1.Orthopedic manipulation combined with percutaneous reduction and Kirschner wire internal fixation for Sanders typeⅡand Ⅲ calcaneal fractures.
Feng DAI ; Jin-Tao LIU ; Zhi-Gang ZHANG ; Xue-Qiang SHEN ; Li-Ming WU ; Peng-Fei YU ; Hong JIANG
China Journal of Orthopaedics and Traumatology 2025;38(3):306-310
OBJECTIVE:
To explore clinical effects of bone setting manipulation combined with pry reduction and Kirschner needle internal fixation in treating SandersⅡ-Ⅲ calcaneal fracture.
METHODS:
Clinical data of 52 patients with types Sanders Ⅱand Ⅲ calcaneal fracture (foot) treated with bone-setting manipulation combined with pry reduction and Kirscher needle internal fixation from July 2017 to July 2019 were retrospectively analyzed, including 43 males and 9 females, aged from 31 to 72 years old with an average of (50.83±10.48) years old; 15 patients with Sanders typeⅡ and 37 patients with Sanders type Ⅲ. The changes of Bühler angle, Gissane angle, calcaneus width and calcaneus height before operation and 24 months after operation were compared, and Maryland foot function score was performed to evaluate clinical effects.
RESULTS:
All patients were followed up from 24 to 60 months with an average of (41.50±9.86)months. The fracture healed normally and the healing time was (11.00±0.95) weeks. Bühler angle, Gissane angle, calcaneal bone width and calcaneal bone height were increased from (16.37±8.36)°, (96.27±9.62)°, (46.82±4.67) mm, (38.41±3.58) mm before operation to (31.48±8.24)°, (111.62±8.69)°, (42.06±4.83) mm, (44.21±3.82) mm at 24 months after operation, and the difference were statistically significant (P<0.01). Postoperative Maryland score at 24 months was (93.04±8.83), 40 patients got excellent result, 7 good and 5 fair.
CONCLUSION
Orthopedic manipulation combined with percutaneous reduction and Kirschner wire internal fixation could significantly improve Bühler angle, Gissane angle, width, and height of Sanders typeⅡ and Ⅲ calcaneal fractures, and the curative effect is satisfactory.
Humans
;
Male
;
Female
;
Calcaneus/surgery*
;
Middle Aged
;
Fracture Fixation, Internal/methods*
;
Adult
;
Aged
;
Fractures, Bone/therapy*
;
Retrospective Studies
;
Bone Wires
;
Manipulation, Orthopedic/methods*
2.Clinical study on the efficacy of unicompartmental knee arthroplasty in elderly patients with medial osteoarthritis and anterior cruciate ligament deficiency.
Hai-Song LIANG ; Dong SHENG ; Xiao-Su HUI ; Xin-Wen BAI ; Yu DENG ; Cong-Ke SHU ; Fa-Song XIANG
China Journal of Orthopaedics and Traumatology 2025;38(4):336-342
OBJECTIVE:
To investigate the short-and med-term clinical efficacy of unicompartmental knee arthroplasty(UKA)for the treatment of medial knee osteoarthritis (OA) in elderly patients with anterior cruciate ligament deficiency(ACLD).
METHODS:
A retrospective analysis was conducted on 31 patients aged over 75 years old with primary medial knee OA and ACLD who underwent UKA between January 2018 and December 2022. The cohort included 12 males and 19 females, aged from 75 to 91 years with an average age of (79.56±4.54) years, with 13 left knee, 16 right knee, and 2 bilateral knees. Clinical outcomes were assessed preoperatively and at final follow-up using the visual analogue scale (VAS), Hospital for Special Surgery(HSS) score, range of motion (ROM), hip-knee-ankle angle (HKA), and tibial component posterior slope angle (TCPSA). Complications such as infection, prosthesis wear, prosthesis loosening, and dislocation were also recorded.
RESULTS:
All 31 patients were followed up from 12 to 63 months with an average of (28.34±10.56) months. The average postoperative TCPSA was (4.83±1.31)° ranged from 2.5° to 6.8°. At the final follow-up, there was significant improvement in VAS (3.24±0.53) vs. (6.59±0.69), HSS score (85.19±4.45) vs. (64.38±5.94), ROM (118.83±5.38)° vs. (98.85±4.08)°, and HKA (176.83±5.16)° vs. (169.57±6.28)° compared to preoperative values (P<0.05). No cases of infection, prosthesis loosening, or dislocation were reported.
CONCLUSION
UKA provides favorable short-and mid-term outcomes for elderly patients with medial knee OA and ACLD . However, long-term clinical efficacy needs further investigation through extended follow-up.
Humans
;
Male
;
Female
;
Arthroplasty, Replacement, Knee/methods*
;
Aged
;
Osteoarthritis, Knee/physiopathology*
;
Retrospective Studies
;
Aged, 80 and over
;
Range of Motion, Articular
;
Anterior Cruciate Ligament Injuries/surgery*
3.Vitamin D and bone metabolism characteristics in knee osteoarthritis with osteoporosis patients.
Xue-Zong WANG ; Yu LU ; Dao-Fang DING ; Yu-Xin ZHENG ; Yue-Long CAO
China Journal of Orthopaedics and Traumatology 2025;38(4):352-357
OBJECTIVE:
To investigate the characteristics of Vitamin D (VitD) and bone metabolism in patients with knee osteoarthritis (KOA) concurrent with osteoporosis (OP).
METHODS:
A retrospective analysis was performed on 240 patients who were admitted to the orthopedics department between March 2019 and March 2024. Patients were stratified into four distinct groups according to their respective disease categories.There were 90 patients in the simple KOA group, comprising 13 males and 77 females, age ranged from 50 to 91 years old with an average of (68.48±8.96) years old. There were 90 patients in the simple OP group, comprising 7 males and 83 females, age ranged from 52 to 88 years old with an average of (69.60±8.94 )years old. There were 30 patients in the KOA with OP group, comprising 1 male and 29 females, age ranged from 51 to 91 years old with an average of(69.03±7.93) years old. There were 30 patients in the physical examination group, comprising 5 males and 25 females, age ranged from 53 to 79 years old with an average of(64.93±6.51) years old. The general data and the levels of osteocalcin (OC), β-CrossLaps, parathyroid hormone(PTH) and VitD in each group were observed.
RESULTS:
The level of VitD in KOA with OP group (19.62±10.38) ng·ml-1 and OP group (20.65±10.50) ng·ml-1 was lower than that in physical examination group (27.46±8.00) ng·ml-1 and KOA group (24.01±9.11) ng·ml-1 (P<0.05). There were significant differences in β- CrossLaps and PTH levels among the four groups (P<0.001, P=0.019, respectively), while there was no significant difference in OC levels (P=0.763). Compared with the two simple disease groups, the KOA with OP group had higher levels of β - CrossLaps(0.81±0.30) ng·ml-1 (P<0.001). There were significant differences in β-CrossLaps and PTH between the simple KOA group(0.54±0.22) ng·ml-1, (46.03±18.08) pg·ml-1 and the physical examination group (0.44±0.19) ng·ml-1, (36.65±9.63) pg·mL-1(P=0.038;P=0.006). There was a significant difference in PTH between the OP group(43.85±14.30) ng·ml-1, and the physical examination group, P=0.004. There was a significant difference in Kallgren-Lawrence grading between KOA with OP group and KOA group (P=0.006). Within KOA with OP group, the differences of β-CrossLaps and VitD levels among different K-L grades were statistically significant (P=0.016). The level of OC, β-CrossLaps and PTH within KOA with OP group was significantly different at different VitD levels (P=0.013, P=0.033, P=0.046).
CONCLUSION
Patients with KOA complicated by OP exhibit greater disturbances in bone metabolism and reduced VitD levels, particularly reflected by elevated β-CrossLaps. These findings underscore the importance of early monitoring of bone turnover and VitD supplementation in advanced-stage KOA with bone loss.
Humans
;
Female
;
Male
;
Middle Aged
;
Aged
;
Vitamin D/blood*
;
Osteoporosis/complications*
;
Aged, 80 and over
;
Osteoarthritis, Knee/complications*
;
Retrospective Studies
;
Bone and Bones/metabolism*
;
Parathyroid Hormone/metabolism*
;
Osteocalcin/metabolism*
4.Predictive value of combined examination of coagulation and fibrinolysis indexes for deep venous thrombosis after proximal femoral nail anti-rotation in elderly patients with femoral intertrochanteric fracture.
Hong-Feng ZHANG ; An-Ji HE ; Xi-Lin ZHAO
China Journal of Orthopaedics and Traumatology 2025;38(4):371-377
OBJECTIVE:
To investigate the prognostic significance of combined coagulation and fibrinolysis marker analysis in predicting the development of deep venous thrombosis (DVT) following proximal femoral anti-rotation intramedullary nail (PFNA) surgery in elderly patients with intertrochanteric femur fractures.
METHODS:
A retrospective analysis was conducted on the clinical data of 80 elderly patients who underwent PFNA treatment for intertrochanteric fractures between April 2019 and April 2023. There were 26 males and 54 females. The patients' ages ranged from 60 to 85 years old, with a mean age of (76.4±5.6) years old. According to the occurrence of DVT following PFNA, patients were categorized into two groups. The DVT group were 29 patients, comprising 10 males and 19 females with a mean age of (76.9 ± 6.1)years old. And the non-DVT group were 51 patients, consisting of 16 males and 35 females with a mean age of (75.3 ± 6.9 )years old. The prothrombin time (PT), activated partial thromboplastin time(APTT), thrombin time(TT), plasma fibrinogen (FIB), plasma thrombin-antithrombin complex(TAT), and D-dimer levels were compared between the two groups immediately post- PFNA surgery, as well as at 3 and 7 days postoperatively. Pearson correlation analysis was conducted to evaluate the relationship between plasma FIB, TAT, and D-dimer levels in patients who developed DVT. Multivariate logistic regression analysis was employed to assess the association between each coagulation and fibrinolysis index following PFNA surgery in elderly patients and the incidence of DVT. The area under the receiver operating characteristic (ROC) curve (AUC) was utilized to determine the predictive value of PT, APTT, TT, FIB, TAT, and D-dimer for postoperative DVT occurrence.
RESULTS:
There were no statistically significant differences in PT, APTT, and TT between the two groups immediately post-surgery, at 3 days, and at 7 days (P>0.05). At immediately, 3 days and 7 days postoperatively in DVT group, FIB were (4.68±1.77), (6.73±2.02), (8.81±2.86) g·L-1, TAT were (10.64±2.30), (12.88±3.45), (14.96±4.87) μg·L-1 respectively. D-dimer were (635.00±100.88), (720.02±168.09), (810.47±170.19) μg· L-1, respectively.In the DVT group FIB were (3.46±0.47), (3.55±0.52), (3.67±0.48) g·L-1, TAT were (8.58±3.37), (8.69±3.48), (8.80±3.50) g·L-1, D-dimer were (588.36±96.68), (589.58±96.45), (591.11±95.50) g·L-1. The difference between the two groups was statistically significant (P<0.05). Pearson correlation analysis revealed significant positive correlations between FIB and D-dimer(r=0.428, 0.523, P<0.05), FIB and TAT(r=0.517, 0.411, P<0.05), as well as TAT and D-dimer(r=0.602, 0.596, P<0.05). Multivariate Logistic regression analysis revealed that FIB OR=3.252, 95% CI(0.640, 3.975), P<0.01, TAT OR=1.461, 95% CI(1.059, 2.011), P<0.05, and D-dimer OR=3.830, 95%CI (2.032 to 7.213), P<0.01 were significantly associated with the development of DVT following PFNA surgery. The combined detection of PT, APTT, TT, FIB, TAT, and D-dimer demonstrates significantly greater predictive value for the occurrence of DVT following PFNA surgery compared to individual index detection (P<0.01).
CONCLUSION
The combined detection of PT, APTT, TT, FIB, TAT and D-D has a high predictive value for DVT in elderly patients with femoral intertrochanteric fracture after PFNA, which is of vital importance in the early diagnosis of DVT and early prevention of pulmonary embolism and other serious complications.
Humans
;
Male
;
Female
;
Venous Thrombosis/diagnosis*
;
Aged, 80 and over
;
Aged
;
Fibrinolysis
;
Retrospective Studies
;
Blood Coagulation
;
Hip Fractures/blood*
;
Fracture Fixation, Intramedullary/adverse effects*
;
Middle Aged
;
Postoperative Complications/blood*
;
Bone Nails/adverse effects*
5.A comparative study of two internal fixation techniques for femoral nonunion after intramedullary nails.
Wu-Ren HOU ; An-Peng XU ; Min-Ou XU
China Journal of Orthopaedics and Traumatology 2025;38(4):378-383
OBJECTIVE:
To compare the effectiveness of dynamic fixation and plate augmentation combined with bone grafting for femoral nonunion after interlocking intramedullary nails.
METHODS:
Between January 2008 and December 2022, a total of 128 patients who developed femoral nonunion following static fixation with interlocking intramedullary nailing were retrospectively analyzed. All patients underwent either dynamic intramedullary nail fixation or plate fixation with bone grafting while retaining the original intramedullary nail. There were 104 males and 24 females;the age ranged from 19 to 59 years old with an average of(32.70±9.21) years old. Patients were categorized into dynamization group and plate group based on the distinct treatment modalities. There were 67 patients in the dynamization group, comprising 54 males and 13 females. The age range was from 19 to 58 years old, with a mean age of (32.68±9.33) years old. All patients underwent open reduction and anterograde interlocking intramedullary nail fixation. Dynamic fixation was implemented between 10 and 28 months postoperatively.The plate group comprised 61 patients, of whom 50 were male and 11 were female. The age distribution ranged from 20 to 59 years old, with a mean age of (32.84±9.07) years old. All patients underwent open reduction and anterograde interlocking intramedullary nailing. Plate reinforcement fixation was performed between 10 and 30 months postoperatively. The incision length, duration of surgery, intraoperative blood loss, hospitalization period, fracture healing status, and incidence of complications were compared between the two groups of patients.
RESULTS:
All patients were followed up for a minimum duration of 1 year. The mean follow-up period for the dynamization group was(26.12±11.82) months, compared to (26.57±12.48) months for the plate group. No statistically significant difference was observed between the two groups (P>0.05). The incision size (2.73±1.21) cm, operation time (22.73±3.20) min and blood loss (19.06±6.22) ml in the dynamization group were significantly less than those in the plate group(22.53±2.24) cm, (126.40±13.91) min and(237.36±81.56) ml, respectively(P<0.05). All nonunion in the plate group were successfully healed, and the healing time duration ranged from 4 to 7 months with an average of(6.16±0.99) months. In the dynamization group, a total of 42 patients achieved fracture healing, with a healing duration ranging from 4 to 8 months with an average of (6.26±1.23) months. There was significant difference in healing rate between 2 groups (P<0.05), but there was no significant difference in healing time between 2 groups (P>0.05). The average treatment cost was(17 700.18±4 846.27) yuan in the plate group and (334.24±18.16) yuan in the dynamization group, and there was significant difference in costs between 2 groups (P<0.05).
CONCLUSION
Either dynamic fixation or plate augmentation combined with bone grafting is an effective method, but dynamic fixation is superior to plate augmentation combined with bone grafting for the treatment of femoral hyperplastic nonunion after interlocking intramedullary nails. Dynamic fixation offers several advantages, including simplified procedures, reduced trauma, and cost-effectiveness in medical expenses, making it superior to additional plate fixation combined with bone grafting. However, dynamic fixation is not suitable for the treatment of femoral atrophic nonunion.
Humans
;
Male
;
Female
;
Adult
;
Middle Aged
;
Fracture Fixation, Intramedullary/adverse effects*
;
Femoral Fractures/surgery*
;
Fractures, Ununited/surgery*
;
Bone Nails
;
Retrospective Studies
;
Bone Plates
;
Young Adult
6.Research on the application of anthropometric parameters in predicting the diameter of autologous quadriceps tendon grafts.
Xiao-Bao WANG ; Kun FU ; Peng YU ; Yi LIN ; Xiao YANG
China Journal of Orthopaedics and Traumatology 2025;38(4):384-388
OBJECTIVE:
To investigate the anthropometric parameters that can accurately predict the diameter of the hamstring tendon graft, and to examine the correlation between disease etiology, duration, and graft diameter.
METHODS:
A retrospective analysis was conducted on data from 166 patients who underwent anterior cruciate ligament reconstruction using hamstring tendon autografts (semitendinosus and gracilis tendon) between January 2013 and December 2023. The cohort conprised 135 males and 31 females;the age ranged from 14 to 62 years old with an average of (28.87±10.46) years old. Pearson correlation coefficients, partial correlation coefficients, and stepwise multiple linear regression analysis were utilized to elucidate the relationship between the outcome variable (diameter of hamstring tendon grafts) and predictive variables (e.g., height).
RESULTS:
Correlation analysis revealed significant associations between the diameter of hamstring tendon grafts and height (r=0.379, P<0.001), weight (r=0.225, P=0.002), male gender (r=0.302, P<0.001), age(r=-0.218, P=0.002), and sports injury etiology (r=0.167, P=0.016). No significant correlations were found with surgical side, body mass index (BMI), or injury duration (P>0.05). Stepwise multiple linear regression analysis using a backward elimination method indicated that height was the sole significant predictive variable (R2=0.144, P<0.001), with the optimal predictive equation being:Graft size =2.636+0.029×Height (cm). Partial correlation analysis, after controlling for height, showed no significant association between age, gender, weight, and injury etiology with graft diameter.
CONCLUSION
Height is an effective predictive factor for the diameter of autologous hamstring tendon grafts. Factors such as gender, age, surgical side, body weight, and BMI are not influential to the diameter of the hamstring tendon grafts. Under the condition of the same height, there is no significant difference in the influence of these factors on the graft diameter. Preoperative physical activity level and the duration of injury do not significantly affect the diameter of the hamstring tendon grafts obtained during surgery. It is recommended to use the formula 'Graft Diameter=2.636 + 0.029 × Height (cm)' for preoperative prediction.
Humans
;
Male
;
Female
;
Adult
;
Middle Aged
;
Retrospective Studies
;
Adolescent
;
Young Adult
;
Transplantation, Autologous
;
Anthropometry
;
Anterior Cruciate Ligament Reconstruction
;
Tendons/anatomy & histology*
;
Autografts
;
Hamstring Tendons/transplantation*
;
Quadriceps Muscle/surgery*
7.Three-dimensional classification and clinical treatment of posterior cruciate ligament tibial avulsion fracture based on CT.
Guang-Kai REN ; Yu-Hang TIAN ; Ming-Yu CUI ; Bao-Ming YUAN ; Yan-Bing WANG ; Chuan-Gang PENG ; Ming LI ; Dan-Kai WU
China Journal of Orthopaedics and Traumatology 2025;38(4):389-395
OBJECTIVE:
A new three-dimensional(3D) classification of posterior cruciate ligament (PCL) tibial avulsion fracture based on computed tomography(CT) features was established and the significance in clinical treatment was explored in this study.
METHODS:
From May 2013 to November 2023, 43 cases of PCL tibial avulsion fracture in the Second Hospital of Jilin University were analyzed retrospectively, including 29 males and 14 females, aged (34.3±8.5) years. According to traditional Meyers and McKeever classification, 3 cases were typeⅠ;2 cases of typeⅡ;38 cases were type Ⅲ. Based on the characteristics of CT images, 43 patients were given specific treatment strategies and followed up to evaluate the curative effect. According to the degree of fracture displacement, involved range and the integrity of fracture block demonstrated by CT images, the new three-dimensional classification of PCL avulsion fracture was established. Kappa coefficient was used for consistency test.
RESULTS:
A new 3D classification of PCL tibial avulsion fracture was established. TypeⅠwas the non-displaced fracture (displacement degree ≤3 mm), in which typeⅠa was the avulsion range limited in the posterior intercondylar fossa, and Ib was the avulsion range beyond the posterior intercondylar fossa. TypeⅡrepresented the displaced fracture in the posterior intercondylar fossa (avulsion limited to the posterior intercondylar fossa and fracture displacement>3 mm), in which typeⅡa represented a slight displacement with a intact broken block and the posterior elevation of the avulsion (hinge mechanism), typeⅡb represented the complete separation of fracture ends with a intact fracture block, and typeⅡc was the comminuted fracture. Type Ⅲ was the displaced fracture beyond the posterior intercondylar fossa (avulsion involving the articular surface of the tibial plateau or the intercondylar ridge and the degree of displacement > 3 mm), among which type Ⅲa was the simple fracture with intact broken block, type Ⅲb represented the comminuted fracture, and type Ⅲc was the complex fracture with tibial plateau fracture. According to this new 3D classification, 43 patients were classified as type Ia in 2 cases and typeⅠb in 1 case;typeⅡa in 2 cases, typeⅡb in 15 cases and typeⅡc in 7 cases;type Ⅲa in 2 cases, type Ⅲb in 5 cases and type Ⅲc in 9 cases. All the 43 cases in this study achieved bone union. At the last follow-up, according to the hospital for special surgery knee score(HSS)evaluation system for the knee joint function, 27 cases were excellent, 11 cases were good, 5 cases were fair. The average Kappa value of inter-observer reliability in the first stage was 0.793, and the second stage was 0.855. The average Kappa value of the whole stage was 0.839, indicating high level of consistency. The average Kappa value of intra-observer reliability was 0.893, indicating high level of consistency.
CONCLUSION
The 3D classification of PCL tibial avulsion fracture is intuitive, demonstrating a high level of reliability. It has a certain guiding significance for the selection of clinical treatment methods, and it is suggested to be promoted and applied as a new classification system in clinical practice.
Humans
;
Male
;
Female
;
Posterior Cruciate Ligament/surgery*
;
Adult
;
Tibial Fractures/classification*
;
Tomography, X-Ray Computed
;
Middle Aged
;
Retrospective Studies
;
Fractures, Avulsion/classification*
;
Imaging, Three-Dimensional
;
Young Adult
8.Application of selective nerve block maintaining active finger flexion and extension in the treatment of stenosing tenosynovitis of fingers.
Li WANG ; Xiao-Jun YU ; Fan YANG ; Juan LI ; Zhi-Qiang WANG
China Journal of Orthopaedics and Traumatology 2025;38(4):411-414
OBJECTIVE:
To explore the efficacy of ultrasound-guided selective nerve block anesthesia in the distal third of the forearm while maintaining active flexion and extension during surgery for stenosing tenosynovitis.
METHODS:
A retrospective analysis was conducted on 61 patients including 15 males and 46 females with American Society of Anesthesiologists(ASA)gradesⅠorⅡ, who underwent surgery for stenosing tenosynovitis in our hospital between January 2017 and January 2022. These patients, aged from 16 to 72 years old (weighing 44 to 75 kg), underwent selective nerve blocks targeting the median and ulnar nerves at the middle and distal third of the forearm, and the superficial branch of radial nerve at the dorsal radial side of wrist joint, under ultrasound guidance. A 0.5% ropivacaine solution was used for each nerve block. The anesthetic dosage for each nerve was recorded, and the efficay of each nerve block was monitored by acupuncture every 30 seconds post-administration. The onset time and ability to perform active finger flexion and extension were recorded. Outpatient or telephone follow-up was performed 1, 3 and 6 months postoperatively to evaluate the efficacy of release.
RESULTS:
The efficacy of anesthesia block was excellent in 60 patients and good in 1 patient. One patient with simple stenosing tenosynovitis of the middle finger reported slight pain intraoperatively, which resolved with additional block of superficial branch of radial nerve of the wrist. Superficial branch of radial nerve was blocked in 20 patients, with a single dose of (1.7±0.3) ml and the onset time of (0.6±0.2) min. Median nerve was blocked in 45 patients, with a single dose of (4.1±1.0) ml and the onset time of (1.2±0.3) min;Ulnar nerve was blocked in 16 patients, with a single dose of (3.9±0.5) ml and the onset time of (1.7±0.3) min. All the patients retained active flexion and extension of the fingers. All 61 patients were followed up for 6 to 10 months with an average of (8.0±2.0) months, and no recurrence was observed.
CONCLUSION
Ultrasound-guided selective nerve block of distal third of the forearm can provide safe, rapid and good anesthesia for patients undergoing surgery for stenosing tenosynovitis of fingers, while maintaining the active finger movement. This technique facilitates intraoperative assessment of release and improves overall surgical outcomes.
Humans
;
Male
;
Female
;
Nerve Block/methods*
;
Middle Aged
;
Adult
;
Retrospective Studies
;
Aged
;
Adolescent
;
Young Adult
;
Fingers/innervation*
;
Tendon Entrapment/physiopathology*
9.Minimally invasive reduction of ulnar bicortex angulation and intramedullary fixation in the treatment of Bado typeⅠchildren with Monteggia fracture.
Chuan-Wei ZHANG ; Deng-Shan CHEN ; Lei WANG ; Xing-Po DING
China Journal of Orthopaedics and Traumatology 2025;38(4):415-419
OBJECTIVE:
To evaluate the effectiveness of minimally invasive reduction and ulna bicortical angulation intramedullary fixation in the management of Bado typeⅠMonteggia fracture in pediatric patients.
METHODS:
Between August 2018 and August 2020, the clinical data of 15 pediatric patients diagnosed with Bado typeⅠfresh Monteggia fracture were retrospectively analyzed. There were 11 males and 4 females. The left side was implicated in 5 cases, while the right side was involved in 10 cases. The age ranged from 4 to 12 years old. There were a total of 10 cases of upper ulna fractures and 5 cases of middle ulna fractures. Among these, the ulnar fracture line presented as transverse or short oblique in 9 cases, and long oblique or spiral in 6 cases. The pediatric patients underwent treatment utilizing minimally invasive reduction and ulna bicortical angulation intramedullary fixation. The effectiveness of the treatment was assessed based on the Mayo elbow scoring system.
RESULTS:
The follow-up period for all 15 cases ranged from 6 to 24 months. Among them, the occurrence of needle tail irritation was observed in 3 cases, all of which exhibited satisfactory healing following routine disinfection and dressing change. The other children had no re dislocation of the radial capitulum, no epiphyseal injury, no osteofascial compartment syndrome, elbow instability and other complications. The degree of limitation of daily life, range of motion of joints, pain level and appearance of limbs were recorded at the last follow-up. According to Mayo elbow scoring system, 12 cases were excellent and 3 cases were good.
CONCLUSION
The minimally invasive reduction and ulna bicortical angulation intramedullary fixation technique is a simple and effective treatment for Bado typeⅠfresh Monteggia fractures in children.
Humans
;
Male
;
Female
;
Child
;
Monteggia's Fracture/surgery*
;
Child, Preschool
;
Minimally Invasive Surgical Procedures/methods*
;
Fracture Fixation, Intramedullary/methods*
;
Retrospective Studies
10.Clinical efficacy of minimally invasive tendon blade technique in the treatment of moderate and severe gluteal muscle contracture.
Jia-Kai GAO ; Tao-Ran WANG ; Long BI ; Xiao-Chao CHEN ; Yan-Wu LIU ; Yao-Ping WU ; Xiang HE ; Zhi-Xia NIU
China Journal of Orthopaedics and Traumatology 2025;38(4):420-423
OBJECTIVE:
To investigate the clinical effect of minimally invasive technique in the treatment of moderate and severe gluteal muscle contracture.
METHODS:
A retrospective study was conducted on 85 patients (170 sides) with bilateral gluteal muscle contracture admitted from January 2016 to December 2019. All patients were treated with minimally invasive release of tendon knife. There were 32 males and 53 females, ranging in age from 15 to 37 years old, with an average age of (22.3±6.3) years old. Operation time, intraoperative blood loss, incision length, first postoperative ambulation time, complication rate, recurrence rate, and Harris hip score (HHS) were analyzed and evaluated.
RESULTS:
The average follow-up time was (16.2±4.6) months, ranging from 12 to 30 months. The operation time ranged from 7 to 15 min, with an average of (10.2±3.1) min. Intraoperative blood loss ranged from 2 to 20 ml, with an average of (8.4±2.2) ml. The incision length ranged from 0.6 to 2.0 cm, with an average of (0.8±0.3) cm. The time to postoperative ambulation ranged from 12 to 28 h, with an average of (20.0±3.2) h. All patients achieved primary wound healing without sciatic nerve injury or recurrence. HHS hip function scores ranged from 90 to 98, with an average score of (96.2±1.4). Complications included intraoperative tendon blade tip fracture in two cases (removed under fluoroscopic guidance) and subcutaneous hematoma in three cases-two resolved with compression and one with open evacuation.. Twenty-nine patients exhibited transient swaying gait postoperatively, of which 24 patients returned to normal after 4 weeks and 5 patients returned to normal after 6 weeks.
CONCLUSION
Minimally invasive tendon blade release is a safe and effective technique for treating gluteal muscle contracture, offering minimal trauma, rapid recovery, and excellent cosmetic and functional outcomes. However, it exhibits a low risk of blade tip fracture and sciatic nerve injury, warranting experienced surgical handling.
Humans
;
Male
;
Female
;
Adult
;
Minimally Invasive Surgical Procedures/methods*
;
Adolescent
;
Retrospective Studies
;
Buttocks/surgery*
;
Young Adult
;
Contracture/surgery*
;
Tendons/surgery*
;
Muscle, Skeletal/surgery*

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