Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.02.005
Yingze Zhang
{"title":"Principles of diagnosis and treatment for traumatic fractures in the epidemic of COVID-19","authors":"Yingze Zhang","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.005","url":null,"abstract":"","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"116-118"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48975671","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 evaluate the effectiveness of anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft. Methods A retrospective analysis was made of the clinical data of 12 patients who had undergone anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft between December 2016 and January 2018. They were 8 males and 4 females, aged from 18 to 38 years (mean, 21.8 years). According to the AO/OTA classification, 5 cases were defined as type 12-A1.2, 2 as type 12-A1.3, 2 as type 12-B1.2, 2 as type 12-B1.3 and one as type 12-C1.1. The operation time, intraoperative blood loss, early postoperative complications and union time were recorded; the functional recovery of the elbow joint was evaluated by the Mayo elbow performance score (MEPS) and that of the shoulder by the University of California at Los Angeles (UCLA) shoulder rating scale at the final follow-up. Results The mean operation time was 63 minutes (range, from 43 to 130 minutes), and the mean intraoperative blood loss 139 mL (range, from 60 to 280 mL). All incisions healed by the first intention without any neurologic complications or wound infection. All the 12 patients were followed up for 10 to 21 months (mean, 13.7 months). Bony union was obtained in all cases after 11 to 20 weeks (mean, 15.8 weeks). No loosening or breakage of internal fixation occurred. At the final follow-up, the MEPS ranged from 90 to 100 (mean, 99) and the UCLA shoulder scores from 31 to 35 (mean, 34.5). Conclusion Anterior minimally invasive osteosynthesis using a locking compression plate is safe and feasible for spiral fractures of the mid-distal humeral shaft, leading to minimal invasion, a low risk for iatrogenic nerve injury and satisfactory effectiveness. Key words: Humerus; Fractures; Fracture fixation, internal; Bone plate
{"title":"Anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of mid-distal humeral shaft","authors":"Huang Zheyuan, Xiaolin Chen, Rui-song Chen, Bo-wen Wang, Xin Liao, Jianming Huang, Yanpeng Huang, Hao-yuan Liu","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.014","url":null,"abstract":"Objective \u0000To evaluate the effectiveness of anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was made of the clinical data of 12 patients who had undergone anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft between December 2016 and January 2018. They were 8 males and 4 females, aged from 18 to 38 years (mean, 21.8 years). According to the AO/OTA classification, 5 cases were defined as type 12-A1.2, 2 as type 12-A1.3, 2 as type 12-B1.2, 2 as type 12-B1.3 and one as type 12-C1.1. The operation time, intraoperative blood loss, early postoperative complications and union time were recorded; the functional recovery of the elbow joint was evaluated by the Mayo elbow performance score (MEPS) and that of the shoulder by the University of California at Los Angeles (UCLA) shoulder rating scale at the final follow-up. \u0000 \u0000 \u0000Results \u0000The mean operation time was 63 minutes (range, from 43 to 130 minutes), and the mean intraoperative blood loss 139 mL (range, from 60 to 280 mL). All incisions healed by the first intention without any neurologic complications or wound infection. All the 12 patients were followed up for 10 to 21 months (mean, 13.7 months). Bony union was obtained in all cases after 11 to 20 weeks (mean, 15.8 weeks). No loosening or breakage of internal fixation occurred. At the final follow-up, the MEPS ranged from 90 to 100 (mean, 99) and the UCLA shoulder scores from 31 to 35 (mean, 34.5). \u0000 \u0000 \u0000Conclusion \u0000Anterior minimally invasive osteosynthesis using a locking compression plate is safe and feasible for spiral fractures of the mid-distal humeral shaft, leading to minimal invasion, a low risk for iatrogenic nerve injury and satisfactory effectiveness. \u0000 \u0000 \u0000Key words: \u0000Humerus; Fractures; Fracture fixation, internal; Bone plate","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"158-161"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42545564","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 suggest strategies for emergency diagnosis and treatment of trauma orthopedics in the epidemic period of Corona Virus Disease 2019(COVID-19). Methods In the epidemic of COVID-19 from January 21 to February 15, 2020, 128 patients with orthopaedic trauma sought emergency treatment at Department of Orthopedic Surgery, The People’s Hospital of Wuhan University. They were 71 males and 57 females with an average age of 48.7 years (from 5 to 88 years).Of them, 107 cases were treated at the outpatient department and 21 hospitalized. Emergency operations were carried out for 4 cases and selective operationsfor 17 cases. COVID-19 infections were recorded in the patients and medical staff as well. Measures taken and experiences learned were summarized since the epidemicoutbreak of COVID-19. Results Of the 107 cases treated at the outpatient department, 3 had a definite diagnosis of COVID-19 and 3 a suspected diagnosis of COVID-19. Of the 4 cases undergoing emergency surgery, one was suspected of having COVID-19. Of the 17 cases undergoing selective surgery, one was diagnosed definitely as COVID-19and 2 were suspected of COVID-19. Two nurses were diagnosed definitely as having mildCOVID-19.One doctor and one nurse were suspected of COVID-19. Since the COVID-19 infections in medical staff occurred all before the preventive and control measures for COVID-19 had been implemented,is was not ruled out that their infections might have come from communities. Conclusions It is particularly important for medical institutions of all levels to maintain safe and effective routine services while doing well in COVID-19 prevention. In the epidemic of COVID-19, front-line medical staff in emergency traumatic orthopedics is faced with great challenges in the process of diagnosing and treating patients. High-quality and safe medical services can be provided as long as nosocomial COVID-19infection is effectively controlled by rigid screening of patientsnewly admitted, classified management of inpatients, optimal management of inpatient wards, standard preventive measures in perioperative period, a perfect system for medical protection, and medical education for patients and their carers. Key words: Corona Virus Disease 2019; Orthopaedics; Wound and injuries; Perioperative period; Prevention
{"title":"Strategies suggested for emergency diagnosis and treatment of traumatic orthopedicsin the epidemic periodof Corona Virus Disease 2019/ 中华创伤骨科杂志","authors":"Yue Yang, Aixi Yu, Wen-bing Xiao, Zhibo Sun, Feng Liu, Fei Wu","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.007","url":null,"abstract":"Objective \u0000To suggest strategies for emergency diagnosis and treatment of trauma orthopedics in the epidemic period of Corona Virus Disease 2019(COVID-19). \u0000 \u0000 \u0000Methods \u0000In the epidemic of COVID-19 from January 21 to February 15, 2020, 128 patients with orthopaedic trauma sought emergency treatment at Department of Orthopedic Surgery, The People’s Hospital of Wuhan University. They were 71 males and 57 females with an average age of 48.7 years (from 5 to 88 years).Of them, 107 cases were treated at the outpatient department and 21 hospitalized. Emergency operations were carried out for 4 cases and selective operationsfor 17 cases. COVID-19 infections were recorded in the patients and medical staff as well. Measures taken and experiences learned were summarized since the epidemicoutbreak of COVID-19. \u0000 \u0000 \u0000Results \u0000Of the 107 cases treated at the outpatient department, 3 had a definite diagnosis of COVID-19 and 3 a suspected diagnosis of COVID-19. Of the 4 cases undergoing emergency surgery, one was suspected of having COVID-19. Of the 17 cases undergoing selective surgery, one was diagnosed definitely as COVID-19and 2 were suspected of COVID-19. Two nurses were diagnosed definitely as having mildCOVID-19.One doctor and one nurse were suspected of COVID-19. Since the COVID-19 infections in medical staff occurred all before the preventive and control measures for COVID-19 had been implemented,is was not ruled out that their infections might have come from communities. \u0000 \u0000 \u0000Conclusions \u0000It is particularly important for medical institutions of all levels to maintain safe and effective routine services while doing well in COVID-19 prevention. In the epidemic of COVID-19, front-line medical staff in emergency traumatic orthopedics is faced with great challenges in the process of diagnosing and treating patients. High-quality and safe medical services can be provided as long as nosocomial COVID-19infection is effectively controlled by rigid screening of patientsnewly admitted, classified management of inpatients, optimal management of inpatient wards, standard preventive measures in perioperative period, a perfect system for medical protection, and medical education for patients and their carers. \u0000 \u0000 \u0000Key words: \u0000Corona Virus Disease 2019; Orthopaedics; Wound and injuries; Perioperative period; Prevention","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"123-127"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44337457","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.02.017
X. Fan, Jian Wang, Jian-qiang Zhao, S. Kai, Hongzi Wu, Feng Mao, Y. Liao
Objective To assess the clinical effects of closed reduction and intramedullary fixation with antegrade Kirschner wire plus rod rotation technique in the treatment of the fifth metacarpal neck fracture. Methods In this retrospective study, 26 patients with the fifth metacarpal neck fracture were treated by closed reduction and intramedullary fixation with antegrade Kirschner wire plus rod rotation technique at Department of Orthopaedics, Central Hospital of Karamay from August 2015 to October 2017. They were 23 males and 3 females, aged from 12 to 53 years with an average age of 25.2 years. In the intramedullary nailing, a Kirschner wire pre-bent by 10° to 15° was inserted from the base of the fifth metacarpal into the medullary canal before closed reduction. After satisfactory reduction was achieved, the Kirschner wire was inserted across the fracture site into the metacarpal head for further reduction and fixation using rod rotation technique. After operation, a plaster was applied to protect the fixation for 2 weeks. Functional exercise was started after removal of the plaster. The Kirschner wire was not removed under local anaesthesia at the outpatient department until about 10 to 16 weeks postoperation when X-ray showed fracture healing. Records of their operation time, head/shaft angle of the fifth affected metacarpal, active range of motion of the metacarpophalangeal joints and Total Active Movement (TAM) of hand function at the last follow-up were collected. Results Their operation time averaged 21 minutes (from 12 to 35 minutes). Anatomical reduction was achieved in 23 cases but not in 3 ones whose metacarpal head/shaft angle and alignment were obviously improved. Follow-ups for 6 to 29 months (average, 15.8 months) showed all the patients obtained solid fracture healing with no infection or delayed fracture healing. The head/shaft angle was improved significantly from preoperative 61.2°±11.2° to postoperative 14.7°±3.5° (P 0.05). The active range of motion of the metacarpophalangeal joint was 89.3°±4.2° after fixation removal, not significantly different from that of the healthy side (90.7°±1.5°) (P>0.05). According to TAM scores at the last follow-up, 22 cases were rated as excellent, 3 as good and one as fair. Conclusion In the treatment of the fifth metacarpal neck fracture, closed reduction and intramedullary fixation with antegrade Kirschner wire plus rod rotation technique is effective, because it is simple and limitedly invasive, and leads to limited complications, low costs and secondary reduction. Key words: Metacarpal bone; Fracture fixation, intramedullary; Bone nail; Fifth metacarpal neck fracture; Rod rotation
{"title":"The fifth metacarpal neck fracture treated by closed reduction and intramedullary fixation with antegrade Kirschner wire plus rod rotation technique","authors":"X. Fan, Jian Wang, Jian-qiang Zhao, S. Kai, Hongzi Wu, Feng Mao, Y. Liao","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.017","url":null,"abstract":"Objective \u0000To assess the clinical effects of closed reduction and intramedullary fixation with antegrade Kirschner wire plus rod rotation technique in the treatment of the fifth metacarpal neck fracture. \u0000 \u0000 \u0000Methods \u0000In this retrospective study, 26 patients with the fifth metacarpal neck fracture were treated by closed reduction and intramedullary fixation with antegrade Kirschner wire plus rod rotation technique at Department of Orthopaedics, Central Hospital of Karamay from August 2015 to October 2017. They were 23 males and 3 females, aged from 12 to 53 years with an average age of 25.2 years. In the intramedullary nailing, a Kirschner wire pre-bent by 10° to 15° was inserted from the base of the fifth metacarpal into the medullary canal before closed reduction. After satisfactory reduction was achieved, the Kirschner wire was inserted across the fracture site into the metacarpal head for further reduction and fixation using rod rotation technique. After operation, a plaster was applied to protect the fixation for 2 weeks. Functional exercise was started after removal of the plaster. The Kirschner wire was not removed under local anaesthesia at the outpatient department until about 10 to 16 weeks postoperation when X-ray showed fracture healing. Records of their operation time, head/shaft angle of the fifth affected metacarpal, active range of motion of the metacarpophalangeal joints and Total Active Movement (TAM) of hand function at the last follow-up were collected. \u0000 \u0000 \u0000Results \u0000Their operation time averaged 21 minutes (from 12 to 35 minutes). Anatomical reduction was achieved in 23 cases but not in 3 ones whose metacarpal head/shaft angle and alignment were obviously improved. Follow-ups for 6 to 29 months (average, 15.8 months) showed all the patients obtained solid fracture healing with no infection or delayed fracture healing. The head/shaft angle was improved significantly from preoperative 61.2°±11.2° to postoperative 14.7°±3.5° (P 0.05). The active range of motion of the metacarpophalangeal joint was 89.3°±4.2° after fixation removal, not significantly different from that of the healthy side (90.7°±1.5°) (P>0.05). According to TAM scores at the last follow-up, 22 cases were rated as excellent, 3 as good and one as fair. \u0000 \u0000 \u0000Conclusion \u0000In the treatment of the fifth metacarpal neck fracture, closed reduction and intramedullary fixation with antegrade Kirschner wire plus rod rotation technique is effective, because it is simple and limitedly invasive, and leads to limited complications, low costs and secondary reduction. \u0000 \u0000 \u0000Key words: \u0000Metacarpal bone; Fracture fixation, intramedullary; Bone nail; Fifth metacarpal neck fracture; Rod rotation","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"170-174"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41573228","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.02.009
Shuangqi Yu, Hexing Zhang, Wei Chen, Song Wan, X. Xiong, Yi Zhang, Fan Ding
{"title":"Surgical treatment of a case of lumbar burst fracture complicated with 2019-nCoV infection","authors":"Shuangqi Yu, Hexing Zhang, Wei Chen, Song Wan, X. Xiong, Yi Zhang, Fan Ding","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.009","url":null,"abstract":"","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"132-136"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44811957","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 : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.02.010
Jing Liu, Mengfei Liu, Xudong Xie, Guohui Liu, T. Xia, Wu Zhou, Faqi Cao, Yun Sun, B. Mi, Y. Xiong, Xue-Feng Hang, Liangcong Hu, Yiqiang Hu, Lang Chen, Chenchen Yan, Ze Lin
{"title":"Surgical treatment of hip fracture complicated with suspected COVID-19: a case report","authors":"Jing Liu, Mengfei Liu, Xudong Xie, Guohui Liu, T. Xia, Wu Zhou, Faqi Cao, Yun Sun, B. Mi, Y. Xiong, Xue-Feng Hang, Liangcong Hu, Yiqiang Hu, Lang Chen, Chenchen Yan, Ze Lin","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.010","url":null,"abstract":"","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"137-140"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43738531","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}
Although the epidemic outbreak of Corona Virus Disease 2019 (COVID-19) restricted freecoming and going of people, it was inevitable that fracture patients, elderly ones with low-energy fracture in part ICU lar, sought medical attention. In this special situation, itwas crucial for trauma orthopaedists to do well in prevention and control of COVID-19 infection and in perioperative management of their patients as well while they went on with routine diagnosis and treatment. It was also of great significance for prognosis of the patients and prevention and control of the epidemic that orthopaedic surgeons chose proper surgical and anesthesia methods. In the process of diagnosis, treatment, nursing and rehabilitation, medical staff too was challenged by how to prevent themselves from infection and how to eliminate cluster COVID-19 transmission. This paper, from the perspectives of orthopedic surgeons, nurses and patients, expounds briefly on the management of patients with orthopedic trauma during the epidemic period of COVID-19 in a mode of multidisciplinary comprehensive interventions. Key words: Corona Virus Disease 2019; Orthopaedics; Wound and injuries; Medical staff
{"title":"Management highlights for patients with orthopedic trauma during the epidemic of COVID-19","authors":"Yingchao Yin, Z. Hou, Yanbin Zhu, Shuhong Yang, Wei Chen, Xiu-Li Wang, Xiuting Li, Qi Zhang, Yingze Zhang","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.006","url":null,"abstract":"Although the epidemic outbreak of Corona Virus Disease 2019 (COVID-19) restricted freecoming and going of people, it was inevitable that fracture patients, elderly ones with low-energy fracture in part ICU lar, sought medical attention. In this special situation, itwas crucial for trauma orthopaedists to do well in prevention and control of COVID-19 infection and in perioperative management of their patients as well while they went on with routine diagnosis and treatment. It was also of great significance for prognosis of the patients and prevention and control of the epidemic that orthopaedic surgeons chose proper surgical and anesthesia methods. In the process of diagnosis, treatment, nursing and rehabilitation, medical staff too was challenged by how to prevent themselves from infection and how to eliminate cluster COVID-19 transmission. This paper, from the perspectives of orthopedic surgeons, nurses and patients, expounds briefly on the management of patients with orthopedic trauma during the epidemic period of COVID-19 in a mode of multidisciplinary comprehensive interventions. \u0000 \u0000Key words: \u0000Corona Virus Disease 2019; Orthopaedics; Wound and injuries; Medical staff","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42145564","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 : 2020-01-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.01.009
Jian Wang, Jia-Lin Fan, M. Cao, Chengwei Wang
Objective To explore the surgical efficacy of trans-syndesmotic ankle fracture dislocation (the "Logsplitter" injury) plus the Tillaux-Chaput fracture/the Wagstaffe-Lefort fracture and the Volkmann fracture without tibiofibular joint screwing. Methods Between January 2015 and December 2018, 16 adult patients with the "Logsplitter" injury plus avulsion fractures were treated by open reduction and internal fixation at Department of Orthopaedics, The Sixth Affiliated Hospital, Xinjiang Medical University. They were 11 males and 5 females with an average age of 36.4 years (range, from 27 to 56 years). There were 2 open fractures (one type Ⅱ and one type ⅢA by the Anderson-Gustilo classification) and 14 closed ones; all fractures were type 44-C by the AO/OTA classification; according to the Lauge-Hansen classification, there were 9 cases of pronation-abduction rotation, 3 cases of pronation-external rotation and 4 cases of supination-external rotation. The fibular fractures were treated through a single lateral approach followed by plate fixation. The Volkmann fractures were fixed with screws and the Tillaux-Chaput fractures/the Wagstaffe-Lefort fractures with screws or Kirschner wires. The ankle functions were assessed postoperatively using the ankle-hindfoot rating system of the American Orthopaedic Foot and Ankle Society (AOFAS), and the dysfunction index and bother index of Short Musculoskeletal Function Assessment (SMFA). Results All the patients were followed up for 8 to 27 months (average, 21.3 months). X-ray films showed complete fracture healing in all cases after 12 to 18 weeks postoperatively (mean, 14.8 weeks). At the last follow up, 13 patients walked normally and 2 with mild discomfort. Their AOFAS scores averaged 96.3 (range, from 86 to 100), giving 12 excellent, 3 good and one poor cases; their SMFA dysfunction index was 15.9 (range, from 8 to 17)and SMFA bother index 6.5 (range, from 3 to 9)at the last follow-up. Conclusions In the treatment of trans-syndesmotic ankle fracture dislocation - the "Logsplitter" injury, open reduction and internal fixation of the Tillaux-Chaput fracture/the Wagstaffe-Lefort fracture and the Volkmann fracture to reconstruct the lower tibiofibular horizontal stable "ring" , without tibiofibular joint screwing, can obtain satisfactory clinical results. Key words: Ankle joint; Fractures; Fracture fixation, internal; Logsplitter injury; Distal tibiofibular syndesmosis
{"title":"Surgical effectiveness of ankle \"Logsplitter\" injury plus avulsion fractures without tibiofibular joint screwing","authors":"Jian Wang, Jia-Lin Fan, M. Cao, Chengwei Wang","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.01.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.01.009","url":null,"abstract":"Objective \u0000To explore the surgical efficacy of trans-syndesmotic ankle fracture dislocation (the \"Logsplitter\" injury) plus the Tillaux-Chaput fracture/the Wagstaffe-Lefort fracture and the Volkmann fracture without tibiofibular joint screwing. \u0000 \u0000 \u0000Methods \u0000Between January 2015 and December 2018, 16 adult patients with the \"Logsplitter\" injury plus avulsion fractures were treated by open reduction and internal fixation at Department of Orthopaedics, The Sixth Affiliated Hospital, Xinjiang Medical University. They were 11 males and 5 females with an average age of 36.4 years (range, from 27 to 56 years). There were 2 open fractures (one type Ⅱ and one type ⅢA by the Anderson-Gustilo classification) and 14 closed ones; all fractures were type 44-C by the AO/OTA classification; according to the Lauge-Hansen classification, there were 9 cases of pronation-abduction rotation, 3 cases of pronation-external rotation and 4 cases of supination-external rotation. The fibular fractures were treated through a single lateral approach followed by plate fixation. The Volkmann fractures were fixed with screws and the Tillaux-Chaput fractures/the Wagstaffe-Lefort fractures with screws or Kirschner wires. The ankle functions were assessed postoperatively using the ankle-hindfoot rating system of the American Orthopaedic Foot and Ankle Society (AOFAS), and the dysfunction index and bother index of Short Musculoskeletal Function Assessment (SMFA). \u0000 \u0000 \u0000Results \u0000All the patients were followed up for 8 to 27 months (average, 21.3 months). X-ray films showed complete fracture healing in all cases after 12 to 18 weeks postoperatively (mean, 14.8 weeks). At the last follow up, 13 patients walked normally and 2 with mild discomfort. Their AOFAS scores averaged 96.3 (range, from 86 to 100), giving 12 excellent, 3 good and one poor cases; their SMFA dysfunction index was 15.9 (range, from 8 to 17)and SMFA bother index 6.5 (range, from 3 to 9)at the last follow-up. \u0000 \u0000 \u0000Conclusions \u0000In the treatment of trans-syndesmotic ankle fracture dislocation - the \"Logsplitter\" injury, open reduction and internal fixation of the Tillaux-Chaput fracture/the Wagstaffe-Lefort fracture and the Volkmann fracture to reconstruct the lower tibiofibular horizontal stable \"ring\" , without tibiofibular joint screwing, can obtain satisfactory clinical results. \u0000 \u0000 \u0000Key words: \u0000Ankle joint; Fractures; Fracture fixation, internal; Logsplitter injury; Distal tibiofibular syndesmosis","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45645947","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 : 2020-01-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.01.007
Chao Gao, Hang Zhang, Kaiwen Chen, Yu Cheng, Hongtao Zhang
Objective To study the clinical efficacy of platelet-rich plasma (PRP) in the treatment of acute Achilles tendon rupture. Methods A retrospective study was performed of the 21 patients who had been treated for acute Achilles tendon rupture at Department of Orthopaedics, The First Affiliated Hospital to Soochow University from January 2018 to January 2019. Of them, 15 were treated by modified Kessler suture combined with PRP injection (PRP group) and 6 by simple modified Kessler suture (control group). The 2 groups were compared in terms of plantar flexion, dorsal expansion, visual analogue scale (VAS), Victorian Institute of Sport Assessment (VISA), and ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS) at 3, 6, and 9 months postoperation. Results The 2 groups were comparable due to insignificant differences between them in the preoperative general data (P>0.05). All patients were followed up for 9 to 12 months (mean, 11.3 months). At 3, 6, and 9 months postoperation, the degrees of plantar flexion (33.5°±1.8°, 38.1°±1.2° and 41.6°±1.6°) and dorsal expansion (10.3°, 16.5° and 21.5°) in the PRP group were all significantly larger than those in the control group (26.9°±2.0°, 31.5°±1.6° and 35.6°±1.4°; 5.3°, 12.7°±0.6° and 18.2°), and the VISA scores (41.2±6.5, 78.7±10.4 and 91.0±4.1) and the AOFAS scores (75.5±5.4, 88.6±5.2 and 95.2±3.5) in the PRP group were all significantly higher than those in the control group (29.8±2.5, 68.0±3.5 and 84.5±2.1; 66.8±4.8, 82.8±3.6 and 90.7±1.1) (all P<0.05). At 3 and 6 months postoperation, the VAS scores in the PRP group (1.7±0.9 and 1.3±0.4) were significantly lower than those in the control group (3.0±0.8 and 2.2±0.7) (all P<0.05). Conclusion As PRP can release a high concentration of growth factors to promote recovery of Achilles tendon rupture and accelerate recovery of foot and ankle function, it can be considered a safe, practical and reliable treatment to use modified Kessler suture plus PRP injection. Key words: Achilles tendon; Platelet-rich plasma; Wounds and injuries; Function recovery
{"title":"Platelet-rich plasma and acute Achilles tendon rupture","authors":"Chao Gao, Hang Zhang, Kaiwen Chen, Yu Cheng, Hongtao Zhang","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.01.007","url":null,"abstract":"Objective \u0000To study the clinical efficacy of platelet-rich plasma (PRP) in the treatment of acute Achilles tendon rupture. \u0000 \u0000 \u0000Methods \u0000A retrospective study was performed of the 21 patients who had been treated for acute Achilles tendon rupture at Department of Orthopaedics, The First Affiliated Hospital to Soochow University from January 2018 to January 2019. Of them, 15 were treated by modified Kessler suture combined with PRP injection (PRP group) and 6 by simple modified Kessler suture (control group). The 2 groups were compared in terms of plantar flexion, dorsal expansion, visual analogue scale (VAS), Victorian Institute of Sport Assessment (VISA), and ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS) at 3, 6, and 9 months postoperation. \u0000 \u0000 \u0000Results \u0000The 2 groups were comparable due to insignificant differences between them in the preoperative general data (P>0.05). All patients were followed up for 9 to 12 months (mean, 11.3 months). At 3, 6, and 9 months postoperation, the degrees of plantar flexion (33.5°±1.8°, 38.1°±1.2° and 41.6°±1.6°) and dorsal expansion (10.3°, 16.5° and 21.5°) in the PRP group were all significantly larger than those in the control group (26.9°±2.0°, 31.5°±1.6° and 35.6°±1.4°; 5.3°, 12.7°±0.6° and 18.2°), and the VISA scores (41.2±6.5, 78.7±10.4 and 91.0±4.1) and the AOFAS scores (75.5±5.4, 88.6±5.2 and 95.2±3.5) in the PRP group were all significantly higher than those in the control group (29.8±2.5, 68.0±3.5 and 84.5±2.1; 66.8±4.8, 82.8±3.6 and 90.7±1.1) (all P<0.05). At 3 and 6 months postoperation, the VAS scores in the PRP group (1.7±0.9 and 1.3±0.4) were significantly lower than those in the control group (3.0±0.8 and 2.2±0.7) (all P<0.05). \u0000 \u0000 \u0000Conclusion \u0000As PRP can release a high concentration of growth factors to promote recovery of Achilles tendon rupture and accelerate recovery of foot and ankle function, it can be considered a safe, practical and reliable treatment to use modified Kessler suture plus PRP injection. \u0000 \u0000 \u0000Key words: \u0000Achilles tendon; Platelet-rich plasma; Wounds and injuries; Function recovery","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"38-44"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47703749","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 : 2020-01-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.01.015
Zhen Wei, Lizhi Zhang, Shi-min Zhang
It has become a research hotspot in the field of trauma orthopedics how to fix intertrochanteric fractures effectively, especially the head-neck fragment, so that the osteoporotic fracture ends can be stabilized. In order to reduce fixation failure, application of bio-reinforced materials is another promising mothod in addition to improving the design of internal fixation. This paper reviews the research history, characteristics, current research into the biomechanics and clinical application of bone reinforced cement materials, intending to help surgeons understand the principles, surgical techniques and application scope of bone bio-reinforced materials for internal fixation. Key words: Hip fractures; Osteoporosis; Fracture fixation, internal; Bone cement; Bone reinforced material
{"title":"Application of bone cement to enhance internal fixation of intertrochanteric fracture","authors":"Zhen Wei, Lizhi Zhang, Shi-min Zhang","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.01.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.01.015","url":null,"abstract":"It has become a research hotspot in the field of trauma orthopedics how to fix intertrochanteric fractures effectively, especially the head-neck fragment, so that the osteoporotic fracture ends can be stabilized. In order to reduce fixation failure, application of bio-reinforced materials is another promising mothod in addition to improving the design of internal fixation. This paper reviews the research history, characteristics, current research into the biomechanics and clinical application of bone reinforced cement materials, intending to help surgeons understand the principles, surgical techniques and application scope of bone bio-reinforced materials for internal fixation. \u0000 \u0000Key words: \u0000Hip fractures; Osteoporosis; Fracture fixation, internal; Bone cement; Bone reinforced material","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"84-87"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44231209","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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