Pub Date : 2019-11-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2019.11.014
Peipei Zhu, Yulin Cao, Yong Liu, Mengcun Chen, W. Tong
Osteoporosis is a metabolic bone disease characterized by decreased bone mass and degenerative changes in the microstructure of bone tissue, leading to increased bone brittleness and fracture risk. Bone fracture after osteoporosis is the most common and serious complication, which often leads to serious consequences in cases of inadequate prevention and late diagnosis. Therefore, more attention should be paid to prevention of osteoporosis and risk assessment of fracture and refracture after osteoporosis. This paper reviews the research progress in risk assessment of fracture and refracture after osteoporosis from the aspects of imaging, clinical manifestations and laboratory examination indexes. In recent years, the imaging methods have developed from dual-energy X-ray absorption, trabecular bone scoring and CT to high resolution peripheral quantitative CT; concern for their clinical manifestations has developed from independent risk factors to fracture risk assessment tools; the laboratory tests have developed from bone turnover markers and serotonin to microRNA. Although these developments have consistently increased the sensitivity of risk assessment for fracture and refracture after osteoporosis, problems still exist and need to be resolved. Key words: Osteoporotic fractures; Risk assessment; Review; Refracture
{"title":"Risk assessments for osteoporotic fracture and refracture","authors":"Peipei Zhu, Yulin Cao, Yong Liu, Mengcun Chen, W. Tong","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.11.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.11.014","url":null,"abstract":"Osteoporosis is a metabolic bone disease characterized by decreased bone mass and degenerative changes in the microstructure of bone tissue, leading to increased bone brittleness and fracture risk. Bone fracture after osteoporosis is the most common and serious complication, which often leads to serious consequences in cases of inadequate prevention and late diagnosis. Therefore, more attention should be paid to prevention of osteoporosis and risk assessment of fracture and refracture after osteoporosis. This paper reviews the research progress in risk assessment of fracture and refracture after osteoporosis from the aspects of imaging, clinical manifestations and laboratory examination indexes. In recent years, the imaging methods have developed from dual-energy X-ray absorption, trabecular bone scoring and CT to high resolution peripheral quantitative CT; concern for their clinical manifestations has developed from independent risk factors to fracture risk assessment tools; the laboratory tests have developed from bone turnover markers and serotonin to microRNA. Although these developments have consistently increased the sensitivity of risk assessment for fracture and refracture after osteoporosis, problems still exist and need to be resolved. \u0000 \u0000 \u0000Key words: \u0000Osteoporotic fractures; Risk assessment; Review; Refracture","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"1005-1008"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46040409","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 clinical application of single-arm external stent combined with free flap in the treatment of forearm fractures of Gustilo type Ⅲ. Methods A retrospective study was conducted of the 16 patients who had been treated at Repair and Reconstruction Center, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University from September 2015 to January 2018 for open forearm fractures combined with soft tissue defects with single-arm external stent combined with free flap. They were 11 men and 5 women, aged from 18 to 64 years (average, 41.6 years). By the Gustilo classification, 9 cases were type ⅢB and 7 type ⅢC. The area of soft tissue defects at the upper arm and hand ranged from 7.5 cm×5.5 cm to 16.5 cm × 11.0 cm. Emergency debridement was performed at the primary stage. After repair of major blood vessels, nerves and tendons, the reduced fractures were fixated with a single-arm external stent. The soft tissue defects were repaired with free flaps at the secondary stage. Nine cases were repaired with a free anterolateral perforating branch flap and 7 with a free ilioinguinal flap. The single-arm external stent became the ultimate fixation mode in 5 cases but was changed into plate fixation after survival of the flaps in the other 11 cases. Complications were recorded postoperatively. At the last follow-up, the upper limb function was evaluated according to the tentative criteria for evaluation of the upper limb function proposed by the Hand Surgery Society of Chinese Medical Association. Results Of all the free flaps, 14 survived smoothly but 2 anterolateral ones survived only after the venous crisis appearing at 24 h after operation was relieved by exploration. The 16 patients were followed up for 9 to 18 months (average, 13.5 months). The fractures united well with fine alignment of the fracture ends and recovered force line. According to the Anderson criteria for forearm fractures, 10 cases were excellent, 4 good and 2 fair after operation. According to the tentative criteria for evaluation of the upper limb function proposed by the Hand Surgery Society of Chinese Medical Association, 11 cases were excellent and 5 good. No nail infection or nonunion occurred. Conclusion In the treatment of forearm fractures of Gustilo type Ⅲ, single-arm external stent plus free flap can effectively restore the force line of upper extremity, promote bone healing, allow reasonable timing for wound repair, reduce postoperative complications like infection and osteomyelitis and facilitate functional recovery of the affected extremity. Key words: Forearm injuries; Fractures, open; External fixators; Free flaps
{"title":"Single-arm external stent combined with free flap used in forearm fractures of Gustilo type III","authors":"Changliang Ou, Xing Zhou, Xuchao Luo, Yonggen Zou, A. Liu, Tian-he Huang, Jiexiang Yang, Xiaojun Chen, Hongbo Zhou","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.11.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.11.011","url":null,"abstract":"Objective \u0000To evaluate the clinical application of single-arm external stent combined with free flap in the treatment of forearm fractures of Gustilo type Ⅲ. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted of the 16 patients who had been treated at Repair and Reconstruction Center, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University from September 2015 to January 2018 for open forearm fractures combined with soft tissue defects with single-arm external stent combined with free flap. They were 11 men and 5 women, aged from 18 to 64 years (average, 41.6 years). By the Gustilo classification, 9 cases were type ⅢB and 7 type ⅢC. The area of soft tissue defects at the upper arm and hand ranged from 7.5 cm×5.5 cm to 16.5 cm × 11.0 cm. Emergency debridement was performed at the primary stage. After repair of major blood vessels, nerves and tendons, the reduced fractures were fixated with a single-arm external stent. The soft tissue defects were repaired with free flaps at the secondary stage. Nine cases were repaired with a free anterolateral perforating branch flap and 7 with a free ilioinguinal flap. The single-arm external stent became the ultimate fixation mode in 5 cases but was changed into plate fixation after survival of the flaps in the other 11 cases. Complications were recorded postoperatively. At the last follow-up, the upper limb function was evaluated according to the tentative criteria for evaluation of the upper limb function proposed by the Hand Surgery Society of Chinese Medical Association. \u0000 \u0000 \u0000Results \u0000Of all the free flaps, 14 survived smoothly but 2 anterolateral ones survived only after the venous crisis appearing at 24 h after operation was relieved by exploration. The 16 patients were followed up for 9 to 18 months (average, 13.5 months). The fractures united well with fine alignment of the fracture ends and recovered force line. According to the Anderson criteria for forearm fractures, 10 cases were excellent, 4 good and 2 fair after operation. According to the tentative criteria for evaluation of the upper limb function proposed by the Hand Surgery Society of Chinese Medical Association, 11 cases were excellent and 5 good. No nail infection or nonunion occurred. \u0000 \u0000 \u0000Conclusion \u0000In the treatment of forearm fractures of Gustilo type Ⅲ, single-arm external stent plus free flap can effectively restore the force line of upper extremity, promote bone healing, allow reasonable timing for wound repair, reduce postoperative complications like infection and osteomyelitis and facilitate functional recovery of the affected extremity. \u0000 \u0000 \u0000Key words: \u0000Forearm injuries; Fractures, open; External fixators; Free flaps","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"991-994"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42037563","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 : 2019-11-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2019.11.012
K. Jin, Li Yongle, Zheng Tiegang, L. Xiaowei, Li Chao, Xuesong Yang, Jia Yanhui, Li Aiwen, Tian Gaobo, Han Shengyi, Yu Tao
Objective To evaluate the efficacy of articular compression molding techniques in the surgery for acetabular posterior wall fracture. Methods A retrospective study was conducted of the 28 patients (28 hips) with fracture of acetabular posterior wall plus comminuted compression of articular surface who had been treated using the articular compression molding techniques at Department of Orthopedics, The Hospital of 81 Group Army of PLA from January 2014 to January 2018. They were 25 males and 3 females, aged from 26 to 63 years (average, 49.3 years). The time from injury to surgery ranged from 4 to 12 days (average, 7.8 days). According to the Letournel-Judet classification, all were single element (simple) posterior wall fractures combined with posterior dislocation of the femoral head and articular compression of different degrees; transient sciatic nerve injury was complicated in 12 cases. The posterior hip dislocations were timely and successful reset at emergency treatment. The compression fractures of the posterior wall and hip joint were treated by open reduction and internal fixation via the acetabular posterior (K-L) approach. The articular compression was treated by 4 stabilization techniques: absorbable screwing and blocking technique in 10 cases, indwelling screwing in 12 cases, indwelling Kirschner wiring in 2 cases and die push and squeeze tamping in 4 cases. The operation time, intraoperative bleeding and complications were recorded. The therapeutic efficacy was evaluated by the modified Merle d’Aubigne & Postel scoring criteria at the final follow-up. Results The operation time lasted from 76 to 118 minutes (average, 94.2 minutes); the intraoperative bleeding ranged from 100 to 320 mL (average,220.8 mL). No incision liquefaction, infection or other complications occurred. The 28 patients were followed up for 10 to 36 months (average, 17.6 months). According to the Matta scoring criteria, 24 cases achieved anatomical reduction but 4 dissatisfactory reduction. By the modified Merle d’Aubigne & Postel scoring criteria at the final follow-up, the efficacy was evaluated as excellent in 26 cases and as good in 2. Heterotopic ossification was observed in 3 cases and microscopic free dense shadow in the joint cavity (about 2 mm in the round ligament) in 3 cases. There were no cases of obvious traumatic arthritis or osteoarthritis, femoral head necrosis, walking pain, lameness or hip abduction weakness. The 12 patients complicated with preoperative transient sciatic nerve injury recovered within 3 months after surgery. Conclusion The articular compression molding techniques can effectively treat severely comminuted articular compression in the acetabular posterior wall fracture and improve reduction of articular surface and hip joint matching, leading to stability and good joint function. Key words: Acetabulum; Hip fractures; Fracture fixation, internal; Articular compression; Reduction molding
{"title":"Articular compression molding techniques for acetabular posterior wall fracture","authors":"K. Jin, Li Yongle, Zheng Tiegang, L. Xiaowei, Li Chao, Xuesong Yang, Jia Yanhui, Li Aiwen, Tian Gaobo, Han Shengyi, Yu Tao","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.11.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.11.012","url":null,"abstract":"Objective \u0000To evaluate the efficacy of articular compression molding techniques in the surgery for acetabular posterior wall fracture. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted of the 28 patients (28 hips) with fracture of acetabular posterior wall plus comminuted compression of articular surface who had been treated using the articular compression molding techniques at Department of Orthopedics, The Hospital of 81 Group Army of PLA from January 2014 to January 2018. They were 25 males and 3 females, aged from 26 to 63 years (average, 49.3 years). The time from injury to surgery ranged from 4 to 12 days (average, 7.8 days). According to the Letournel-Judet classification, all were single element (simple) posterior wall fractures combined with posterior dislocation of the femoral head and articular compression of different degrees; transient sciatic nerve injury was complicated in 12 cases. The posterior hip dislocations were timely and successful reset at emergency treatment. The compression fractures of the posterior wall and hip joint were treated by open reduction and internal fixation via the acetabular posterior (K-L) approach. The articular compression was treated by 4 stabilization techniques: absorbable screwing and blocking technique in 10 cases, indwelling screwing in 12 cases, indwelling Kirschner wiring in 2 cases and die push and squeeze tamping in 4 cases. The operation time, intraoperative bleeding and complications were recorded. The therapeutic efficacy was evaluated by the modified Merle d’Aubigne & Postel scoring criteria at the final follow-up. \u0000 \u0000 \u0000Results \u0000The operation time lasted from 76 to 118 minutes (average, 94.2 minutes); the intraoperative bleeding ranged from 100 to 320 mL (average,220.8 mL). No incision liquefaction, infection or other complications occurred. The 28 patients were followed up for 10 to 36 months (average, 17.6 months). According to the Matta scoring criteria, 24 cases achieved anatomical reduction but 4 dissatisfactory reduction. By the modified Merle d’Aubigne & Postel scoring criteria at the final follow-up, the efficacy was evaluated as excellent in 26 cases and as good in 2. Heterotopic ossification was observed in 3 cases and microscopic free dense shadow in the joint cavity (about 2 mm in the round ligament) in 3 cases. There were no cases of obvious traumatic arthritis or osteoarthritis, femoral head necrosis, walking pain, lameness or hip abduction weakness. The 12 patients complicated with preoperative transient sciatic nerve injury recovered within 3 months after surgery. \u0000 \u0000 \u0000Conclusion \u0000The articular compression molding techniques can effectively treat severely comminuted articular compression in the acetabular posterior wall fracture and improve reduction of articular surface and hip joint matching, leading to stability and good joint function. \u0000 \u0000 \u0000Key words: \u0000Acetabulum; Hip fractures; Fracture fixation, internal; Articular compression; Reduction molding","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"995-999"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45689997","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}
Posterior tibial slope (PTS) is used to describe the sagittal alignment of the tibial plateau of the knee. As its values indicate the steepness or gentleness of the tibial platform, it is an important basis for knee surgery, such as total knee replacement (TKA), anterior cruciate ligament/posterior cruciate ligament reconstruction (RACL/RPCL) and tibia high-level osteotomy (HTO), and affects the indication and efficacy of knee surgery. Since there has been no consensus description of PTS at present in clinical practice in China, this paper intends to discuss PTS from perspectives of epidemiology, measurement, its influence on knee joint activity, relationship between subchondral bone and knee ligament, and its significance in various knee joint operations. This review hopes to contribute to the knee surgery after the surgeons have a comprehensive understanding of the clinical significance and applications of PTS. Key words: Tibia; Knee joint; Ligaments; Tibial plateau; Clinical significance
{"title":"Clinical significance of posterior tibial slope in knee surgery","authors":"Xiaodong Lin, Muxin Zheng, Weiyi Xia, Hongliang Liu, Shuchai Xu, Zexin Huang","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.017","url":null,"abstract":"Posterior tibial slope (PTS) is used to describe the sagittal alignment of the tibial plateau of the knee. As its values indicate the steepness or gentleness of the tibial platform, it is an important basis for knee surgery, such as total knee replacement (TKA), anterior cruciate ligament/posterior cruciate ligament reconstruction (RACL/RPCL) and tibia high-level osteotomy (HTO), and affects the indication and efficacy of knee surgery. Since there has been no consensus description of PTS at present in clinical practice in China, this paper intends to discuss PTS from perspectives of epidemiology, measurement, its influence on knee joint activity, relationship between subchondral bone and knee ligament, and its significance in various knee joint operations. This review hopes to contribute to the knee surgery after the surgeons have a comprehensive understanding of the clinical significance and applications of PTS. \u0000 \u0000 \u0000Key words: \u0000Tibia; Knee joint; Ligaments; Tibial plateau; Clinical significance","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"914-917"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43800992","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.1671-7600.2019.10.003
Yunchu Sun, Gen Wen, Jia Xu, Fengji Xu, Yimin Cai
Objective To report our clinical application of free fibular composite tissue flap with peroneus longus and brevis in the treatment of complicated extremity trauma. Methods From August 2014 to September 2017, 5 patients with complicated extremity trauma were treated using a free fibular composite tissue flap with peroneus longus and brevis at Department of Orthopaedics, The Sixth People's Hospital of Shanghai. They were 4 men and one woman, aged from 23 to 52 years (average, 35.1 years). All of them had tendon defects; one had a radius defect, one an ulnar defect and three a tibial defect. The length of bone defects ranged from 8 cm to 18 cm; the size of soft tissue defects ranged from 10 cm × 5 cm to 18 cm ×8 cm. A fibular composite tissue flap was designed according to the soft tissue condition and defect area to repair and fixate the bone defect after thorough debridement and cover the wound before functional reconstruction. Postoperatively, survival of the flap and functional recovery of the corresponding tendon at the recipient site, healing time of the tibia, and wound healing, ankle motion and complications at the donor site were all observed. Results The 5 patients were followed up for 18 to 38 months (average, 25.2 months). All flaps survived without any vascular crisis or infection. The union time for the fibular graft ranged from 4 to 16 months (average, 8.4 months). In the 3 patients with a tibial defect, the maximum angle of dorsal extension ranged from 0° to 10° and no foot drop was observed. Thumb and digital flexion was reconstructed in the patients with a forearm bone defect only to achieve opposition of index finger and thumb but we failed to make them have a fist. At the 5 flap donor sites, the wound was sutured by the second stage after vacuum suction and healed well; obvious scar formed in one of them. No obvious foot varus was observed at the donor site. The patients were satisfactory with their ankle joint motion. No refracture of the fibular graft occurred during follow-up. Conclusion A free fibular composite tissue flap with peroneus longus and brevis is a good choice for complicated extremity trauma. Key words: Surgical flaps; Fibula; Composite tissue defects; Fibular osteocutaneous flap
{"title":"Free fibular composite tissue flap with peroneus longus and brevis for complicated extremity trauma","authors":"Yunchu Sun, Gen Wen, Jia Xu, Fengji Xu, Yimin Cai","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.003","url":null,"abstract":"Objective \u0000To report our clinical application of free fibular composite tissue flap with peroneus longus and brevis in the treatment of complicated extremity trauma. \u0000 \u0000 \u0000Methods \u0000From August 2014 to September 2017, 5 patients with complicated extremity trauma were treated using a free fibular composite tissue flap with peroneus longus and brevis at Department of Orthopaedics, The Sixth People's Hospital of Shanghai. They were 4 men and one woman, aged from 23 to 52 years (average, 35.1 years). All of them had tendon defects; one had a radius defect, one an ulnar defect and three a tibial defect. The length of bone defects ranged from 8 cm to 18 cm; the size of soft tissue defects ranged from 10 cm × 5 cm to 18 cm ×8 cm. A fibular composite tissue flap was designed according to the soft tissue condition and defect area to repair and fixate the bone defect after thorough debridement and cover the wound before functional reconstruction. Postoperatively, survival of the flap and functional recovery of the corresponding tendon at the recipient site, healing time of the tibia, and wound healing, ankle motion and complications at the donor site were all observed. \u0000 \u0000 \u0000Results \u0000The 5 patients were followed up for 18 to 38 months (average, 25.2 months). All flaps survived without any vascular crisis or infection. The union time for the fibular graft ranged from 4 to 16 months (average, 8.4 months). In the 3 patients with a tibial defect, the maximum angle of dorsal extension ranged from 0° to 10° and no foot drop was observed. Thumb and digital flexion was reconstructed in the patients with a forearm bone defect only to achieve opposition of index finger and thumb but we failed to make them have a fist. At the 5 flap donor sites, the wound was sutured by the second stage after vacuum suction and healed well; obvious scar formed in one of them. No obvious foot varus was observed at the donor site. The patients were satisfactory with their ankle joint motion. No refracture of the fibular graft occurred during follow-up. \u0000 \u0000 \u0000Conclusion \u0000A free fibular composite tissue flap with peroneus longus and brevis is a good choice for complicated extremity trauma. \u0000 \u0000 \u0000Key words: \u0000Surgical flaps; Fibula; Composite tissue defects; Fibular osteocutaneous flap","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"839-842"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45887316","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.1671-7600.2019.10.018
D. Hao
{"title":"Development and prospect of digital intelligence medicine in spinal surgery","authors":"D. Hao","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.018","url":null,"abstract":"","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"918-920"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43879555","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.1671-7600.2019.10.009
Yuchang Liu, Junzhong Luo, Yazhou Li, Xuan Wang
Objective To evaluate a self-designed external fixation restorer used for femoral shaft fractures in children. Methods From September 2016 to October 2017, 19 children were treated at Department of Pediatric Orthopaedics, The Third Hospital of Hebei Medical University for irreducible femoral shaft fractures using our self-designed external fixation restorer. They were 15 males and 4 females, aged from 4 years and 2 months to 8 years (average, 6.3 years). There were 7 transverse fractures, 11 short oblique fractures and one oblique fracture. The restorer was applied directly to the femur for traction and temporary external fixation. The femoral shaft fractures were reduced closely before internal fixation with elastic stable intramedullary nails. The Flynn criteria for lower limb fracture were used to evaluate the curative effects postoperatively. Results The operative time ranged from 32 to 45 minutes (37 minutes on average). All the fractures obtained closed reduction. No such intraoperative complications occurred as traction and compression injury to soft tissues like muscle, nerve and blood vessel. Follow-ups ranged from 8 to 20 months (average, 13 months). All the fractures got united after 7 to 15 weeks (average, 10.1 weeks). No implant failure or breakage occurred. The implants were removed 6 to 8 months after operation when the fractures got united. According to the Flynn evaluation criteria at the last follow-up, 18 cases were excellent and one was good. Conclusions Due to its advantages of simplicity, easy manipulation and direct action on the femur for traction, our self-designed external fixation restorer can improve the closed reduction for femoral shaft fractures in children so that its sustained and effective traction force and high quality of fracture closure avoid surgical opening. The temporarily fixation it provides after fracture reduction can facilitate intraoperative fluoroscopy of the femur. Key words: Femoral fractures; Fracture fixation, internal; Bone nails; Children; Fixation restorer
{"title":"Application of a self-designed external fixation restorer for femoral shaft fractures in children","authors":"Yuchang Liu, Junzhong Luo, Yazhou Li, Xuan Wang","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.009","url":null,"abstract":"Objective \u0000To evaluate a self-designed external fixation restorer used for femoral shaft fractures in children. \u0000 \u0000 \u0000Methods \u0000From September 2016 to October 2017, 19 children were treated at Department of Pediatric Orthopaedics, The Third Hospital of Hebei Medical University for irreducible femoral shaft fractures using our self-designed external fixation restorer. They were 15 males and 4 females, aged from 4 years and 2 months to 8 years (average, 6.3 years). There were 7 transverse fractures, 11 short oblique fractures and one oblique fracture. The restorer was applied directly to the femur for traction and temporary external fixation. The femoral shaft fractures were reduced closely before internal fixation with elastic stable intramedullary nails. The Flynn criteria for lower limb fracture were used to evaluate the curative effects postoperatively. \u0000 \u0000 \u0000Results \u0000The operative time ranged from 32 to 45 minutes (37 minutes on average). All the fractures obtained closed reduction. No such intraoperative complications occurred as traction and compression injury to soft tissues like muscle, nerve and blood vessel. Follow-ups ranged from 8 to 20 months (average, 13 months). All the fractures got united after 7 to 15 weeks (average, 10.1 weeks). No implant failure or breakage occurred. The implants were removed 6 to 8 months after operation when the fractures got united. According to the Flynn evaluation criteria at the last follow-up, 18 cases were excellent and one was good. \u0000 \u0000 \u0000Conclusions \u0000Due to its advantages of simplicity, easy manipulation and direct action on the femur for traction, our self-designed external fixation restorer can improve the closed reduction for femoral shaft fractures in children so that its sustained and effective traction force and high quality of fracture closure avoid surgical opening. The temporarily fixation it provides after fracture reduction can facilitate intraoperative fluoroscopy of the femur. \u0000 \u0000 \u0000Key words: \u0000Femoral fractures; Fracture fixation, internal; Bone nails; Children; Fixation restorer","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"869-873"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42532103","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.1671-7600.2019.10.002
Bin Yu
{"title":"Current situation and development of treatment of open fractures","authors":"Bin Yu","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.002","url":null,"abstract":"","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"835-838"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45430258","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.1671-7600.2019.10.007
D. Guan, Dongyan Wang, T. Jia, Chen Tianxin, Zhao Dongbo
Objective To evaluate one-stage repair of leg open fracture with soft tissue defect by fixation plus skin flap. Methods From January 2011 to January 2018, 34 patients with leg open fracture plus soft tissue defect were treated at Department of Orthopedics, The Second Affiliated Hospital to Harbin Medical University. They were 31 males and 3 females, aged from 13 to 54 years(average, 35 years). According to the Gustilo classification, the defects were type ⅢA in 31 cases and type ⅢB in 3 cases. The wound size ranged from 6 cm×3 cm to 25 cm×10 cm. All patients were treated with emergency fracture fixation and flap repair by one stage after thorough debridement. Internal bone plating was performed in 32 patients and external fixation at a single arm in 2 patients. All defects were repaired with a free anterolateral thigh flap. Flap survival, vascular crisis and bone infection were followed up postoperatively. Results All the free flaps survived in the 34 cases with no vascular crisis. These patients were followed up for 6 months to 3 years (average, 10 years). The flaps healed well, with good appearance and soft texture. No bone infection occurred at the defective sites. After postoperative rehabilitation, the knee extension ranged from 160° to 180°, knee flexion from 90° to 110°, ankle dorsal extension from 90° to 110°, and ankle plantar flexion from 100° to 120°. Conclusion Soft tissue defects in leg open fracture can be effectively treated by flap repair after thorough debridement at the same time of fracture fixation, because the primary wound healing can avoid infection and lead to fine survival of the flap. Key words: Fractures, open; Soft tissue defects; Surgical flaps; Reconstructive surgical procedures; Legs
{"title":"One-stage repair of soft tissue defects in open leg fracture","authors":"D. Guan, Dongyan Wang, T. Jia, Chen Tianxin, Zhao Dongbo","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.007","url":null,"abstract":"Objective \u0000To evaluate one-stage repair of leg open fracture with soft tissue defect by fixation plus skin flap. \u0000 \u0000 \u0000Methods \u0000From January 2011 to January 2018, 34 patients with leg open fracture plus soft tissue defect were treated at Department of Orthopedics, The Second Affiliated Hospital to Harbin Medical University. They were 31 males and 3 females, aged from 13 to 54 years(average, 35 years). According to the Gustilo classification, the defects were type ⅢA in 31 cases and type ⅢB in 3 cases. The wound size ranged from 6 cm×3 cm to 25 cm×10 cm. All patients were treated with emergency fracture fixation and flap repair by one stage after thorough debridement. Internal bone plating was performed in 32 patients and external fixation at a single arm in 2 patients. All defects were repaired with a free anterolateral thigh flap. Flap survival, vascular crisis and bone infection were followed up postoperatively. \u0000 \u0000 \u0000Results \u0000All the free flaps survived in the 34 cases with no vascular crisis. These patients were followed up for 6 months to 3 years (average, 10 years). The flaps healed well, with good appearance and soft texture. No bone infection occurred at the defective sites. After postoperative rehabilitation, the knee extension ranged from 160° to 180°, knee flexion from 90° to 110°, ankle dorsal extension from 90° to 110°, and ankle plantar flexion from 100° to 120°. \u0000 \u0000 \u0000Conclusion \u0000Soft tissue defects in leg open fracture can be effectively treated by flap repair after thorough debridement at the same time of fracture fixation, because the primary wound healing can avoid infection and lead to fine survival of the flap. \u0000 \u0000 \u0000Key words: \u0000Fractures, open; Soft tissue defects; Surgical flaps; Reconstructive surgical procedures; Legs","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"859-863"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48097428","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.1671-7600.2019.10.012
Yijie Liu, Sen Yang, Xuefeng Li, Weimin Jiang, Renjie Li, Heng Wang, Huaqing Guan, Jie Chen, Genlin Wang
Objective To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) in the treatment of stage Ⅲ Kummell＇s disease with no neurological symptom. Methods From January 2009 to June 2018, 45 patients underwent PKP for stage Ⅲ Kummell＇s disease with no neurological symptom at Department of Orthopaedics, The First Hospital Affiliated to Soochow University. They were 12 males and 33 females, aged from 61 to 85 years (average, 70.9 years). Their visual analog scale (VAS) scores for back pain, Oswestry disability indexes (ODI), heights of fractured vertebrae and kyphosis cob angles were recorded and compared between preoperation, one day, 3 months and final follow-up after operation. Results All the 45 patients were followed up for 12 to 48 months (average, 28.0 months). Their VAS scores (2.4±0.7, 2.2±0.7 and 2.3±0.6), ODI sores (34.7±6.8, 34.2±6.5 and 34.1±6.6) and cobb angles (15.7°±2.2°, 15.8°±2.2° and 15.9°±2.4°) at one day, 3 months and final follow-up after operation were significantly lower than those (8.2±1.1, 75.3±9.0 and 25.2°±3.9°) before operation (P<0.001). Their anterior height ratios of the fractured vertebra (54.0%±4.3%, 53.7%±4.2% and 53.6%±4.0%) and median height ratios of the fractured vertebra (56.8%±4.0%, 56.5%±3.9% and 56.6%±3.9%) at one day, 3 months and final follow-up after operation were significantly higher than those (25.8%±3.9% and 27.2%±3.1%) before operation (P<0.001). The rate of cement leakage was 13.3%(6/45). No patients had neurological symptoms after operation. Conclusion PKP is a minimally invasive, safe and effective treatment for stage Ⅲ Kummell's disease with no neurological symptom, because it can relieve the symptoms of the patients, restore the height of the fractured vertebral body and reduce the local kyphosis cobb angle. Key words: Vertebroplasty; Kyphosis; Spinal cord compression; Kummell’s disease
{"title":"Percutaneous kyphoplasty for stage III Kümmell＇s disease with no neurological symptom","authors":"Yijie Liu, Sen Yang, Xuefeng Li, Weimin Jiang, Renjie Li, Heng Wang, Huaqing Guan, Jie Chen, Genlin Wang","doi":"10.3760/CMA.J.ISSN.1671-7600.2019.10.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2019.10.012","url":null,"abstract":"Objective \u0000To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) in the treatment of stage Ⅲ Kummell＇s disease with no neurological symptom. \u0000 \u0000 \u0000Methods \u0000From January 2009 to June 2018, 45 patients underwent PKP for stage Ⅲ Kummell＇s disease with no neurological symptom at Department of Orthopaedics, The First Hospital Affiliated to Soochow University. They were 12 males and 33 females, aged from 61 to 85 years (average, 70.9 years). Their visual analog scale (VAS) scores for back pain, Oswestry disability indexes (ODI), heights of fractured vertebrae and kyphosis cob angles were recorded and compared between preoperation, one day, 3 months and final follow-up after operation. \u0000 \u0000 \u0000Results \u0000All the 45 patients were followed up for 12 to 48 months (average, 28.0 months). Their VAS scores (2.4±0.7, 2.2±0.7 and 2.3±0.6), ODI sores (34.7±6.8, 34.2±6.5 and 34.1±6.6) and cobb angles (15.7°±2.2°, 15.8°±2.2° and 15.9°±2.4°) at one day, 3 months and final follow-up after operation were significantly lower than those (8.2±1.1, 75.3±9.0 and 25.2°±3.9°) before operation (P<0.001). Their anterior height ratios of the fractured vertebra (54.0%±4.3%, 53.7%±4.2% and 53.6%±4.0%) and median height ratios of the fractured vertebra (56.8%±4.0%, 56.5%±3.9% and 56.6%±3.9%) at one day, 3 months and final follow-up after operation were significantly higher than those (25.8%±3.9% and 27.2%±3.1%) before operation (P<0.001). The rate of cement leakage was 13.3%(6/45). No patients had neurological symptoms after operation. \u0000 \u0000 \u0000Conclusion \u0000PKP is a minimally invasive, safe and effective treatment for stage Ⅲ Kummell's disease with no neurological symptom, because it can relieve the symptoms of the patients, restore the height of the fractured vertebral body and reduce the local kyphosis cobb angle. \u0000 \u0000 \u0000Key words: \u0000Vertebroplasty; Kyphosis; Spinal cord compression; Kummell’s disease","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"21 1","pages":"888-893"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44328366","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：