OBJECTIVETo evaluate the effect of less invasive surgical treatment for high-energy tibia plateau injury with half-ring external fixation combined with minimum internal fixation.

METHODSFrom January, 2003 to May,2006, 16 cases of high-energy tibia plateau fracture were treated with half-ring external fixation combined with minimum internal fixation including 10 cases of type V and 6 cases of type VI according to Schatzker's classification. The average age of the patients was 42.4 years (range 25 to 50 years).

RESULTSAll patients were followed for an average of 16 months (range 5 to 27 months). All the fractures healed after an average time of 3.5 months. Two patients developed infections of the pin holes. According to the criteria of Rasmussen, excellent results were achieved in 10, good results in 4 cases, moderate in 2, and poor in none.

CONCLUSIONHalf-ring external fixation combined with minimum internal fixation can be ideal for treatment of complex tibia plateau fracture.

Adult ; External Fixators ; Female ; Follow-Up Studies ; Fracture Fixation ; instrumentation ; methods ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery ; Treatment Outcome

Bone Plates ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Minimally Invasive Surgical Procedures ; instrumentation ; methods ; Tibial Fractures ; surgery

Bone Nails ; Bone Plates ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Humans ; Tibial Fractures ; surgery

OBJECTIVETo summarize application of rafting K-wires technique for tibial plateau fractures.

METHODSFrom January 2013 to January 2015,45 patients with tibial plateau fractures were treated by locking plate with rafting K-wires, including 33 males and 12 females with an average of 44.2 years old ranging from 22 to 56 years old. According to Schatzker classification, 6 cases were type II, 8 were type Ill, 4 were type IV, 4 were type V, and 5 were type VI. Allogeneic bone graft were performed for bone defects. All patients were fixed with two to five K-wires. Part of weight loading were encouraged at 3 months after operation,and full weight-loading were done at 5 months after operation. Postoperative complications were observed,and Rasmussen clinical and radiological assessment were used to evaluate clinical results.

RESULTSAll Patients were followed up from 10 to 23 months with average of 14 months. According to Rasmussen clinical and radiological assessment, clinical scores 23.58 ± 6.33, radiological scores were 14.00 ± 6.33; and excellent and good rates were 82.2% and 77.8% respectively. Four patients occurred severe osteoporosis and collapse of articular surface; 5 patients occurred traumatic arthritis.

CONCLUSIONRafting K-wires technique with anatomized armor plate could effective fix and support platform collapse and joint bone fragments, increase support surface area and reduce postoperative reduction loss rate.

Adult ; Bone Wires ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

OBJECTIVETo study the biomechanical characteristics of Ni-Ti shape-memory alloy-enclosed interlocking intramedular nail Ni-Ti En for clinical application.

METHODSSix transverse fractures were induced in 6 fresh humeral shafts and fixed with Ni-Ti En, plate, interlocking intramedullary nail, and Ender nail, respectively. The specimens then underwent stress analysis for comparison of the bending strength, twisting force, and flexibility.

RESULTSThe bending strength of Ni-Ti En was not significantly different from that of the plate and better than ender's nail; the twisting force of the interlocking intramedullary nail was comparable with the plate, but better than Ender nail.

CONCLUSIONNi-Ti Enpossess good biomechanical property to meet the demand of osteosynthesis, and its less stress protection, freedom of distant nail locking, flexibility and stable fixation may accelerate fracture healing.

Biomechanical Phenomena ; Bone Nails ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Nickel ; Titanium

OBJECTIVETo investigate the influence on fracture stability by different pin construct during percutaneous pinning for the treatment of proximal humerus fractures.

METHODSEighteen pairs (36) adult fresh-frozen humeri were match-paired and divided into 4 groups. Dual-energy bone density scan had been used in order to rule out the influence by different degrees of osteoporosis of the cadaver. Two-part surgical neck fracture model was carried out unanimously in all 36 humeri. Four terminal threaded pins (2.5 mm in diameter) were used in fixation for all specimen. Parallel type pinning (box type) were carried out in 2 groups and convergent type pinning (fan shape) in the other 2 groups. Instron5566 biomechanical tester was applied in determining both anti-shear and anti-torsion ultimate load of each specimen.

RESULTSThere was no statistical difference between parallel pin construct and convergent construct in regard of anti-shear resistance (P = 0.73). But by mean of anti-torsion resistance, the parallel construct had significant advantage over the convergent construct (P = 0.04).

CONCLUSIONAccording to our biomechanical data, parallel pin construct seems to have better torsional stability. We suggest that parallel pin fixation should be applied whenever possible. Convergent pin construct should be considered when parallel construct is not possible or the distance between pins are too small (< 1 cm).

Biomechanical Phenomena ; Bone Nails ; Cadaver ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Shoulder Fractures ; physiopathology ; surgery

Bones of Lower Extremity ; injuries ; Fracture Fixation ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans

OBJECTIVETo investigate the mechanical characteristics of new type two-head automatic pressure external fixator in the view of biomechanics.

METHODSFifteen fresh and humid specimens were selected and divided into experimental group (5 cases) and control group (10 cases). The control group were respectively applied with DHS (5 cases) and traditional external fixator (5 cases). In order to compare the different apparatus, the strength, stiffness and twist mechanical function of femoral intertrochanteric fracture with different device were measured respectively when the specimens were under the pressure of 0-1800 N and loading speed 1.4 mn/min.

RESULTSThe strength, stiffness, twist mechanical function and maximum endurance of femora in the experimental group were obviously superior than that of DHS and traditional external fixator (P < 0.05).

CONCLUSIONTwo head automatic new type pressure external fixator can embed more tightly without sliding, also can prevent the occurrence of coxa vara effectively.

External Fixators ; Femoral Fractures ; surgery ; Fracture Fixation ; instrumentation ; methods ; Humans ; Stress, Mechanical

Bone Plates ; Bone Screws ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Humans

Acromioclavicular Joint ; anatomy & histology ; injuries ; surgery ; Fracture Fixation ; instrumentation ; methods ; Humans ; Male ; Shoulder Dislocation ; surgery