Pub Date : 2019-10-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2019.10.014
F. Bao, Tao Liu, Shijie Kang, Dongsheng Huang, T. Jiang
Objective To evaluate a self-designed novel anatomical bone plate for fractures of ulnar coronoid process in cadaveric specimens. Methods Our database search in the Imaging Center, Qilu Hospital of Shandong University (Qingdao) yielded CT reconstruction images of 45 normal adult elbows (26 males and 19 females) which met our criteria. On the 3D reformatted CT images, sagittal curvature angle of the ulnar coronal process (△1), tangent angle of the coronal process apex to olecranon fossa (△2), projective length (L) and projective height (H) were measured; the transverse width of the coronal process was also measured at 5 mm and 10 mm from the tip (K1 and K2). The minimum value was used for △2° in order to avoid cutting into the joint while the mean value for other parameters. After the shape of the plate and angles of the screws were designed using computer 3D software, a new anatomic plate for coronal process was produced. Five cadaver specimens were used to test the internal fixation of the coronal process with our novel anatomic bone plate. Attachment of the bone plate to the coronal process and screw penetration into the joint cavity were observed by X-ray and 3D CT scanning. Results △1 was 45.52°±6.07°, △2 65.25°±7.09° (the minimum value 53.2°), L 52.27±7.78 mm, H 21.62±2.63 mm, K1 16.32±2.22 mm and K2 14.58±2.18 mm. Our new anatomic bone plate was designed based on the above data. X-ray and 3D CT scan after plate internal fixation showed that our self-designed bone plate produced fine attachment and no screws penetrated into the joint. Conclusion Our new anatomical bone plate may perfectly fit the anatomy of the adult ulnar coronal process in size and shape so that the coronary process can be fully covered and no screws will penetrate into the joint cavity. Key words: Bone plate; Elbow Joint; Anatomy; Cadaver
目的探讨自行设计的新型尺冠突骨折解剖钢板在尸体标本中的应用价值。方法在山东大学(青岛)齐鲁医院影像中心检索符合标准的45例正常成人肘部CT重建图像(男26例，女19例)。在三维重建的CT图像上，测量尺冠状突矢状曲率角(△1)、冠状突顶点与鹰嘴窝的切角(△2)、投影长度(L)和投影高度(H);冠状突的横向宽度也在距离尖端5 mm和10 mm处测量(K1和K2)。为避免切入接头，取最小值△2°，其他参数取平均值。利用计算机三维软件对钢板形状和螺钉角度进行设计后，制作出一种新型冠状突解剖钢板。五个尸体标本被用来测试冠状突内固定与我们的新型解剖骨板。通过x线和三维CT扫描观察骨板与冠状突的附着情况和螺钉进入关节腔的情况。结果△1为45.52°±6.07°，△2为65.25°±7.09°(最小值53.2°)，L为52.27±7.78 mm, H为21.62±2.63 mm, K1为16.32±2.22 mm, K2为14.58±2.18 mm。我们的新解剖骨板是基于上述数据设计的。钢板内固定后x线及3D CT扫描显示，我们自行设计的接骨板附着良好，无螺钉刺入关节。结论新型解剖骨板在尺寸和形状上与成人尺冠状突解剖结构完全吻合，可以完全覆盖冠状突，避免螺钉穿入关节腔。关键词:接骨板;肘关节;解剖学的;尸体
{"title":"Design of a novel anatomical plate for fractures of ulnar coronoid process","authors":"F. Bao, Tao Liu, Shijie Kang, Dongsheng Huang, T. Jiang","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.014","url":null,"abstract":"Objective \u0000To evaluate a self-designed novel anatomical bone plate for fractures of ulnar coronoid process in cadaveric specimens. \u0000 \u0000 \u0000Methods \u0000Our database search in the Imaging Center, Qilu Hospital of Shandong University (Qingdao) yielded CT reconstruction images of 45 normal adult elbows (26 males and 19 females) which met our criteria. On the 3D reformatted CT images, sagittal curvature angle of the ulnar coronal process (△1), tangent angle of the coronal process apex to olecranon fossa (△2), projective length (L) and projective height (H) were measured; the transverse width of the coronal process was also measured at 5 mm and 10 mm from the tip (K1 and K2). The minimum value was used for △2° in order to avoid cutting into the joint while the mean value for other parameters. After the shape of the plate and angles of the screws were designed using computer 3D software, a new anatomic plate for coronal process was produced. Five cadaver specimens were used to test the internal fixation of the coronal process with our novel anatomic bone plate. Attachment of the bone plate to the coronal process and screw penetration into the joint cavity were observed by X-ray and 3D CT scanning. \u0000 \u0000 \u0000Results \u0000△1 was 45.52°±6.07°, △2 65.25°±7.09° (the minimum value 53.2°), L 52.27±7.78 mm, H 21.62±2.63 mm, K1 16.32±2.22 mm and K2 14.58±2.18 mm. Our new anatomic bone plate was designed based on the above data. X-ray and 3D CT scan after plate internal fixation showed that our self-designed bone plate produced fine attachment and no screws penetrated into the joint. \u0000 \u0000 \u0000Conclusion \u0000Our new anatomical bone plate may perfectly fit the anatomy of the adult ulnar coronal process in size and shape so that the coronary process can be fully covered and no screws will penetrate into the joint cavity. \u0000 \u0000 \u0000Key words: \u0000Bone plate; Elbow Joint; Anatomy; Cadaver","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"901-905"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42233606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2019.10.015
Z. Zhuang, Bolton He, Yuangao Liu, Lianghao Wu, Yi Shi, Jiajun Wu, Kun-chuang Wang
Objective To evaluate the surgical treatment of calcaneal fracture malunion. Methods A retrospective analysis was conducted of the 19 patients with calcaneal fracture malunion (19 feet) who had been treated from January 2011 to September 2017 at Departments of Joint Surgery and Orthopedic Trauma, The Third Affiliated Hospital, Sun Yat-Sen University. They were 16 males and 3 females with the average age of 36.2 years (from 22 to 57 years). According to Stephens-Sanders classification, the malunion was defined as type Ⅰ in 10 cases, as type Ⅱ in 6 and as type Ⅲ in 3. The patients with malunion of type Ⅰ were treated by lateral wall osteotomy and decompression of long and short peroneus muscles to preserve the subtalar joint, those with malunion of type Ⅱ by lateral wall osteotomy and decompression of long and short peroneus muscles followed by subtalar joint fusion, and those with malunion of type Ⅲ by lateral wall osteotomy, decompression of long and short peroneus muscles, medial oblique osteotomy for correction of varus deformity and subtalar joint fusion via both the medial and lateral approaches. The Maryland functional scores were used to assess the postoperative surgical efficacy. Results No such complications happened as incision or implant infection, screw breakage or joint non-fusion. Of the 19 patients, 17 were followed up for 18 to 26 months (mean, 20.5 months). The Maryland scores at the final follow-ups were 90.2±7.3, significantly higher than the preoperative values (38.6±5.5) (t=53.370, P<0.001). Conclusions In the surgical treatment of calcaneal fracture malunion, satisfactory clinical efficacy can be achieved by lateral wall osteotomy and preservation of the subtalar joint for patients with maunion of Stephens-Sanders type Ⅰ, and by subtalar fusion for those with maunion of Stephens-Sanders types Ⅱ-Ⅲ. Key words: Calcaneus; Fractures, bone; Fracture healing; Subtalar joint; Fusion
{"title":"Surgical treatment of calcaneal fracture malunion","authors":"Z. Zhuang, Bolton He, Yuangao Liu, Lianghao Wu, Yi Shi, Jiajun Wu, Kun-chuang Wang","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.015","url":null,"abstract":"Objective \u0000To evaluate the surgical treatment of calcaneal fracture malunion. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted of the 19 patients with calcaneal fracture malunion (19 feet) who had been treated from January 2011 to September 2017 at Departments of Joint Surgery and Orthopedic Trauma, The Third Affiliated Hospital, Sun Yat-Sen University. They were 16 males and 3 females with the average age of 36.2 years (from 22 to 57 years). According to Stephens-Sanders classification, the malunion was defined as type Ⅰ in 10 cases, as type Ⅱ in 6 and as type Ⅲ in 3. The patients with malunion of type Ⅰ were treated by lateral wall osteotomy and decompression of long and short peroneus muscles to preserve the subtalar joint, those with malunion of type Ⅱ by lateral wall osteotomy and decompression of long and short peroneus muscles followed by subtalar joint fusion, and those with malunion of type Ⅲ by lateral wall osteotomy, decompression of long and short peroneus muscles, medial oblique osteotomy for correction of varus deformity and subtalar joint fusion via both the medial and lateral approaches. The Maryland functional scores were used to assess the postoperative surgical efficacy. \u0000 \u0000 \u0000Results \u0000No such complications happened as incision or implant infection, screw breakage or joint non-fusion. Of the 19 patients, 17 were followed up for 18 to 26 months (mean, 20.5 months). The Maryland scores at the final follow-ups were 90.2±7.3, significantly higher than the preoperative values (38.6±5.5) (t=53.370, P<0.001). \u0000 \u0000 \u0000Conclusions \u0000In the surgical treatment of calcaneal fracture malunion, satisfactory clinical efficacy can be achieved by lateral wall osteotomy and preservation of the subtalar joint for patients with maunion of Stephens-Sanders type Ⅰ, and by subtalar fusion for those with maunion of Stephens-Sanders types Ⅱ-Ⅲ. \u0000 \u0000 \u0000Key words: \u0000Calcaneus; Fractures, bone; Fracture healing; Subtalar joint; Fusion","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"906-909"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48004045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2019.10.013
Yuanjing Xu, L. Zhiyuan, Liu Yihao, Yang Zezheng, Keming Wan, Fei Liu, Jinwu Wang, K. Dai
Objective To investigate the feasibility of an accuracy evaluation method for 3D reconstructed bone model based on 3D reconstruction software Arigin3D Pro. Methods Pig femurs were used as solid models which were scanned by CT and MRI respectively. The scan data were imported into software Arigin3D Pro for 3D model reconstruction by 3 operators with different reconstruction experience (≤1 year, 2 to 3 years, and ≥4 years, respectively). Each operator reconstructed the femurs 3 times and in each reconstruction measured the diameter of the femoral head, the length of the femur and the width of the knee joint at the distal end of the femur 3 times respectively using software Geomagic Wrap. The above parameters of the solid models were measured using a vernier caliper. The parameter values of reconstructed models and solid models were compared and the differences were analyzed. Results The measurements by Geomagic Wrap showed deviations between the CT and MRI reconstruction models and the solid models, and the maximum deviation percentages were 1.47% and 1.08%, respectively. The percentages of intra-operater difference ranged from 0.29% to 1.53%; the 3D models reconstructed by operators with different reconstruction experience were not identical. Conclusions It is a feasible accuracy evaluation method to compare key parameters between the 3D bone model reconstructed by software Arigin3D Pro and the real animal bone. The deviations of 3D reconstructed bone model based on CT and MRI images are acceptable. The accuracy of 3D bone construction is related to the difference in operators. Key words: Skeleton; Software; Imaging, three-dimensional; Medical images; Accuracy
{"title":"Accuracy evaluation for 3D bone reconstruction based on medical 3D reconstruction software","authors":"Yuanjing Xu, L. Zhiyuan, Liu Yihao, Yang Zezheng, Keming Wan, Fei Liu, Jinwu Wang, K. Dai","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.013","url":null,"abstract":"Objective \u0000To investigate the feasibility of an accuracy evaluation method for 3D reconstructed bone model based on 3D reconstruction software Arigin3D Pro. \u0000 \u0000 \u0000Methods \u0000Pig femurs were used as solid models which were scanned by CT and MRI respectively. The scan data were imported into software Arigin3D Pro for 3D model reconstruction by 3 operators with different reconstruction experience (≤1 year, 2 to 3 years, and ≥4 years, respectively). Each operator reconstructed the femurs 3 times and in each reconstruction measured the diameter of the femoral head, the length of the femur and the width of the knee joint at the distal end of the femur 3 times respectively using software Geomagic Wrap. The above parameters of the solid models were measured using a vernier caliper. The parameter values of reconstructed models and solid models were compared and the differences were analyzed. \u0000 \u0000 \u0000Results \u0000The measurements by Geomagic Wrap showed deviations between the CT and MRI reconstruction models and the solid models, and the maximum deviation percentages were 1.47% and 1.08%, respectively. The percentages of intra-operater difference ranged from 0.29% to 1.53%; the 3D models reconstructed by operators with different reconstruction experience were not identical. \u0000 \u0000 \u0000Conclusions \u0000It is a feasible accuracy evaluation method to compare key parameters between the 3D bone model reconstructed by software Arigin3D Pro and the real animal bone. The deviations of 3D reconstructed bone model based on CT and MRI images are acceptable. The accuracy of 3D bone construction is related to the difference in operators. \u0000 \u0000 \u0000Key words: \u0000Skeleton; Software; Imaging, three-dimensional; Medical images; Accuracy","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"894-900"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44293728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2019.10.011
Bolong Zheng, D. Hao, Liang Yan, Zheng-wei Xu, Xiaobin Yang, Z. Chang
Objective To compare the curative effects between our self-designed flexible vertebroplasty device and the conventional straight bone cement injector in the treatment of osteoporotic thoracic compression fractures. Methods A retrospective case-control study was conducted to analyze the clinical data of 140 patients with osteoporotic thoracic compression fracture who had been admitted to Department of Spine Surgery, Xi’an Honghui Hospital from June 2016 to January 2017. They were 61 males and 79 females, aged from 55 to 88 years (average, 70.3 years). Their fractured vertebrae distributed from T5 to T12. Our self-designed flexible vertebroplasty device was used in 67 of them (group A) while the conventional straight bone cement injector in the other 73 patients (group B). The 2 groups were compared in terms of operative time, amount of bone cement injected, distribution ratio of bone cement on the contralateral side, bone cement leakage, and visual analogue scale (VAS), anterior height ratio of the fractured vertebra and kyphosis cobb angle at 1 d, 1 and 2 years after operation. Results The 2 groups were comparable due to their insignificant differences in preoperative general data (P>0.05). All the patients were followed up for more than 2 years, with an average of 26.7 months. There were no significant differences between the 2 groups in operation time (28.1±4.2 min versus 26.3±3.2 min) or in bone cement leakage [34.3%(23/67) versus 17.8%(13/73)] (P>0.05). However, group A was significantly higher than group B in amount of bone cement injection (5.6±1.2 mL versus 4.9±1.1 mL) and in distribution ratio of bone cement on the contralateral side (71.5%±11.3% versus 65.7%±12.9%), significantly lower than group B in VAS at 1 and 2 years after operation (2.8±0.7 and 3.0±0.9 versus 3.1±0.8 and 3.4±0.8) and in kyphosis cobb angle at 1 and 2 years after operation (25.2°±5.2° and 26.8°±5.5° versus 27.7°±4.9° and 29.1°±1.6°), and significantly higher than group B in anterior height ratio of the fractured vertebra at 1 and 2 years after operation (39.2%±8.1% and 37.1%±7.2% versus 35.4%±7.8% and 33.2%±8.4%) (all P 0.05). Conclusions Compared with the conventional straight bone cement injector, our self-designed flexible vertebroplasty device can lead to better contralateral distribution of bone cement, more effective maintenance of the height of injured vertebra, and better long-term analgesic effect in the treatment of osteoporotic thoracic compression fractures. Key words: Vertebroplasty; Osteoporosis; Thoracic fracture; Flexible; Kyphosis
目的比较自行设计的柔性椎体成形术装置与常规直骨水泥注射器治疗骨质疏松性胸部压缩性骨折的疗效。方法采用回顾性病例对照研究，分析2016年6月至2017年1月西安市宏辉医院脊柱外科收治的140例骨质疏松性胸部压缩性骨折患者的临床资料。男61例，女79例，年龄55 ~ 88岁，平均70.3岁。骨折椎体分布于T5至T12。其中A组67例采用自行设计的柔性椎体成形术装置，B组73例采用常规直骨水泥注射器。比较两组术后1d、1、2年的手术时间、骨水泥注射量、对侧骨水泥分布比例、骨水泥漏出、视觉模拟评分(VAS)、骨折椎体前高度比及cobb角。结果两组术前一般资料差异无统计学意义(P < 0.05)，具有可比性。所有患者均随访2年以上，平均26.7个月。两组手术时间(28.1±4.2 min vs 26.3±3.2 min)和骨水泥渗漏(34.3%(23/67)vs 17.8%(13/73))差异无统计学意义(P < 0.05)。但A组骨水泥注射量(5.6±1.2 mL)和对侧骨水泥分布比(71.5%±11.3%)显著高于B组(4.9±1.1 mL)，术后1年和2年VAS评分(2.8±0.7和3.0±0.9比3.1±0.8和3.4±0.8)和术后1年和2年cobb角评分(25.2°±5.2°和26.8°±5.5°比27.7°±4.9°和29.1°±1.6°)显著低于B组。术后1年和2年骨折椎体前高度比(39.2%±8.1%和37.1%±7.2%)显著高于B组(35.4%±7.8%和33.2%±8.4%)，差异均有统计学意义(P < 0.05)。结论与传统的直骨水泥注射器相比，我们自行设计的柔性椎体成形术装置对侧骨水泥分布更好，损伤椎体高度维持更有效，治疗骨质疏松性胸部压缩性骨折的远期镇痛效果更好。关键词:椎体成形术;骨质疏松症;胸椎骨折;灵活的;驼背
{"title":"A flexible vertebroplasty device used in vertebroplasty for osteoporotic thoracic compression fractures","authors":"Bolong Zheng, D. Hao, Liang Yan, Zheng-wei Xu, Xiaobin Yang, Z. Chang","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.011","url":null,"abstract":"Objective \u0000To compare the curative effects between our self-designed flexible vertebroplasty device and the conventional straight bone cement injector in the treatment of osteoporotic thoracic compression fractures. \u0000 \u0000 \u0000Methods \u0000A retrospective case-control study was conducted to analyze the clinical data of 140 patients with osteoporotic thoracic compression fracture who had been admitted to Department of Spine Surgery, Xi’an Honghui Hospital from June 2016 to January 2017. They were 61 males and 79 females, aged from 55 to 88 years (average, 70.3 years). Their fractured vertebrae distributed from T5 to T12. Our self-designed flexible vertebroplasty device was used in 67 of them (group A) while the conventional straight bone cement injector in the other 73 patients (group B). The 2 groups were compared in terms of operative time, amount of bone cement injected, distribution ratio of bone cement on the contralateral side, bone cement leakage, and visual analogue scale (VAS), anterior height ratio of the fractured vertebra and kyphosis cobb angle at 1 d, 1 and 2 years after operation. \u0000 \u0000 \u0000Results \u0000The 2 groups were comparable due to their insignificant differences in preoperative general data (P>0.05). All the patients were followed up for more than 2 years, with an average of 26.7 months. There were no significant differences between the 2 groups in operation time (28.1±4.2 min versus 26.3±3.2 min) or in bone cement leakage [34.3%(23/67) versus 17.8%(13/73)] (P>0.05). However, group A was significantly higher than group B in amount of bone cement injection (5.6±1.2 mL versus 4.9±1.1 mL) and in distribution ratio of bone cement on the contralateral side (71.5%±11.3% versus 65.7%±12.9%), significantly lower than group B in VAS at 1 and 2 years after operation (2.8±0.7 and 3.0±0.9 versus 3.1±0.8 and 3.4±0.8) and in kyphosis cobb angle at 1 and 2 years after operation (25.2°±5.2° and 26.8°±5.5° versus 27.7°±4.9° and 29.1°±1.6°), and significantly higher than group B in anterior height ratio of the fractured vertebra at 1 and 2 years after operation (39.2%±8.1% and 37.1%±7.2% versus 35.4%±7.8% and 33.2%±8.4%) (all P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Compared with the conventional straight bone cement injector, our self-designed flexible vertebroplasty device can lead to better contralateral distribution of bone cement, more effective maintenance of the height of injured vertebra, and better long-term analgesic effect in the treatment of osteoporotic thoracic compression fractures. \u0000 \u0000 \u0000Key words: \u0000Vertebroplasty; Osteoporosis; Thoracic fracture; Flexible; Kyphosis","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"881-887"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42590818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2019.10.006
Yanbiao Wang, Lifeng Liu, Xuecheng Cao, Jinfang Cai
Objective To evaluate our replantation and functional reconstruction of amputated lower extremities. Methods From February 2013 to October 2017, 13 patients with an amputated lower extremity were treated at Orthopaedic Department, The 960th Hospital of the PLA Joint Logistics Support Force. They were 10 males and 3 females, aged from 15 to 63 years (average, 39 years). In all the patients, large segmental shortening and extremity replantation was conducted at the first stage and Ilizarov extremity lengthening at the secondary stage. After desired extension was achieved, the frame of Ilizarov external fixator was removed and replaced by external fixation with a locking plate under closed reduction. Postoperatively, functions of the knee and ankle joints, sensory recovery of the foot sole, length and appearance of the extremity were observed. Results All the 13 patients were followed up for 12 to 24 months (average, 16 months). All the limb replants survived well. Of them, 12 were satisfied with their weight-bearing walking and therapeutic outcomes. Conclusions For an amputated lower extremity, the first-stage shortening and replantation can result in fine extremity salvage and the secondary Ilizarov extremity lengthening can lead to fine therapeutic outcomes. Key words: Replantation; Bone lengthening; External fixators; Amputated lower extremities
{"title":"Orthopaedic Replantation and functional reconstruction of an amputated lower extremity","authors":"Yanbiao Wang, Lifeng Liu, Xuecheng Cao, Jinfang Cai","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.006","url":null,"abstract":"Objective \u0000To evaluate our replantation and functional reconstruction of amputated lower extremities. \u0000 \u0000 \u0000Methods \u0000From February 2013 to October 2017, 13 patients with an amputated lower extremity were treated at Orthopaedic Department, The 960th Hospital of the PLA Joint Logistics Support Force. They were 10 males and 3 females, aged from 15 to 63 years (average, 39 years). In all the patients, large segmental shortening and extremity replantation was conducted at the first stage and Ilizarov extremity lengthening at the secondary stage. After desired extension was achieved, the frame of Ilizarov external fixator was removed and replaced by external fixation with a locking plate under closed reduction. Postoperatively, functions of the knee and ankle joints, sensory recovery of the foot sole, length and appearance of the extremity were observed. \u0000 \u0000 \u0000Results \u0000All the 13 patients were followed up for 12 to 24 months (average, 16 months). All the limb replants survived well. Of them, 12 were satisfied with their weight-bearing walking and therapeutic outcomes. \u0000 \u0000 \u0000Conclusions \u0000For an amputated lower extremity, the first-stage shortening and replantation can result in fine extremity salvage and the secondary Ilizarov extremity lengthening can lead to fine therapeutic outcomes. \u0000 \u0000 \u0000Key words: \u0000Replantation; Bone lengthening; External fixators; Amputated lower extremities","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"853-858"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47974736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation. Methods From January 2015 to January 2019, 16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery, The Second Affiliated Hospital to Inner Mongolia Medical University. They were 14 men and 2 women with a mean age of 38.4 years (range, from 20 to 55 years). All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy. The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes. Results All patients were followed up for a mean time of 12.6 months (range, from 6 to 30 months). The mean operation time was 68.4 minutes (range, from 52 to 96 minutes); the mean amount of hemorrhage during operation was 96.8 mL (range, from 48 to 122 mL); the mean period of bone union was 4.8 months (range, from 3 to 8 months). The postoperative mean AOFAS score was 75.3 points (range, from 43 to 91 points). Complications occurred in 4 cases, including one case of talus ischemic necrosis, one case of partial talus ischemic necrosis accompanied by tibial arthritis, one case of subtalar arthritis, and one case of combined tibial, talar and subtalar arthritis. All incisions obtained primary healing, with no complications like infection, screw breakage, delayed union or nonunion. Conclusion Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced. Key words: Talus; Fractures, bone; Fracture fixation, internal; Bone nails; Malleolus medialis osteotomy
{"title":"Operative treatment of Sneppen V talus fracture through approach for malleolus medialis V osteotomy plus hollow compression screw fixation","authors":"Zeng-tao Hao, Xiaolong Wang, Chao Yin, Jihong Wang, Wen Shuzheng, Dongsheng Fan, Yongfei Wang, D. Jiang","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.016","url":null,"abstract":"Objective \u0000To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation. \u0000 \u0000 \u0000Methods \u0000From January 2015 to January 2019, 16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery, The Second Affiliated Hospital to Inner Mongolia Medical University. They were 14 men and 2 women with a mean age of 38.4 years (range, from 20 to 55 years). All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy. The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes. \u0000 \u0000 \u0000Results \u0000All patients were followed up for a mean time of 12.6 months (range, from 6 to 30 months). The mean operation time was 68.4 minutes (range, from 52 to 96 minutes); the mean amount of hemorrhage during operation was 96.8 mL (range, from 48 to 122 mL); the mean period of bone union was 4.8 months (range, from 3 to 8 months). The postoperative mean AOFAS score was 75.3 points (range, from 43 to 91 points). Complications occurred in 4 cases, including one case of talus ischemic necrosis, one case of partial talus ischemic necrosis accompanied by tibial arthritis, one case of subtalar arthritis, and one case of combined tibial, talar and subtalar arthritis. All incisions obtained primary healing, with no complications like infection, screw breakage, delayed union or nonunion. \u0000 \u0000 \u0000Conclusion \u0000Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced. \u0000 \u0000 \u0000Key words: \u0000Talus; Fractures, bone; Fracture fixation, internal; Bone nails; Malleolus medialis osteotomy","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"910-913"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45608919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2019.10.005
Hongshu Wang, Jia Xu, Gen Wen, Shengdi Lu
Objective To evaluate osteotomy, bone shortening and lengthening by one stage with external fixation for a large bone defect following open femoral fracture. Methods From April 2014 to April 2019, 11 consecutive patients with a large bone defect following open femoral fracture were treated at Department of Orthopaedics, The Sixth People’s Hospital of Shanghai. They were 9 males and 2 females, with an average age of 40.5 years (from 18 to 70 years). The left side was involved in 6 cases and the right side in 5. All their primary open fractures had deteriorated into osteomyelitis and bone defects after treatment. Their bone defects averaged 60.5 mm after thorough debridement. Postoperative X-ray examinations were taken regularly. Bony union time and index, time till removal of external fixator, external fixation index, flap survival, soft tissue healing, visual analogue scale (VAS), Association for Studying and Application of Methods of Ilizarov (ASAMI) scores for bone healing and lower limb function were recorded. Results All the patients were followed up for 9 to 30 months (mean, 21.9 months). The bony union time averaged 10.5 months (from 5.2 to 22.3 months). The bony union indexes averaged 52.9 d/cm (from 33.4 to 73.3 d/cm). The time till removal of external fixator averaged 15.5 months (from 9.8 to 27.5 months). The external fixation indexes averaged 86.0 d/cm (from 60 to 113 d/cm). All the bone nonunions healed with no recurrence of osteomyelitis. Complications like union failure, refracture at ends of bone lengthening or fracture, or leg length discrepancy>2.5 cm, happened in none. The VAS scores ranged from 0 to 3 points. By ASAMI evaluation, the bony union was excellent in 10 cases and good in one case, and the lower limb function was excellent in 3 cases, good in 7 cases and fair in one. Conclusion Osteotomy, bone shortening and lengthening by one stage with external fixation is a reliable treatment for large femoral bone defects because this strategy can remove the lesions and restore the femoral length at the same time. Key words: Fracture, open; Osteogenesis, distraction; Lower extremity deformities; Nonunion
{"title":"Osteotomy, bone shortening and lengthening by one stage with external fixation for a large bone defect following open femoral fracture","authors":"Hongshu Wang, Jia Xu, Gen Wen, Shengdi Lu","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.005","url":null,"abstract":"Objective \u0000To evaluate osteotomy, bone shortening and lengthening by one stage with external fixation for a large bone defect following open femoral fracture. \u0000 \u0000 \u0000Methods \u0000From April 2014 to April 2019, 11 consecutive patients with a large bone defect following open femoral fracture were treated at Department of Orthopaedics, The Sixth People’s Hospital of Shanghai. They were 9 males and 2 females, with an average age of 40.5 years (from 18 to 70 years). The left side was involved in 6 cases and the right side in 5. All their primary open fractures had deteriorated into osteomyelitis and bone defects after treatment. Their bone defects averaged 60.5 mm after thorough debridement. Postoperative X-ray examinations were taken regularly. Bony union time and index, time till removal of external fixator, external fixation index, flap survival, soft tissue healing, visual analogue scale (VAS), Association for Studying and Application of Methods of Ilizarov (ASAMI) scores for bone healing and lower limb function were recorded. \u0000 \u0000 \u0000Results \u0000All the patients were followed up for 9 to 30 months (mean, 21.9 months). The bony union time averaged 10.5 months (from 5.2 to 22.3 months). The bony union indexes averaged 52.9 d/cm (from 33.4 to 73.3 d/cm). The time till removal of external fixator averaged 15.5 months (from 9.8 to 27.5 months). The external fixation indexes averaged 86.0 d/cm (from 60 to 113 d/cm). All the bone nonunions healed with no recurrence of osteomyelitis. Complications like union failure, refracture at ends of bone lengthening or fracture, or leg length discrepancy>2.5 cm, happened in none. The VAS scores ranged from 0 to 3 points. By ASAMI evaluation, the bony union was excellent in 10 cases and good in one case, and the lower limb function was excellent in 3 cases, good in 7 cases and fair in one. \u0000 \u0000 \u0000Conclusion \u0000Osteotomy, bone shortening and lengthening by one stage with external fixation is a reliable treatment for large femoral bone defects because this strategy can remove the lesions and restore the femoral length at the same time. \u0000 \u0000 \u0000Key words: \u0000Fracture, open; Osteogenesis, distraction; Lower extremity deformities; Nonunion","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"848-852"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47641043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2019.10.010
Jianbo Jia, Ao Rongguang, Baoqing Yu, Jianhua Zhou, Jiawen He
Objective To evaluate the minimally invasive splayed incisions in the internal fixation with a conventional calcaneal plate for calcaneal fractures of sanders types Ⅱ and Ⅲ. Methods This prospective study was conducted from May 1st, 2016 to December 1st, 2017 in the 40 patients with calcaneal fracture at Department of Orthopedics, Shanghai Pudong Hospital. Their ages ranged from 23 to 55 years (average, 39.5 years). According to the Sanders classification, 27 fractures were type Ⅱ and 13 type Ⅲ. They were all treated with a conventional calcaneal plate through minimally invasive splayed incisions. The Bohler and Gissane angles, the height, width and length of the affected calcaneus were compared between preoperation, 3 months after operation and the last follow-up; the clinical function of the affected feet was graded using the Maryland foot score; postoperative complications were observed. Results The 40 patients were followed up for an average of 12.5 months (from 11 to 16 months). All the skin incisions healed well with no skin necrosis or wound infection. No injury to the sural nerve occurred. All the fractures healed after an average of 8 weeks (from 7 to 10 weeks). All the patients resumed their routine daily activities and returned to their former work post after an average time of 4.1 months (from 3 to 6 months). At pre-operation, 3 months after operation and the last follow-up, their Bohler angles were respectively 19.2°±6.3°, 30.5°±6.4° and 29.9°±6.5°; their Gissane angles 103.9°±14.8°, 119.3°±5.6° and 119.8°±6.3°; their calcaneal heights (32.5±3.5) mm, (36.8±1.5) mm and (36.5±1.8) mm; their calcaneal widths (36.8±3.4) mm, (33.1±3.8) mm and (33.0±3.2) mm; their lengths (61.4±4.5) mm, (65.5±6.9) mm and (65.5±9.4) mm. In all the patients, the Bohler and Gissane angles and the calcaneal heights and lengths increased significantly while the calcaneal widths decreased significantly at 3 months after operation and the last follow-up (P 0.05). Their Maryland foot scores showed 35 excellent cases, 4 good cases and one fair case, giving an excellent and good rate of 97.5%. Conclusions A conventional calcaneal plate plus minimally invasive splayed incisions can be effective for calcaneal fractures of Sanders types Ⅱ and Ⅲ, leading to reduced wound complications, anatomical restoration of calcaneal morphology, and smooth subtalar articular surface. Key words: Calcaneus; Fractures, bone; Bone plate; Fracture fixation, internal; Minimally invasive
{"title":"Minimally invasive splayed incisions for calcaneal fractures of sanders types II and III","authors":"Jianbo Jia, Ao Rongguang, Baoqing Yu, Jianhua Zhou, Jiawen He","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.010","url":null,"abstract":"Objective \u0000To evaluate the minimally invasive splayed incisions in the internal fixation with a conventional calcaneal plate for calcaneal fractures of sanders types Ⅱ and Ⅲ. \u0000 \u0000 \u0000Methods \u0000This prospective study was conducted from May 1st, 2016 to December 1st, 2017 in the 40 patients with calcaneal fracture at Department of Orthopedics, Shanghai Pudong Hospital. Their ages ranged from 23 to 55 years (average, 39.5 years). According to the Sanders classification, 27 fractures were type Ⅱ and 13 type Ⅲ. They were all treated with a conventional calcaneal plate through minimally invasive splayed incisions. The Bohler and Gissane angles, the height, width and length of the affected calcaneus were compared between preoperation, 3 months after operation and the last follow-up; the clinical function of the affected feet was graded using the Maryland foot score; postoperative complications were observed. \u0000 \u0000 \u0000Results \u0000The 40 patients were followed up for an average of 12.5 months (from 11 to 16 months). All the skin incisions healed well with no skin necrosis or wound infection. No injury to the sural nerve occurred. All the fractures healed after an average of 8 weeks (from 7 to 10 weeks). All the patients resumed their routine daily activities and returned to their former work post after an average time of 4.1 months (from 3 to 6 months). At pre-operation, 3 months after operation and the last follow-up, their Bohler angles were respectively 19.2°±6.3°, 30.5°±6.4° and 29.9°±6.5°; their Gissane angles 103.9°±14.8°, 119.3°±5.6° and 119.8°±6.3°; their calcaneal heights (32.5±3.5) mm, (36.8±1.5) mm and (36.5±1.8) mm; their calcaneal widths (36.8±3.4) mm, (33.1±3.8) mm and (33.0±3.2) mm; their lengths (61.4±4.5) mm, (65.5±6.9) mm and (65.5±9.4) mm. In all the patients, the Bohler and Gissane angles and the calcaneal heights and lengths increased significantly while the calcaneal widths decreased significantly at 3 months after operation and the last follow-up (P 0.05). Their Maryland foot scores showed 35 excellent cases, 4 good cases and one fair case, giving an excellent and good rate of 97.5%. \u0000 \u0000 \u0000Conclusions \u0000A conventional calcaneal plate plus minimally invasive splayed incisions can be effective for calcaneal fractures of Sanders types Ⅱ and Ⅲ, leading to reduced wound complications, anatomical restoration of calcaneal morphology, and smooth subtalar articular surface. \u0000 \u0000 \u0000Key words: \u0000Calcaneus; Fractures, bone; Bone plate; Fracture fixation, internal; Minimally invasive","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"874-880"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49602604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2019.10.008
Zhijian Sun, Xu Sun, Weitong Sun, Zhi-yang Gao, Ting Li
Objective To investigate expert opinions on the recommendations in Expert Consensus on Optimized Treatments of Ankle Fracture in Light of Enhanced Recovery after Surgery and Expert Consensus on Optimized Treatments of Distal Radius Fracture in Light of Enhanced Recovery after Surgery so as to provide a reference for orthopaedic surgeons when they refer to the 2 documents. Methods At the symposium in November 2018, all members of Orthopaedic Trauma Committee of Bethune Public Welfare Foundation were interviewed through questionnaires. The questionnaires involved 30 recommendations from the 2 documents concerning optimized perioperative managements. The rates of recommendation and strong recommendation by these experts were calculated about the 30 recommendations from the 2 above documents. Results A total of 68 experts from the 89 members of Orthopaedic Trauma Committee of Bethune Public Welfare Foundation finished the questionnaires. Of the 30 recommendations, 26 obtained recommendation from these experts at a rate of above 95%, and 4 recommendation from these experts at a rate from 80% to 90%. The rates of strong recommendation were not high, ranging from 60% to 80% in 26 recommendations and <60% in 4. Conclusions The recommendations from the above 2 documents have been highly agreed upon by these experts we investigated but obtained a relatively low rate of strong recommendation. The present investigation may serve as a significant complement for recommendations from the 2 documents of expert consensus and a necessary reference for orthopaedic surgeons. Key words: Questionnaires; Ankle joint; Radius; Enhanced recovery after surgery; Expert consensus
{"title":"Expert opinions on optimized treatments of ankle and distal radius fractures in light of Enhanced Recovery after Surgery","authors":"Zhijian Sun, Xu Sun, Weitong Sun, Zhi-yang Gao, Ting Li","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.008","url":null,"abstract":"Objective \u0000To investigate expert opinions on the recommendations in Expert Consensus on Optimized Treatments of Ankle Fracture in Light of Enhanced Recovery after Surgery and Expert Consensus on Optimized Treatments of Distal Radius Fracture in Light of Enhanced Recovery after Surgery so as to provide a reference for orthopaedic surgeons when they refer to the 2 documents. \u0000 \u0000 \u0000Methods \u0000At the symposium in November 2018, all members of Orthopaedic Trauma Committee of Bethune Public Welfare Foundation were interviewed through questionnaires. The questionnaires involved 30 recommendations from the 2 documents concerning optimized perioperative managements. The rates of recommendation and strong recommendation by these experts were calculated about the 30 recommendations from the 2 above documents. \u0000 \u0000 \u0000Results \u0000A total of 68 experts from the 89 members of Orthopaedic Trauma Committee of Bethune Public Welfare Foundation finished the questionnaires. Of the 30 recommendations, 26 obtained recommendation from these experts at a rate of above 95%, and 4 recommendation from these experts at a rate from 80% to 90%. The rates of strong recommendation were not high, ranging from 60% to 80% in 26 recommendations and <60% in 4. \u0000 \u0000 \u0000Conclusions \u0000The recommendations from the above 2 documents have been highly agreed upon by these experts we investigated but obtained a relatively low rate of strong recommendation. The present investigation may serve as a significant complement for recommendations from the 2 documents of expert consensus and a necessary reference for orthopaedic surgeons. \u0000 \u0000 \u0000Key words: \u0000Questionnaires; Ankle joint; Radius; Enhanced recovery after surgery; Expert consensus","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"864-868"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43347420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2019.09.005
Jie-chang Ren, Xin Lyu, Fei Li
Objective To compare the efficacy between reduction assisted by a double-needle repositor and manual reduction in the treatment of femoral neck fractures of Garden types Ⅲ-Ⅳ. Methods From May 2015 to October 2017, 67 patients with femoral neck fracture of Garden type Ⅲ or Ⅳ were treated by hollow screw fixation at Department of Orthopaedics, The Second Affiliated Hospital to Shanxi Medical University. They were divided into 2 groups according to the different reduction methods. The reduction was assisted by a double-needle repositor in 37 cases (group A); they were 21 males and 16 females with an age of 46.2±8.1 years and there were 13 cases of Garden type Ⅲ and 24 cases of Garden type Ⅳ. The reduction was conducted manually in another 30 cases (group B); they were 18 males and 12 females with an age of 48.8±9.1 years and there were 13 cases of Garden type Ⅲ and 17 cases of Garden type Ⅳ. The 2 groups were compared in terms of reduction time, anatomical reduction rate, operation time, intraoperative bleeding volume, fracture healing time, postoperative complications and Harris hip scores at the last follow-up. Results There were no significant differences between the 2 groups of patients in their preoperative general data, indicating they were compatible(P>0.05). All the 67 patients were followed up for 20 to 30 months (average, 24 months). The anatomic reduction rate in group A [94.6% (35/37)] was significantly higher than that in group B [83.3% (25/30)]; the reduction time, operation time and fracture healing time in group A (33.2±4.6 min, 70.2±5.0 min and 4.6±0.7 months) were significantly shorter than those in group B (45.8±8.6 min, 90.6±9.2 min and 5.6±0.6 months); the Harris hip scores at the last follow-up in group A (84.3±8.6 points) were significantly higher than in group B (81.2±7.8 points) (all P 0.05). Conclusion Reduction assisted by a double-needle repositor is fine for femoral neck fractures of Garden types of Ⅲ-Ⅳ, because it has advantages of limited invasion, simplicity, a high rate of anatomical reduction, quick reduction and good functional recovery. Key words: Femoral neck fractures; Fracture fixation, internal; Bone nails; Reduction; Double-needle repositor
{"title":"Reduction assisted by a double-needle repositor for femoral neck fractures of Garden types III-IV","authors":"Jie-chang Ren, Xin Lyu, Fei Li","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.09.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.09.005","url":null,"abstract":"Objective \u0000To compare the efficacy between reduction assisted by a double-needle repositor and manual reduction in the treatment of femoral neck fractures of Garden types Ⅲ-Ⅳ. \u0000 \u0000 \u0000Methods \u0000From May 2015 to October 2017, 67 patients with femoral neck fracture of Garden type Ⅲ or Ⅳ were treated by hollow screw fixation at Department of Orthopaedics, The Second Affiliated Hospital to Shanxi Medical University. They were divided into 2 groups according to the different reduction methods. The reduction was assisted by a double-needle repositor in 37 cases (group A); they were 21 males and 16 females with an age of 46.2±8.1 years and there were 13 cases of Garden type Ⅲ and 24 cases of Garden type Ⅳ. The reduction was conducted manually in another 30 cases (group B); they were 18 males and 12 females with an age of 48.8±9.1 years and there were 13 cases of Garden type Ⅲ and 17 cases of Garden type Ⅳ. The 2 groups were compared in terms of reduction time, anatomical reduction rate, operation time, intraoperative bleeding volume, fracture healing time, postoperative complications and Harris hip scores at the last follow-up. \u0000 \u0000 \u0000Results \u0000There were no significant differences between the 2 groups of patients in their preoperative general data, indicating they were compatible(P>0.05). All the 67 patients were followed up for 20 to 30 months (average, 24 months). The anatomic reduction rate in group A [94.6% (35/37)] was significantly higher than that in group B [83.3% (25/30)]; the reduction time, operation time and fracture healing time in group A (33.2±4.6 min, 70.2±5.0 min and 4.6±0.7 months) were significantly shorter than those in group B (45.8±8.6 min, 90.6±9.2 min and 5.6±0.6 months); the Harris hip scores at the last follow-up in group A (84.3±8.6 points) were significantly higher than in group B (81.2±7.8 points) (all P 0.05). \u0000 \u0000 \u0000Conclusion \u0000Reduction assisted by a double-needle repositor is fine for femoral neck fractures of Garden types of Ⅲ-Ⅳ, because it has advantages of limited invasion, simplicity, a high rate of anatomical reduction, quick reduction and good functional recovery. \u0000 \u0000 \u0000Key words: \u0000Femoral neck fractures; Fracture fixation, internal; Bone nails; Reduction; Double-needle repositor","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"758-763"},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45843691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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