1.Treatment of displaced intra-articular calcaneus fractures using the extensile lateral approach and internal fixation
Yunfei LI ; Sheng GAO ; Pingchang XI
Orthopedic Journal of China 2006;0(18):-
[Objective]To evaluate our protocol with the extensile lateral approach to open reduction and internal fixation in the treatment of displaced intra-articular calcaneus fractures.[Method]From 2001 to 2005,35 patients(41 feets)were treated with open reduction and internal fixation using extensile lateral approach,with 25 right feet and 16 left feet and with plate fixation using in 40 cases,single screw fixation using in 1 case.[Result]Evaluated with postoperative plain radiographs,90%(37/41) fracture had anatomic or near anatomic reduction of posterior facet.73%(30/41) Bhler angle above than 20? in 28 cases,32 feets among the patients were followed up at a mean of 14 months(ranged,9 to 24 mouths) and evaluated according to hind foot and ankle score system of AOFAS,average score was 87.The function were satisfactory.It took average 4 month to come back normal action,none of nerves injury,4 patients had wound hematoma.Two cases developed surgical wound edge necrosis and dehiscence among them,who were treated in initial phase in the treat group,the 2 cases were managed with dressing changes and healed in 1 month,whitout skin flaps and grafts.[Conclusion]Open reduction and internal fixation using lateral approach is a better choice to treat intra-articular calcaneal fractures,because it can correct directly the pathology of calcaneal fractures.Anatomical reduction of joint congruity and the shape of the calcaneus are important prognostic factors.
2.Biomechanical comparison of surgical operation and non-operation therapy for acute damnification of elbow ulnar collateral ligament in rabbits
Lude YANG ; Xianlong ZHANG ; Yijin WANG ; Pingchang XI ; Sheng GAO
Chinese Journal of Trauma 2010;26(4):370-374
Objective To compare the difference of therapeutic effect of surgical operation and non-operation for acute damnification of elbow ulnar collateral ligament in rabbits.Methods A total of 81 New Zealand rabbits were randomly and equally divided into three groups(27 rabbits per group),ie,Group A(control group):the ulnar collateral ligaments of right elbow joint were only enclosed;Group B:the ulnar collateral ligaments of right elbow joint were severed and sutured;Group C:the ulnar collateral ligaments of right elbow joint were severed,without suture.The biomechanics was detected at time intervals of 3 and 6 weeks.Results Twelve weeks after transplantation,the displacements of the ligaments in Groups B and C were(6.06±0.4)mm and(7.72±0.44)mm,with statistical difference(P < 0.05).The displacement of the ligaments in Group A was(5.87±0.46)mm,which was similar to that of Group B(P>0.05).The maximum loads of the ligaments of Groups B and C were(68.23±5.64)N and (42.45±3.66)N respectively,with statistical difference(P<0.05).The maximum load of the ligaments of Group A was(72.86±2.99)N,which was similar to that of Group B(P > 0.05).The rigidities of the ligaments of Groups B and C were(11.33±1.52)N/mm and(5.52±0.67)N/mm respectively,with significant difference(P < 0.05).The rigidities of the ligaments of Group A was(12.49±1.44)N/mm,which was similar to that of Group B(P > 0.05).The power consumption of the ligaments of Groups B and C were(0.206±0.017)J and(0.163±0.013)J respectively,with statistical difference(P<0.05).The power consumption of the ligaments of Group A was(0.213±0.010)J,which was similar to that of Group B(P>0.05).Conclusion Surgical operation is more effective than the non-operation in dealing with acute damnification of the ulnar collateral ligaments of elbow ulnar collateral ligament in rabbits.