Objective To investigate the effects of first external fixator and second locking plate fixation in treating open tibiofibular fractures. Methods We retrospectively analyzed the 36 patients with Gustilo'sⅢtype tibia and fibula fractures from Jan. 2009 to Dec. 2010. All the patients were treated with first external fixator and second locking plate fixation,and the curative effect and the extremity function were evaluated.Results All patients were followed-up for 18 months (6 to 24 months) in average,and all the fractures were healed in 5.5 months averagely. According the Johner-Wruhs evaluation standard, excellent was in 24 cases, good was 10 cases,and bad was in 2 cases. The excellent and good rate was 94%. According the Merchant evaluation standard, excellent was in 26 cases,good was in 5 cases,fair was in 4 cases,bad was in 2 cases. The excellent and good rate was 86.1%.The outcome was satisfactory. Conclusion The first external Fixator and second locking plate fixation in treating open tibiofibular fractures can improve the healing rate and the functional recovery.

BACKGROUND:Single fracture or colapse of the posterolateral tibial plateau fractures is relatively rare in the clinical work. Rational choice of surgical approach and internal fixation for posterolateral plateau fracture is significant to restore the lower limb force line, maintain the joint stability and obtain good biocompatibility.
OBJECTIVE:To compare the stability and biocompatibility of Carlson posterolateral and posterior midline approaches for the treatment of posterolateral tibial plateau fractures with “T” shaped locking plate.
METHODS:From July 2011 to July 2014, 43 patients with posterolateral tibial plateau fractures, who were treated in the Affiliated Hospital of Jining Medical University, were retrospectively analyzed. Al patients were assigned to two groups according to approaches. In the Carlson posterolateral approach group, 22 cases received “T”-shaped plate insertion by Carlson posterolateral approach. In the posterior midline approach group, 21 cases received “T”-shaped plate insertion by posterior midline approach. After repair, perioperative data, fixation effects and knee function score were compared and analyzed between both groups.
RESULTS AND CONCLUSION:(1) 43 cases (43 knees) of posterolateral tibial plateau fractures were folowed up strictly. (2) No significant difference in operation time, fracture healing time, total load time, Hospital for Special Surgery score at 12 months postoperatively, tibial plateau angle and posterior slope angle immediately and 12 months postoperatively was detected between both groups (P > 0.05). (3) Significant differences in fracture exposure, blood loss, and excelent and good rate of Rasmussen at 12 months postoperatively were identified in both groups. Moreover, above indexes were better in the Carlson posterolateral approach group than in the posterior midline approach group (P< 0.05). (4) These findings confirmed that for a single fracture or colapse of the posterolateral tibial plateau fractures, two kinds of surgical approaches can achieve ful and direct exposure. Carlson posterolateral approach has good repair effect, fixation effect and biocompatibility.

BACKGROUND:Pelvic and acetabular fractures in elderly are frequently observed in the clinic, and the incidence gradual y increased. Moreover, it is difficult to conduct reduction and fixation due to their physical status and osteoporosis to different degrees. Locking plate is ideal fixation material in surgical treatment of acetabular fractures in elderly due to the special functions and good molding of screw and locking plate.
OBJECTIVE:To analyze the advantages and disadvantages of locking reconstruction plate used in the acetabular fracture for the aged patients and to improve the clinical effect of acetabular fractures in elderly.
METHODS:From January 2010 to February 2013, 21 aged patients with acetabular fracture were treated by open reduction and internal fixation with locking reconstruction plates made of titanium and 00Cr 18 Ni 14 Mo 3 stainless steel in the Department of Orthopedics Affiliated Hospital of Jining Medical University.
RESULTS AND CONCLUSION:Of 21 patients, 20 cases were fol owed up for 12-18 months (mean 14 months), but one dropped out. Al the fractures were healed within 4-6 months and no failure cases. According to Matta evaluation criteria, the satisfactory rate was 90%. According to the D’Aubigne scoring system, the excellent and good rate was 95%. These data indicated that locking reconstruction titanium plate is reliable, has low failure rate and satisfactory clinical effects for acetabular fracture in aged patients, and is ideal fixation material in treatment of acetabular fractures in elderly.

Objective:To investigate the application effect of the humble tutor mode in the teaching of nursing interns in operating room.Methods:A total of 40 nursing interns in the Operating Room of Affiliated Hospital of Jining Medical University from August 2020 to June 2021 were selected as control group, and 46 nursing interns from August 2021 to September 2022 were selected as experimental group. The interns in the control group received teaching with the conventional tutor mode, and those in the experimental group received teaching with the humble tutor mode. The two groups were compared in terms of the scores of theoretical knowledge and operation skills, voice behavior, self-efficacy, and humble tutor perception. SPSS 19.0 was used to perform the t-test, the chi-square test, and the correlation analysis. Results:At the time of department rotation, the experimental group had significantly higher scores of theoretical knowledge (93.86±3.53) and operation skills (90.90±5.68) than the control group ( P<0.001). Compared with the control group, the experimental group had significantly higher scores of voice behavior [(35.22±7.60) vs. (30.43±5.96), P=0.002], self-efficacy [(28.17±5.03) vs. (24.38±3.39), P<0.001], and humble tutor perception [(37.04±4.34) vs. (26.33±6.63), P<0.001]. Humble tutor perception was positively correlated with voice behavior ( r=0.89, P<0.001), self-efficacy ( r=0.72, P<0.001), operation skills ( r=0.66, P<0.001), and score of theoretical knowledge ( r=0.39, P=0.007). Conclusion:The humble tutor mode has a significant effect in operating room teaching and can improve the assessment scores of theoretical knowledge and operation skills, promote the formation of humble tutors, and strengthen the teaching effect of voice behavior and self-efficacy in nursing interns.