 were randomly divided into control group(60 cases)and observation group(60 cases).The control group was treated with plate screw internal fixation,The observation group used locking compression plate internal fixation,Compare the effect of treatment,the success rate of operation and the time of postoperative recovery.results:compared the effective rate of the two groups,the observation group(93.33%)was significantly higher than the control group(75.00%).Compared with the two groups,the success rate of operation and the time of postoperative recovery,the observed composition power was higher than that of the control group,and the postoperative recovery time was lower than that of the control group,P<0.05.Conclusion:The use of locking compression plate for the treatment of limb fracture can significantly increase the probability of successful operation,shorten the recovery time after operation,the overall curative effect is ideal,and the clinical popularization value is high.
文摘Objective: to analyze the effect of high quality nursing on functional recovery and quality of life of patients with limb fracture. Methods: 40 patients with limb fracture admitted to our hospital from September 2019 to September 2021 were included. They were divided into study group and control group by random number table method, with 20 cases in each group. Quality nursing and routine nursing were carried out respectively, and functional recovery and quality of life were evaluated and compared between groups. Results: after 2 weeks of nursing, fim score and whoqolbref score in the study group were higher than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion: quality nursing services for patients with limb fracture can promote functional recovery and improve the quality of life of patients.
文摘Objective: to analyze the effect of humanistic nursing intervention on elderly patients with lower limb fracture after operation. Methods: a comparative study was carried out in this paper with 100 cases. It is mainly the elderly patients with lower limb fractures collected in our hospital in recent years. They are randomly divided into 50 cases in each group. During the operation, the corresponding intervention conditions were set as the control group, and the differences between the two groups were analyzed. Results: it can be found that the psychological, life and nursing satisfaction of the two groups of patients are evaluated and scored respectively, and it can be found that the experimental group has obvious advantages, the result is less than zero, P<0.05 has statistical significance. Conclusion: for elderly patients with lower limb fractures, in the process of humanistic intervention and nursing, improving the patients' survival satisfaction is beneficial to the patients' early recovery and improving the patients' living standard.
文摘Objective: To analyze the clinical effect of rehabilitation nursing on knee joint stiffness after lower extremity trauma fracture. Methods: A total of 82 patients with knee stiffness after lower extremity trauma fracture surgery were selected by random number table method. The results were divided into the experimental group (n41) and the control group (n41), who were given rehabilitation nursing and routine nursing respectively. Results: Before nursing implementation, there was no significant difference in muscle strength and flexion and extension of patients with knee stiffness after lower limb trauma fracture surgery between the two groups. After nursing implementation, the muscle strength and flexion and extension of patients in the experimental group were (8.85±0.86) kg and (85.48±5.68). The muscle strength and flexion and extension of the control group were (5.95±0.89) kg and (63.53±6.71), respectively. The improvement effect of the muscle strength and flexion and extension of the experimental group was better than that of the control group, P < 0.05. The improvement effect of knee stiffness in patients with lower extremity trauma fracture after surgery was compared between the two groups, and the experimental group was better than the control group, P < 0.05;After the implementation of nursing care, the quality of life score of patients in the experimental group was higher than that in the control group, P < 0.05;After the implementation of nursing care, the experimental group was higher than the control group, P < 0.05;The complication rate of the experimental group was better than that of the control group (P < 0.05). Conclusion: In view of the symptoms of knee stiffness in patients with lower extremity trauma fracture after surgery, rehabilitation nursing is helpful to improve the function of knee stiffness.
文摘Objective To observe the changes of thrombelastography (TEG) and color Doppler flow imaging (CDFI) in the perioperative period after closed lower limb fracture.Methods Fasting venous blood samples in the morning from 11 healthy adults were used
文摘Objective: to explore the preventive effect of evidence-based nursing intervention on venous thrombosis of lower limbs and the effect on wound healing time for patients with lower limb fractures admitted to the clinic. Methods: from September 2018 to May 2020 as the research time range, 60 patients with clinical lower limb fractures in our hospital were selected and randomly divided into control group (30 cases) and observation group (30 cases) respectively. The venous thrombosis rate and wound healing time of lower limb were compared. Results: compared with the control group, the incidence of venous thrombosis in the observation group was lower (P < 0.05). Compared with the control group, the wound healing time and average hospitalization time in the observation group were shorter (P < 0.05). Conclusion: for patients with lower limb fractures, the application of evidence-based nursing model can effectively reduce the rate of lower limb venous thrombosis and shorten the healing time of patients with fracture. It has significant nursing effect and is worthy of clinical recommendation and use.
文摘Purpose： Bear maul injuries are the most common wild animal inflicted injuries in India. More than 300 bear maul injuries report to our hospital per year. Methods： Twenty-one consecutive patients over a period of 1 year reported to our department for orthopaedic management of bear maul injuries. All the patients were referred either from peripheral hospitals or from other surgical departments of our hospital. Results： All the patients had facial[scalp injuries of variable severity. In all the patients the severity of limb and facial trauma was inversely proportional to each other. Pattern of upper limb trauma in most of the patients was similar. Fifteen patients had either fractures of distal humerus or mid shaft/proximal forearm bone fracture. Two had distal forearm bone fracture, 2 had carpal/metacarpal fractures and I had clavicle fracture. Only I had lower limb fracture. Thirteen out of 21 patients had associated neurovascular injury of the involved limb. The characteristic feature was extensive soft tissue involvement of the affected limb. Conclusion： Upper limb injuries in bear maul patients usually have similar pattern. The severity of upper limb and facial/scalp trauma is inversely proportional to each other. Multistage orthopaedic surgeries are needed for such comolex limb injuries.
