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Corrigendum to "Dexmedetomidine reduces hippocampal microglia inflammatory response induced by surgical injury through inhibiting NLRP3" [Chinese J Traumatol 22 (2019) 161-165]. 右美托咪定通过抑制NLRP3降低手术损伤诱导的海马小胶质细胞炎症反应[J].中华创伤杂志22(2019)161-165。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-12-28 DOI: 10.1016/j.cjtee.2024.12.001
Ji Peng, Peng Zhang, Han Zheng, Yun-Qin Ren, Hong Yan
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引用次数: 0
The age, sex, and provoked factors of acute symptomatic deep vein thrombosis on the left and right lower extremities. 左、右下肢急性症状性深静脉血栓形成的年龄、性别及诱发因素。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-12-27 DOI: 10.1016/j.cjtee.2024.07.014
Chong-Li Ren, Jian-Ming Sun, Hai-Yang Wang, Jian Fu, Ye-Liang Xu, Jin Wang, Meng-Lin Nie

Purpose: Deep vein thrombosis (DVT) of the left and right lower extremities was treated in the same way, but the left and right extremities received different levels of attention. This study aimed to investigate the differences between the right and left lower extremity deep vein thrombosis (LEDVT).

Methods: Clinical characteristics of LEDVT patients from July 2020 to June 2022 were retrospectively analyzed to compare the incidence of LEDVT on different limbs, demographics, predisposing factors, and anatomical characteristics. The exclusion criteria were bilateral LEDVT and recurrent thrombosis. Measured data was analyzed using independent samples t-test or Mann-Whitney test. Count data were analyzed by Chi-square test. A p < 0.05 was considered a statistically significant difference.

Results: There were 478 patients included in this study and the ratio of patients with LEDVT on the left and right limbs was 3.16:1 (363:115). LEDVT of the left limb was predominantly female, and the age was usually > 50 years (50 - 60 years: 16.80%; > 60 years: 57.30%). The primary predisposing factor was iliac vein compression syndrome, with iliofemoral thrombosis being the main type. Male patients with LEDVT on the right limb were predominant and the age of onset was usually ≤ 60 years (52.17%). The main predisposing factor was recent surgery or trauma (< 30 days) and femoropopliteal thrombosis was the main type. In more detail, the left iliac vein was compressed mainly in the proximal segment, and the right iliac vein was compressed mainly in the intermediate and distal segments. Recent surgery or trauma to the locomotor system and genitourinary system often induced LEDVT.

Conclusion: The incidence of LEDVT on the left is significantly higher than that on the right. LEDVT on different sides has different characteristics, which is crucial for prevention and diagnosis in the relevant population so there are also differences in treatment of the affected limbs.

目的:左、右下肢深静脉血栓形成(DVT)的治疗方法相同,但对左、右下肢的重视程度不同。本研究旨在探讨左右下肢深静脉血栓形成(LEDVT)的差异。方法:回顾性分析2020年7月至2022年6月LEDVT患者的临床特点,比较不同肢体LEDVT的发病率、人口统计学、易感因素及解剖学特征。排除标准为双侧LEDVT和复发血栓形成。测量数据采用独立样本t检验或Mann-Whitney检验进行分析。计数资料采用卡方检验。结果:本研究纳入478例患者,左右肢体LEDVT患者比例为3.16:1(363:115)。左肢体LEDVT以女性为主,年龄多在50 ~ 50岁之间(50 ~ 60岁:16.80%;60岁:57.30%)。主要诱发因素为髂静脉压迫综合征,以髂股血栓形成为主。右肢LEDVT以男性为主,发病年龄通常≤60岁(52.17%)。主要易感因素为近期手术或外伤(< 30天),股腘动脉血栓形成为主要易感因素。更详细地说,左侧髂静脉主要在近段受到压迫,右侧髂静脉主要在中、远段受到压迫。最近的手术或运动系统和泌尿生殖系统的创伤常引起LEDVT。结论:左侧LEDVT发生率明显高于右侧。不同侧面的LEDVT具有不同的特点,这对于相关人群的预防和诊断至关重要,因此患肢的治疗也存在差异。
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引用次数: 0
Systematic review and meta-analysis comparative analysis of the safety and efficacy of fenestrated pedicle screw with cement and conventional pedicle screw with cement in the treatment of osteoporotic vertebral fractures: A meta-analysis. 系统回顾与meta分析:对开窗骨水泥椎弓根螺钉与常规骨水泥椎弓根螺钉治疗骨质疏松性椎体骨折的安全性和有效性进行meta分析。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-12-25 DOI: 10.1016/j.cjtee.2024.07.013
Li Cao, Hong-Jie Xu, Yi-Kang Yu, Huan-Huan Tang, Bo-Hao Fang, Ke Chen
<p><strong>Purpose: </strong>Bone cement-reinforced fenestrated pedicle screws (FPSs) have been widely used in the internal fixation and repair of the spine with osteoporosis in recent years and show significant improvement in fixation strength and stability. However, compared with conventional reinforcement methods, the advantages of bone cement-reinforced FPSs remain undetermined. This article compares the effects of fenestrated and conventional pedicle screws (CPSs) combined with bone cement in the treatment of osteoporosis.</p><p><strong>Methods: </strong>A clinical control study of FPSs and CPSs combined with bone cement reinforcement in osteoporotic vertebral internal fixation was performed using the database PubMed, Embase, Cochrane Library, CNKI, the Wanfang, and the China Biomedical Literature Service System. Two evaluators screened the relevant literature in strict accordance with the inclusion criteria (diagnosis of participants, type of clinical study, treatment with FPS and CPS, and outcome indicators) and exclusion criteria (duplicate literature and missing or incorrect data) and independently conducted data extraction and quality evaluation. Clinical control studies of direct comparison between FPS and CPS combined with bone cement reinforcement in patients who were definitively diagnosed with thoracolumbar fractures or spinal degenerative diseases were included. Quality evaluation was conducted using the Cochrane risk bias evaluation tool for randomized controlled studies and using the Newcastle-Ottawa scale for retrospective case-control studies. RevMan software (version 5.3) was used for the meta-analysis to compare the clinical efficacy, radiological results, and related complications of the 2 methods.</p><p><strong>Results: </strong>A total of 13 articles were included, including 7 randomized controlled studies and 6 retrospective case-control studies. There were 909 patients in these studies, 451 in the FPS and polymethyl methacrylate (FPS & PMMA) group and 458 in the CPS and polymethyl methacrylate (CPS & PMMA) group. The results of the meta-analysis showed that there was no significant difference between the 2 groups in operation time, hospital stay, visual analogue score, Japanese orthopaedic association score, Oswestry disability index score, Cobb angle, vertebral body deformation index and fusion rate (p > 0.05). The mean difference of intraoperative bleeding volume was -10.45, (95% confidence intervals (CI) (-16.92, -3.98), p = 0.002), the mean difference of loss height of the anterior edge of the vertebral body after surgery was -0.69 (95% CI (-0.93, -0.44), p < 0.001), and the relative risk (RR) of overall complication rate was 0.43 (95% CI (0.27, 0.68), p < 0.001), including the RR of bone cement leakage rate was 0.57 (95% CI (0.39, 0.85), p = 0.005). The screw loosening rate (RR = 0.26, 95% CI (0.13, 0.54), p < 0.001) of the FPS group was significantly lower than that of the CPS group.</p><p><strong>Conclusion: </st
目的:骨水泥增强开窗椎弓根螺钉(FPSs)近年来广泛应用于骨质疏松脊柱的内固定和修复,其固定强度和稳定性均有显著提高。然而,与传统的加固方法相比,骨水泥增强FPSs的优势尚不确定。本文比较了开窗椎弓根螺钉与常规椎弓根螺钉联合骨水泥治疗骨质疏松症的疗效。方法:采用PubMed、Embase、Cochrane图书馆、中国知网、万方、中国生物医学文献服务系统等数据库,对FPSs和cps联合骨水泥加固治疗骨质疏松性椎体内固定进行临床对照研究。两名评价员严格按照纳入标准(受试者诊断、临床研究类型、FPS和CPS治疗、结局指标)和排除标准(文献重复、缺失或错误)筛选相关文献,独立进行资料提取和质量评价。对明确诊断为胸腰椎骨折或脊柱退行性疾病的患者进行FPS与CPS联合骨水泥加固直接比较的临床对照研究。随机对照研究采用Cochrane风险偏倚评价工具,回顾性病例对照研究采用Newcastle-Ottawa量表进行质量评价。采用RevMan软件(version 5.3)进行meta分析,比较两种方法的临床疗效、影像学结果及相关并发症。结果:共纳入文献13篇,其中随机对照研究7篇,回顾性病例对照研究6篇。本研究共909例患者,其中FPS +聚甲基丙烯酸甲酯(FPS + PMMA)组451例,CPS +聚甲基丙烯酸甲酯(CPS + PMMA)组458例。meta分析结果显示,两组患者手术时间、住院时间、视觉模拟评分、日本骨科协会评分、Oswestry残疾指数评分、Cobb角、椎体变形指数、融合率比较,差异均无统计学意义(p < 0.05)。术中出血量平均差值为-10.45,(95%可信区间(CI) (-16.92, -3.98), p = 0.002),术后椎体前端损失高度平均差值为-0.69,(95% CI (-0.93, -0.44), p现有临床证据表明,与CPS联合骨水泥相比,在骨质疏松性椎体内固定中使用FPS修复可以减少术中出血量,更有利于保持椎体高度,并显著减少术后骨水泥渗漏、螺钉松动等并发症的发生。
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引用次数: 0
Protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on a yorkshire model of brain injury after traumatic blood loss. 亚低温机械灌注联合膜肺氧合对创伤性失血脑损伤约克郡模型的保护作用。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-12-22 DOI: 10.1016/j.cjtee.2024.10.003
Xiang-Yu Song, Yang-Hui Dong, Zhi-Bo Jia, Lei-Jia Chen, Meng-Yi Cui, Yan-Jun Guan, Bo-Yao Yang, Si-Ce Wang, Sheng-Feng Chen, Peng-Kai Li, Heng Chen, Hao-Chen Zuo, Zhan-Cheng Yang, Wen-Jing Xu, Ya-Qun Zhao, Jiang Peng
<p><strong>Purpose: </strong>To investigate the protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on ischemic hypoxic injury of yorkshire brain tissue caused by traumatic blood loss.</p><p><strong>Methods: </strong>This article performed a random controlled trial. Brain tissue of 7 yorkshire was selected and divided into the sub-low temperature anterograde machine perfusion group (n = 4) and the blank control group (n = 3) using the random number table method. A yorkshire model of brain tissue injury induced by traumatic blood loss was established. Firstly, the perfusion temperature and blood oxygen saturation were monitored in real-time during the perfusion process. The number of red blood cells, hemoglobin content, NA<sup>+</sup>, K<sup>+</sup>, and Ca<sup>2+</sup> ions concentrations and pH of the perfusate were detected. Following perfusion, we specifically examined the parietal lobe to assess its water content. The prefrontal cortex and hippocampus were then dissected for histological evaluation, allowing us to investigate potential regional differences in tissue injury. The blank control group was sampled directly before perfusion. All statistical analyses and graphs were performed using GraphPad Prism 8.0 Student t-test. All tests were two-sided, and p value of less than 0.05 was considered to indicate statistical significance.</p><p><strong>Results: </strong>The contents of red blood cells and hemoglobin during perfusion were maintained at normal levels but more red blood cells were destroyed 3 h after the perfusion. The blood oxygen saturation of the perfusion group was maintained at 95% - 98%. NA<sup>+</sup> and K<sup>+</sup> concentrations were normal most of the time during perfusion but increased significantly at about 4 h. The Ca<sup>2+</sup> concentration remained within the normal range at each period. Glucose levels were slightly higher than the baseline level. The pH of the perfusion solution was slightly lower at the beginning of perfusion, and then gradually increased to the normal level. The water content of brain tissue in the sub-low and docile perfusion group was 78.95% ± 0.39%, which was significantly higher than that in the control group (75.27% ± 0.55%, t = 10.49, p < 0.001), and the difference was statistically significant. Compared with the blank control group, the structure and morphology of pyramidal neurons in the Prefrontal cortex and CA1 region of the hippocampal gyrus were similar, and their integrity was better. The structural integrity of granulosa neurons was destroyed and cell edema increased in the perfusion group compared with the blank control group. Immunofluorescence staining for glail fibrillary acidic protein and Iba1, markers of glial cells, revealed well-preserved cell structures in the perfusion group. While there were indications of abnormal cellular activity, the analysis showed no significant difference in axon thickness or integrity compared to th
目的:探讨亚低温机械灌注联合膜肺氧合对外伤性失血所致约克郡脑组织缺血性缺氧损伤的保护作用。方法:采用随机对照试验。选取7只大约克羊脑组织,采用随机数字表法分为亚低温顺行机灌注组(n = 4)和空白对照组(n = 3)。建立外伤性失血致脑组织损伤约克郡模型。首先,实时监测灌注过程中的灌注温度和血氧饱和度。检测灌注液红细胞数量、血红蛋白含量、NA+、K+、Ca2+离子浓度及pH值。灌注后,我们专门检查顶叶以评估其含水量。然后解剖前额叶皮层和海马体进行组织学评估,使我们能够研究组织损伤的潜在区域差异。空白对照组在灌注前直接取样。所有统计分析和图表均采用GraphPad Prism 8.0学生t检验。所有检验均为双侧检验,p值小于0.05为有统计学意义。结果:灌注时红细胞和血红蛋白含量维持在正常水平,但灌注后3 h红细胞破坏较多。灌注组血氧饱和度维持在95% ~ 98%。NA+和K+浓度在灌注期间大部分时间正常,但在4 h左右显著升高。Ca2+浓度在各时期保持在正常范围内。血糖水平略高于基线水平。灌注液的pH值在灌注开始时略低,然后逐渐升高至正常水平。亚低温和温和灌注组脑组织含水量为78.95%±0.39%,显著高于对照组(75.27%±0.55%),t = 10.49, p结论:亚低温机灌注可通过持续供氧,维持离子稳态,降低组织代谢水平,改善外伤性失血引起的约克郡脑组织缺血缺氧损伤,延缓约克郡脑组织坏死和凋亡。
{"title":"Protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on a yorkshire model of brain injury after traumatic blood loss.","authors":"Xiang-Yu Song, Yang-Hui Dong, Zhi-Bo Jia, Lei-Jia Chen, Meng-Yi Cui, Yan-Jun Guan, Bo-Yao Yang, Si-Ce Wang, Sheng-Feng Chen, Peng-Kai Li, Heng Chen, Hao-Chen Zuo, Zhan-Cheng Yang, Wen-Jing Xu, Ya-Qun Zhao, Jiang Peng","doi":"10.1016/j.cjtee.2024.10.003","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.10.003","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To investigate the protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on ischemic hypoxic injury of yorkshire brain tissue caused by traumatic blood loss.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This article performed a random controlled trial. Brain tissue of 7 yorkshire was selected and divided into the sub-low temperature anterograde machine perfusion group (n = 4) and the blank control group (n = 3) using the random number table method. A yorkshire model of brain tissue injury induced by traumatic blood loss was established. Firstly, the perfusion temperature and blood oxygen saturation were monitored in real-time during the perfusion process. The number of red blood cells, hemoglobin content, NA&lt;sup&gt;+&lt;/sup&gt;, K&lt;sup&gt;+&lt;/sup&gt;, and Ca&lt;sup&gt;2+&lt;/sup&gt; ions concentrations and pH of the perfusate were detected. Following perfusion, we specifically examined the parietal lobe to assess its water content. The prefrontal cortex and hippocampus were then dissected for histological evaluation, allowing us to investigate potential regional differences in tissue injury. The blank control group was sampled directly before perfusion. All statistical analyses and graphs were performed using GraphPad Prism 8.0 Student t-test. All tests were two-sided, and p value of less than 0.05 was considered to indicate statistical significance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The contents of red blood cells and hemoglobin during perfusion were maintained at normal levels but more red blood cells were destroyed 3 h after the perfusion. The blood oxygen saturation of the perfusion group was maintained at 95% - 98%. NA&lt;sup&gt;+&lt;/sup&gt; and K&lt;sup&gt;+&lt;/sup&gt; concentrations were normal most of the time during perfusion but increased significantly at about 4 h. The Ca&lt;sup&gt;2+&lt;/sup&gt; concentration remained within the normal range at each period. Glucose levels were slightly higher than the baseline level. The pH of the perfusion solution was slightly lower at the beginning of perfusion, and then gradually increased to the normal level. The water content of brain tissue in the sub-low and docile perfusion group was 78.95% ± 0.39%, which was significantly higher than that in the control group (75.27% ± 0.55%, t = 10.49, p &lt; 0.001), and the difference was statistically significant. Compared with the blank control group, the structure and morphology of pyramidal neurons in the Prefrontal cortex and CA1 region of the hippocampal gyrus were similar, and their integrity was better. The structural integrity of granulosa neurons was destroyed and cell edema increased in the perfusion group compared with the blank control group. Immunofluorescence staining for glail fibrillary acidic protein and Iba1, markers of glial cells, revealed well-preserved cell structures in the perfusion group. While there were indications of abnormal cellular activity, the analysis showed no significant difference in axon thickness or integrity compared to th","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Total laparoscopic closed reduction and internal fixation for AO/OTA B2.1 pelvic fracture: A case report and literature review. 全腹腔镜闭合复位和内固定治疗 AO/OTA B2.1 骨盆骨折:病例报告和文献综述。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-12-11 DOI: 10.1016/j.cjtee.2024.10.002
Huanyu Shi, Xiao Zhong, Yan Wang, Wei Chen, Hao Tan, Wanfei Wu, Lianyang Zhang, Yang Li

Endoscopic techniques have been widely used in orthopedic surgery, such as arthroscopy and transforaminal endoscopy, but the application in fracture is rarely reported. We reported a case of a 69-year-old male with pelvic fracture (AO/OTA type B2.1) who underwent successful laparoscopy-assisted pubic ramus plate fixation without auxiliary incision. We designed and applied a separate custom-made lengthening surgical instrument for internal fixation installation suitable for laparoscopic surgery, and the entire reduction and internal fixation installation were performed under laparoscopy. The patient could sit up 1 day after surgery, and the reported pain visual analogue scale score decreased from 5 points before surgery to 1 point. At 2 weeks after surgery, the patient could walk with a single crutch. At 4 weeks after surgery, the Majeed score was 73 points, and at 10 weeks after surgery, the Majeed score increased to 81 points. Twelve weeks after surgery, the patient was able to walk independently without pain, defecation and urination function, and the Majeed score was 87. Laparoscopic surgery is a new strategy for treating pelvic ring fractures. The case proves that full laparoscopic-assisted closed reduction and internal fixation of pelvic fractures is feasible.

内窥镜技术已广泛应用于骨科手术,如关节镜、椎间孔内窥镜等,但在骨折中的应用鲜有报道。我们报告了一例69岁男性骨盆骨折(AO/OTA型B2.1),他成功地接受了腹腔镜辅助耻骨支钢板固定,没有辅助切口。我们设计并应用了适用于腹腔镜手术的单独定制的内固定安装加长手术器械,在腹腔镜下完成整个复位和内固定安装。术后1天患者可坐起,疼痛视觉模拟评分由术前5分下降至1分。术后2周,患者可单根拐杖行走。术后4周,Majeed评分为73分,术后10周,Majeed评分上升至81分。术后12周,患者能够独立行走,无疼痛,无排便和排尿功能,Majeed评分为87分。腹腔镜手术是治疗骨盆环骨折的新策略。本病例证明全腹腔镜辅助下骨盆骨折闭合复位内固定是可行的。
{"title":"Total laparoscopic closed reduction and internal fixation for AO/OTA B2.1 pelvic fracture: A case report and literature review.","authors":"Huanyu Shi, Xiao Zhong, Yan Wang, Wei Chen, Hao Tan, Wanfei Wu, Lianyang Zhang, Yang Li","doi":"10.1016/j.cjtee.2024.10.002","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.10.002","url":null,"abstract":"<p><p>Endoscopic techniques have been widely used in orthopedic surgery, such as arthroscopy and transforaminal endoscopy, but the application in fracture is rarely reported. We reported a case of a 69-year-old male with pelvic fracture (AO/OTA type B2.1) who underwent successful laparoscopy-assisted pubic ramus plate fixation without auxiliary incision. We designed and applied a separate custom-made lengthening surgical instrument for internal fixation installation suitable for laparoscopic surgery, and the entire reduction and internal fixation installation were performed under laparoscopy. The patient could sit up 1 day after surgery, and the reported pain visual analogue scale score decreased from 5 points before surgery to 1 point. At 2 weeks after surgery, the patient could walk with a single crutch. At 4 weeks after surgery, the Majeed score was 73 points, and at 10 weeks after surgery, the Majeed score increased to 81 points. Twelve weeks after surgery, the patient was able to walk independently without pain, defecation and urination function, and the Majeed score was 87. Laparoscopic surgery is a new strategy for treating pelvic ring fractures. The case proves that full laparoscopic-assisted closed reduction and internal fixation of pelvic fractures is feasible.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Peri-implant femoral fractures in elderly: Morbidity, mortality, treatment options and good practices. 老年人股骨假体周围骨折:发病率、死亡率、治疗选择和良好做法。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-12-09 DOI: 10.1016/j.cjtee.2024.07.012
Luca Bianco Prevot, Vittorio Bolcato, Stefania Fozzato, Riccardo Accetta, Michela Basile, Livio Pietro Tronconi, Giuseppe Basile

Purpose: Femur fractures are among the most common fractures treated surgically, representing a significant challenge for the orthopedic surgeon. Peri-implant femoral fractures (PIFFs) represent a rare complication of the surgical treatment. It is necessary to pay attention during osteosynthesis, evaluating not only the fracture site but the entire femoral skeletal structure, the characteristics of the fracture, the health comorbidities, and the risk of malunion and pseudarthrosis. There are few studies on the incidence, treatment, and outcomes of PIFFs near osteosynthesis. This study aimed to investigate PIFF after osteosynthesis of femoral fractures and evaluate the mortality after surgery and the morbidity associated with these types of fractures.

Methods: A retrospective cohort study was carried out at the IRCCS Galeazzi Orthopedic Institute, Milan, Italy, between January, 2017 and December, 2022. Inclusion criteria were the presence of a femur fracture around an intramedullary nail to treat a previous fracture, follow-up ≥ 12 months, and patient age ≥ 65 years. Exclusion criterion was intraoperative periprosthetic fractures. The data were expressed as frequency and percentage. Continuous variables were expressed as mean ± standard deviation or median and range.

Results: Overall, 25 patients were enrolled (88.0% female) and the mean age was 84.5 years (range of 70 - 92 years). There were 20 patients having type B PIFF and 5 having type C. In 22 patients, multiple comorbidities were found with an average Charlson comorbidity score of 5.5 and the mean time to peri-implant fracture was 38 months. After surgery, 1 patient (4.0%) presented renal failure, 1 (4.0%) needed removal surgery for their loosening, and 2 (8.0%) presented surgical site infection. Nine patients (36.0%) died within 1 year with a mortality rate of 20. 0% at 30 days, 8.0% at 3 months, and 8.0% at 12 months.

Conclusions: PIFFs in elderly patients are associated with high short-term mortality and morbidity, so careful planning for primary fracture surgery and patient awareness to ensure prolonged compliance and a healthy lifestyle are essential for prevention.

目的:股骨骨折是外科治疗中最常见的骨折之一,对骨科医生来说是一个重大的挑战。股骨假体周围骨折(PIFFs)是手术治疗中一种罕见的并发症。在植骨过程中要注意,不仅要评估骨折部位,还要评估整个股骨骨骼结构、骨折特征、健康合并症、畸形愈合和假关节的风险。关于骨融合术附近piff的发生率、治疗和结局的研究很少。本研究旨在探讨股骨骨折植骨后的PIFF,并评估其术后死亡率和与此类骨折相关的发病率。方法:回顾性队列研究于2017年1月至2022年12月在意大利米兰的IRCCS Galeazzi骨科研究所进行。纳入标准为既往骨折治疗时髓内钉周围存在股骨骨折,随访≥12个月,患者年龄≥65岁。排除标准为术中假体周围骨折。数据以频率和百分比表示。连续变量以均数±标准差或中位数和极差表示。结果:共纳入25例患者(88.0%为女性),平均年龄为84.5岁(70 - 92岁)。20例患者为B型PIFF, 5例为c型。22例患者存在多种合并症,Charlson合并症平均评分为5.5,平均种植体周围骨折时间为38个月。术后1例(4.0%)出现肾功能衰竭,1例(4.0%)因肾脏松动需要切除,2例(8.0%)出现手术部位感染。1年内死亡9例(36.0%),死亡率为20。30天0%,3个月8.0%,12个月8.0%。结论:老年患者的PIFFs与较高的短期死亡率和发病率相关,因此精心规划原发性骨折手术,患者意识确保长期依从性和健康的生活方式对预防至关重要。
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引用次数: 0
Minimally invasive reduction of irreducible, sagittally unstable peritrochanteric fractures: Novel technique and early results. 不可复位、矢状不稳定转子周围骨折的微创复位:新技术和早期结果。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-12-06 DOI: 10.1016/j.cjtee.2024.08.010
Ke Li, Xing Du, Zhongyao Chen, Wei Shui

Purpose: The management of irreducible, sagittally unstable peritrochanteric fractures presents a significant challenge due to the inability to achieve closed reduction using conventional techniques. This study introduces a novel minimally invasive technique leveraging the mechanical advantage principle with long, angled hemostatic clamps.

Methods: A retrospective review was performed on 16 patients who sustained sagittally unstable peritrochanteric fractures and underwent a percutaneous hemostatic clamp leverage reduction procedure.

Inclusion criteria: (1) Preoperative confirmation of fracture type as peritrochanteric fracture; (2) Intraoperative imaging confirms the presence of sagittal plane displacement at the fracture site; (3) Age > 18 years.

Exclusion criteria: (1) Open fractures, pathological fractures, and diabetes; (2) Long-term use of corticosteroids; (3) Patients with local skin or systemic conditions not suitable for surgery. Regular follow-ups at intervals of 6 - 8 weeks continued until evidence of bone consolidation was apparent in radiographic assessments. Evaluation of the alignment quality considered factors such as the re-establishment of the neck-shaft angle, the integrity of all cortical bone edges, and the rectification of any translational displacement, while the assessment of hip functionality was performed using the Harris scoring system. Statistical analysis of the relevant data was performed using SPSS 25.0 software.

Results: The average age of these 16 patients was 56.8 years (ranging from 25 to 81 years), consisting of 8 males and 8 females. According to the AO/OTA fracture classification, the cohort included 13 cases of type 31A, 2 cases of type 32A, and 1 case of type 32C. The time from hospital admission to the day of surgery ranged from 3 to 11 days, with an average of 5.1 days. Closed reduction was successfully implemented in all 10 instances, negating the necessity for transition to open reduction procedures. The mean operative duration was 105.8 min (range 80 - 180 min). Satisfactory results of the quality of reduction were determined by comparison with the normal side. The average Harris hip score was 94.1 (range 87 - 99), and the fracture healing time was 4.2 months (3 - 6 months). Implant failure and malunion were not observed.

Conclusions: This study provides an alternative, minimally invasive technique for reducing sagittally unstable, irreducible peritrochanteric fractures. This technique holds the potential to manage complex fractures with the same efficacy as is typically reserved for simple and easily reducible fractures.

目的:由于传统技术无法实现闭合复位,因此无法复位、矢状面不稳定的转子周围骨折的治疗面临重大挑战。本研究介绍一种新颖的微创技术,利用长角度止血钳的机械优势原理。方法:对16例经皮止血钳杠杆复位术治疗的矢状不稳定转子周围骨折患者进行回顾性分析。纳入标准:(1)术前确认骨折类型为转子周围骨折;(2)术中影像学证实骨折部位矢状面移位;(3)年龄:18岁。排除标准:(1)开放性骨折、病理性骨折、糖尿病患者;(2)长期使用皮质类固醇;(3)局部皮肤或全身状况不适合手术的患者。定期随访,间隔6 - 8周,直到在x线评估中有明显的骨巩固证据。对对齐质量的评估考虑了诸如颈轴角的重建、所有皮质骨边缘的完整性以及任何平移位移的矫正等因素,同时使用Harris评分系统对髋关节功能进行评估。采用SPSS 25.0软件对相关数据进行统计分析。结果:16例患者平均年龄56.8岁(25 ~ 81岁),男8例,女8例。根据AO/OTA骨折分类,该队列包括31A型13例,32A型2例,32C型1例。从入院到手术当天的时间为3 ~ 11天,平均5.1天。所有10例病例均成功实施闭合复位,无需过渡到开放式复位。平均手术时间为105.8 min (80 ~ 180 min)。通过与正常侧的对比,确定了满意的还原质量。Harris髋关节评分平均为94.1(范围87 ~ 99),骨折愈合时间4.2个月(3 ~ 6个月)。未见种植体失败和畸形愈合。结论:本研究为降低矢状面不稳定、不可复位的转子周围骨折提供了一种替代的微创技术。该技术具有治疗复杂骨折的潜力,其疗效与通常用于简单且易于复位的骨折相同。
{"title":"Minimally invasive reduction of irreducible, sagittally unstable peritrochanteric fractures: Novel technique and early results.","authors":"Ke Li, Xing Du, Zhongyao Chen, Wei Shui","doi":"10.1016/j.cjtee.2024.08.010","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.08.010","url":null,"abstract":"<p><strong>Purpose: </strong>The management of irreducible, sagittally unstable peritrochanteric fractures presents a significant challenge due to the inability to achieve closed reduction using conventional techniques. This study introduces a novel minimally invasive technique leveraging the mechanical advantage principle with long, angled hemostatic clamps.</p><p><strong>Methods: </strong>A retrospective review was performed on 16 patients who sustained sagittally unstable peritrochanteric fractures and underwent a percutaneous hemostatic clamp leverage reduction procedure.</p><p><strong>Inclusion criteria: </strong>(1) Preoperative confirmation of fracture type as peritrochanteric fracture; (2) Intraoperative imaging confirms the presence of sagittal plane displacement at the fracture site; (3) Age > 18 years.</p><p><strong>Exclusion criteria: </strong>(1) Open fractures, pathological fractures, and diabetes; (2) Long-term use of corticosteroids; (3) Patients with local skin or systemic conditions not suitable for surgery. Regular follow-ups at intervals of 6 - 8 weeks continued until evidence of bone consolidation was apparent in radiographic assessments. Evaluation of the alignment quality considered factors such as the re-establishment of the neck-shaft angle, the integrity of all cortical bone edges, and the rectification of any translational displacement, while the assessment of hip functionality was performed using the Harris scoring system. Statistical analysis of the relevant data was performed using SPSS 25.0 software.</p><p><strong>Results: </strong>The average age of these 16 patients was 56.8 years (ranging from 25 to 81 years), consisting of 8 males and 8 females. According to the AO/OTA fracture classification, the cohort included 13 cases of type 31A, 2 cases of type 32A, and 1 case of type 32C. The time from hospital admission to the day of surgery ranged from 3 to 11 days, with an average of 5.1 days. Closed reduction was successfully implemented in all 10 instances, negating the necessity for transition to open reduction procedures. The mean operative duration was 105.8 min (range 80 - 180 min). Satisfactory results of the quality of reduction were determined by comparison with the normal side. The average Harris hip score was 94.1 (range 87 - 99), and the fracture healing time was 4.2 months (3 - 6 months). Implant failure and malunion were not observed.</p><p><strong>Conclusions: </strong>This study provides an alternative, minimally invasive technique for reducing sagittally unstable, irreducible peritrochanteric fractures. This technique holds the potential to manage complex fractures with the same efficacy as is typically reserved for simple and easily reducible fractures.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
FM1-Editorial board FM1-编辑部
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-11-20 DOI: 10.1016/S1008-1275(24)00121-4
{"title":"FM1-Editorial board","authors":"","doi":"10.1016/S1008-1275(24)00121-4","DOIUrl":"10.1016/S1008-1275(24)00121-4","url":null,"abstract":"","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 6","pages":"Page i"},"PeriodicalIF":1.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The basal cisternostomy for management of severe traumatic brain injury: A retrospective study. 基底池造口术治疗严重外伤性脑损伤:回顾性研究。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-11-20 DOI: 10.1016/j.cjtee.2024.09.007
Tangrui Han, Zhiqiang Jia, Xiaokai Zhang, Hao Wu, Qiang Li, Shiqi Cheng, Yan Zhang, Yonghong Wang

Purpose: Traumatic brain injury (TBI) is a significant public health issue that impacts individuals all over the world and is one of the main causes of mortality and morbidity. Decompressive craniectomy is the usual course of treatment. Basal cisternostomy has been shown to be highly effective as an alternative procedure to decompressive craniectomy.

Methods: We conducted a retrospective cohort of patients who received surgery for severe TBI between January 2019 and March 2023. Inclusion criterias were patients between the ages of 18 and 70 years who met the diagnostic criteria for severe TBI at first presentation and who underwent surgical intervention. The exclusion criteria were patients who have severe multiple injuries at the time of admission; preoperative intracranial pressure > 60 mmHg; cognitive impairment before the onset of the disease; hematologic disorders; or impaired functioning of the heart, liver, kidneys, or other visceral organs. Depending on the surgical approach, the patients were categorized into decompressive craniectomy group as well as basal cisternostomy group. General data and postoperative indicators, including Glasgow coma scale, intracranial pressure, etc., were recorded for both groups of patients. Among them, the Glasgow outcome scale extended assessment at 6 months served as the primary outcome. After that, the data were statistically analyzed using SPSS software.

Results: The trial enrolled 41 patients (32 men and 9 women) who met the inclusion criteria. Among them, 25 patients received decompressive decompressive craniectomy, and 16 patients received basal cisternostomy. Three days postoperative intracranial pressure levels were 10.07 ± 2.94 mmHg and 17.15 ± 14.65 mmHg (p = 0.013), respectively. The 6 months following discharge Glasgow outcome scale extended of patients was 4.73 ± 2.28 and 3.14 ± 2.15 (p = 0.027), respectively.

Conclusion: Our study reveals that basal cisternostomy in patients with surgically treated severe TBI has demonstrated significant efficacy in reducing intracranial pressure as well as patient prognosis follow-up and avoids removal of the bone flap. The efficacy of cisternostomy has to be studied in larger, multi-clinical center randomized trials.

目的:创伤性脑损伤(TBI)是影响全世界个体的重大公共卫生问题,是导致死亡和发病的主要原因之一。通常的治疗方法是开颅减压术。基底脑池造口术已被证明是一种非常有效的替代手术,以减压颅骨切除术。方法:我们对2019年1月至2023年3月期间接受严重TBI手术的患者进行了回顾性队列研究。纳入标准是年龄在18岁至70岁之间,首次出现时符合严重TBI诊断标准并接受手术干预的患者。排除标准为入院时有严重多发伤的患者;术前颅内压> 60 mmHg;发病前的认知障碍;血液疾病;或心脏、肝脏、肾脏或其他内脏器官功能受损。根据手术入路的不同,将患者分为减压开颅组和基底池造口组。记录两组患者一般资料及术后指标,包括格拉斯哥昏迷评分、颅内压等。其中,6个月时的格拉斯哥结局量表扩展评估作为主要结局。之后,使用SPSS软件对数据进行统计分析。结果:该试验纳入41例患者(32男9女),符合纳入标准。其中25例行减压颅脑切除术,16例行基底池造口术。术后3 d颅内压分别为10.07±2.94 mmHg和17.15±14.65 mmHg (p = 0.013)。患者出院后6个月格拉斯哥预后量表延长值分别为4.73±2.28和3.14±2.15 (p = 0.027)。结论:我们的研究表明,基底池造瘘术在外科治疗的严重TBI患者中具有显著的降低颅内压和患者预后随访的效果,并且避免了骨瓣的切除。胆池造口术的疗效需要在更大的、多临床中心的随机试验中进行研究。
{"title":"The basal cisternostomy for management of severe traumatic brain injury: A retrospective study.","authors":"Tangrui Han, Zhiqiang Jia, Xiaokai Zhang, Hao Wu, Qiang Li, Shiqi Cheng, Yan Zhang, Yonghong Wang","doi":"10.1016/j.cjtee.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.09.007","url":null,"abstract":"<p><strong>Purpose: </strong>Traumatic brain injury (TBI) is a significant public health issue that impacts individuals all over the world and is one of the main causes of mortality and morbidity. Decompressive craniectomy is the usual course of treatment. Basal cisternostomy has been shown to be highly effective as an alternative procedure to decompressive craniectomy.</p><p><strong>Methods: </strong>We conducted a retrospective cohort of patients who received surgery for severe TBI between January 2019 and March 2023. Inclusion criterias were patients between the ages of 18 and 70 years who met the diagnostic criteria for severe TBI at first presentation and who underwent surgical intervention. The exclusion criteria were patients who have severe multiple injuries at the time of admission; preoperative intracranial pressure > 60 mmHg; cognitive impairment before the onset of the disease; hematologic disorders; or impaired functioning of the heart, liver, kidneys, or other visceral organs. Depending on the surgical approach, the patients were categorized into decompressive craniectomy group as well as basal cisternostomy group. General data and postoperative indicators, including Glasgow coma scale, intracranial pressure, etc., were recorded for both groups of patients. Among them, the Glasgow outcome scale extended assessment at 6 months served as the primary outcome. After that, the data were statistically analyzed using SPSS software.</p><p><strong>Results: </strong>The trial enrolled 41 patients (32 men and 9 women) who met the inclusion criteria. Among them, 25 patients received decompressive decompressive craniectomy, and 16 patients received basal cisternostomy. Three days postoperative intracranial pressure levels were 10.07 ± 2.94 mmHg and 17.15 ± 14.65 mmHg (p = 0.013), respectively. The 6 months following discharge Glasgow outcome scale extended of patients was 4.73 ± 2.28 and 3.14 ± 2.15 (p = 0.027), respectively.</p><p><strong>Conclusion: </strong>Our study reveals that basal cisternostomy in patients with surgically treated severe TBI has demonstrated significant efficacy in reducing intracranial pressure as well as patient prognosis follow-up and avoids removal of the bone flap. The efficacy of cisternostomy has to be studied in larger, multi-clinical center randomized trials.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bone loss in patients with spinal cord injury: Incidence and influencing factors. 脊髓损伤患者骨质流失的发生率及影响因素。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-11-15 DOI: 10.1016/j.cjtee.2024.05.003
Min Jiang, Jun-Wei Zhang, He-Hu Tang, Yu-Fei Meng, Zhen-Rong Zhang, Fang-Yong Wang, Jin-Zhu Bai, Shu-Jia Liu, Zhen Lyu, Shi-Zheng Chen, Jie-Sheng Liu, Jia-Xin Fu

Purpose: To investigate the incidence and influencing factors of bone loss in patients with spinal cord injury (SCI).

Methods: A retrospective case-control study was conducted. Patients with SCI in our hospital from January 2019 to March 2023 were collected. According to the correlation between bone mineral density (BMD) at different sites, the patients were divided into the lumbar spine group (T) and the hip joint group. According to the BMD value, the patients were divided into the normal bone mass group (t > -1.0 standard deviation) and the osteopenia group (t ≤ -1.0 standard deviation). The influencing factors accumulated as follows: gender, age, height, weight, cause of injury, injury segment, injury degree, time after injury, start time of rehabilitation, motor score, sensory score, spasticity, serum value of alkaline phosphatase, calcium, and phosphorus. The trend chart was drawn and the influencing factors were analyzed. SPSS 26.0 was used for statistical analysis. Correlation analysis was used to test the correlation between the BMD values of the lumbar spine and bilateral hips. Binary logistic regression analysis was used to explore the influencing factors of osteoporosis after SCI. p < 0.05 was considered statistically significant.

Results: The incidence of bone loss in patients with SCI was 66.3%. There was a low concordance between bone loss in the lumbar spine and the hip, and the hip was particularly susceptible to bone loss after SCI, with an upward trend in incidence (36% - 82%). In this study, patients with SCI were divided into the lumbar spine group (n = 100) and the hip group (n = 185) according to the BMD values of different sites. Then, the lumbar spine group was divided into the normal bone mass group (n = 53) and the osteopenia group (n = 47); the hip joint group was divided into the normal bone mass group (n = 83) and the osteopenia group (n = 102). Of these, lumbar bone loss after SCI is correlated with gender and weight (p = 0.032 and < 0.001, respectively), and hip bone loss is correlated with gender, height, weight, and time since injury (p < 0.001, p = 0.015, 0.009, and 0.012, respectively).

Conclusions: The incidence of bone loss after SCI was high, especially in the hip. The incidence and influencing factors of bone loss in the lumbar spine and hip were different. Patients with SCI who are male, low height, lightweight, and long time after injury were more likely to have bone loss.

目的:探讨脊髓损伤(SCI)患者骨丢失的发生率及影响因素。方法:采用回顾性病例对照研究。收集2019年1月至2023年3月我院收治的SCI患者。根据不同部位骨密度(BMD)的相关性,将患者分为腰椎组(T)和髋关节组。根据骨密度值将患者分为正常骨量组(t≤-1.0标准差)和骨质减少组(t≤-1.0标准差)。影响因素累积如下:性别、年龄、身高、体重、损伤原因、损伤节段、损伤程度、损伤后时间、康复开始时间、运动评分、感觉评分、痉挛、血清碱性磷酸酶值、钙、磷。绘制了趋势图,并分析了影响因素。采用SPSS 26.0进行统计分析。采用相关分析检验腰椎与双侧髋关节骨密度值的相关性。采用二元logistic回归分析探讨脊髓损伤后骨质疏松的影响因素。结果:脊髓损伤患者骨丢失发生率为66.3%。腰椎和髋关节骨质流失的一致性较低,而髋关节在脊髓损伤后特别容易发生骨质流失,其发生率呈上升趋势(36% - 82%)。本研究根据不同部位BMD值将SCI患者分为腰椎组(n = 100)和髋关节组(n = 185)。然后将腰椎组分为骨量正常组(n = 53)和骨质减少组(n = 47);将髋关节组分为骨量正常组(n = 83)和骨质减少组(n = 102)。其中,脊髓损伤后腰椎骨丢失与性别和体重相关(p分别= 0.032和< 0.001),髋部骨丢失与性别、身高、体重和损伤后时间相关(p分别< 0.001、p = 0.015、0.009和0.012)。结论:脊髓损伤后骨丢失的发生率较高,尤其是在髋关节。腰椎、髋部骨质流失的发生率及影响因素不同。男性、低身高、体重轻、伤后时间长的SCI患者更易发生骨质流失。
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引用次数: 0
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Chinese Journal of Traumatology
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