OBJECTIVETo investigate the value of spiral CT examination for diagnosis occult fracture of the patients with negative result of X-ray examination and with high suspicion of fractures,so as to reduce misdiagnosis.

METHODSFrom January 2007 to June 2010, 31 patients with ankle trauma performed spiral CT examination, including 18 males and 13 females, ranging in age from 21 to 67 years, with a mean of 35 years. The main symptoms of the patients included ankle pain, local swelling, obvious tenderness and activity limitation. All the patients had negative results of X-ray examination.

RESULTSThe spiral CT examination revealed 11 patients with fractures, involving a total of 17 points. Single fracture were found in 6 cases,and multiple fractures were found in 5 cases. Among single fractures, the lateral malleolus fracture was found in 1 case, talus fracture was found in 1 case, scaphoid fracture was found in 1 case, the fracture of the base of 5th metatarsal base was found in 1 case and calcaneal fractures were found in 2 cases. Within multiple fractures,internal and lateral malleolus fracture were found in 1 case; medial malleolus, calcaneus and talus fractures were found in 1 case; talus and scaphoid fractures were found in 1 case; the fractures of 1st and 2nd cuneiform bone were found in 1 case; the 2nd and 3rd metatarsal base fracture was found in 1 case.

CONCLUSIONFor the patients with negative X-ray examination and high suspicion of fractures,the spiral CT examination is needed, which could significantly improve the detection rate of occult fractures, and provide imaging basis for clinical treatment and judicial identify.

Adult ; Aged ; Ankle Injuries ; diagnostic imaging ; Female ; Foot Injuries ; diagnostic imaging ; Fractures, Closed ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods

OBJECTIVETo discuss feasibility of minimal-invasive surgical treatment of the pelvis fractures.

METHODSTwenty-six patients with pelvis fractures were treated by micro-surgical treatment. There were 15 male and 11 female with an average age of 40 years ranging from 20 to 62 years. All patients were closed fractures, 17 patients were hemi-pelvis fractures, 9 patients were bilateral-pelvis fractures. The fracture type of posterior ring of pelvis as follows:8 patients were sacro-iliac joint dislocation, 12 patients were vertical section fractures in the outboard of the sacrum. The fracture type of anterior ring of pelvis as follows: 9 patients were hemi-fracture of rami ossis pubisi or hemi-fracture of rami ischi, 7 patients were bilateral-fracture of rami ossis pubisi or bilateral-fracture of rami ischii, 6 patients were separation of symphysis pubis. Six patients accompanied with shock. Anterior ring of pelvis was fixation by lag screw via superior ramus of pubis and pubic symphysis; Posterior ring of pelvis was fixation by lag screw via sacroiliac joint or intrasacral rod via ilium. X-ray films and multi-slice spiral CT of pelvis was obtained in order to understand exterior and inner details about pelvis fractures. Adopt orientation in body and inducted by C-arm digital subtracting X-ray system when operating.

RESULTSBlood loss was about 10 to 50 ml (mean 30 ml). Operation time was 30 to 50 minutes. Time of fracture union was 8 to 12 weeks (mean 11 weeks). Wound infection, ununion of fracture and nerve injuries had not been found.

CONCLUSIONMinimally invasive operation has the merit of short operation time, fine effect, soon recovering and few complication.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; diagnostic imaging ; surgery ; Fractures, Closed ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Pelvic Bones ; diagnostic imaging ; injuries ; surgery ; Radiography

Ulnar nerve injury in closed fracture of forearm in children is uncommon.Commonly, neurapraxia is the reason for this palsy but other severe injuries or nerve entrapment has been reported in some cases. The importance of diagnosis concerning the types of the nerve injury lies in the fact that they have totally different management.We present a case of ulnar nerve deficit in a child following a closed fracture of the forearm bones. It is imperative to diagnose exact cause of palsy as it forms the basis for treatment. MRI scan can help diagnosis and accordingly guide the management. Simple nerve contusion should be treated conservatively, and exploration with fixation of the fracture should be done in lacerations and entrapments of the nerve. Surgery is not the treatment of choice in cases that could be managed conservatively.
Accidental Falls ; Child ; Diagnostic Errors ; Fractures, Closed ; complications ; diagnosis ; therapy ; Humans ; Magnetic Resonance Imaging ; Radius Fractures ; complications ; diagnosis ; therapy ; Ulna Fractures ; complications ; diagnosis ; therapy ; Ulnar Nerve ; injuries ; Ulnar Neuropathies ; diagnosis ; etiology

OBJECTIVE: To investigate the diagnostic value of multislice spiral CT (MSCT) and MRI in occult fracture of knee joint with meniscus and ligament injury. METHODS: From January 2020 to March 2021, 63 patients with knee occult fracture with meniscus and ligament injury, including 41 males and 22 females, aged from 21 to 67 years old, with an average of (44.35±8.77) years old, the course of disease ranged from 1 to 6 days, with an average of (4.64±1.75) days, the body mass index (BMI) was (19.85±2.78) kg/m². MSCT and MRI data of 63 patients were collected and statistically analyzed to evaluage their diagnist value. RESULTS: The detection of MRI for occult knee fravtures with meniscus and ligament injury, joint cavity effusion, bone marrow edema, and articular surface injury were 100.00% (63/63), 95.24% (60/63), 42.86% (27/63) and 36.51% (23/63), respectively. The detection rates of MSCT were 49.21% (31/63), 41.27% (26/63), 0.00% (0/63) and 1.59% (1/63), respectively, significantly lwver than that of MRI (P<0.05). The diagnostic sensitivity, specificity and accuracy of MRI were significantly higher than those of MSCT(P<0.05). CONCLUSION The sensitivity, specificity and accuracy of magnetic resonance imaging in the diagnosis of occult fracture of knee joint with meniscus and ligament injury are significantly better than that of MSCT. MRI has higher accuracy in the diagnosis of peripheral tissue diseases such as joint cavity, articular surface and bone marrow, and can reduce the risk of clinical misdiagnosis.
Male ; Female ; Humans ; Young Adult ; Adult ; Middle Aged ; Aged ; Tibial Meniscus Injuries/diagnostic imaging* ; Fractures, Closed/diagnostic imaging* ; Arthroscopy/methods* ; Knee Injuries/diagnostic imaging* ; Knee Joint/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Ligaments ; Meniscus ; Tomography, Spiral Computed ; Fractures, Bone ; Anterior Cruciate Ligament Injuries

OBJECTIVETo investigate the clinical effects of surgery reduction and internal fixation through posteromedial knee approaches in the treatment of posteromedial condylar split fracture of tibial plateau.

METHODSFrom January 2006 to July 2009,21 patients with posteromedial condylar split fracture of tibial plateau were treated by posteromedial knee approaches. Among the patients, 14 cases were males and 7 cases were females,ranging from 28 to 68 years old with an average of 36.9 years old. For traumatic causes, 14 cases were injured by traffic accident and 7 cases by fall. Compound injury, 15 cases combined with anterior cruciate ligament injury and tibia insertion avulsion fracture; 14 cases combined with posterolateral de-pressed tibial plateau fracture. Rasmussen assessment criteria was used to evaluate the therapeutic effects.

RESULTSAll patients were followed up,from 12 to 30 months with an average of 17.3 months. All patients didn't undergo infection,looseness and rupture of fixation,nonunion of fracture,inversion and eversion of the knee or displacement of fracture. All cases attained anatomical reduction after operation,only 1 patient felt numbness of posterior lower part of the calf. According to Rasmussen assessment criteria, 12 cases got an excellent result, 7 good and 2 fair.

CONCLUSIONIt is beneficial for the postermedial knee approaches to be used in the reduction and fixation of posteromedial condylar split fracture of tibial plateau. It has advantages of clearly exposure, convenient placement of the internal fixation, less trauma and good therapeutic effects.

Adult ; Aged ; Bone Nails ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Fractures, Closed ; surgery ; Humans ; Knee Injuries ; surgery ; Knee Joint ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radiography ; Tibial Fractures ; surgery

OBJECTIVEA study was conducted to investigate the relevant applied technique and clinical value of endoscope-assisted repair of zygomatic arch fracture.

METHODSA total of 10 cases of unilateral zygomatic arch fracture and 8 cases ofunilateral zygomatic fracture were included. Reduction and fixation of the zygomatic arch in all cases were performed via asmall face incision by an endoscope. Endoscope-assisted repair allowed exposure of zygomatic arch fracture and ended the anatomy of the reset. Zygomatic arch was stabilized with titanium plates.

RESULTSSymmetric malar was achieved in allcases after operation. Patients did not show difficulty in opening the mouth. No chewing problems or severe complicationswere evident. This method had the advantage of hidden incision, and it did not leave scars on the face. Postoperative CT examination showed excellent reduction of zygomatic arch fracture and good fixed position of titanium plate.

CONCLUSIONEndoscope-assisted repair of zygomatic arch fracture via a small face incision can be an alternative operation for zygomaticarch fracture. Patients are less traumatized. There are fewer complications. A good reduction of fracture is achieved.

Bone Plates ; Endoscopes ; Endoscopy ; methods ; Facial Bones ; Fracture Fixation, Internal ; methods ; Fractures, Closed ; surgery ; Humans ; Titanium ; Tomography, X-Ray Computed ; Treatment Outcome ; Wound Healing ; Zygoma ; injuries ; Zygomatic Fractures ; diagnostic imaging ; surgery

OBJECTIVETo study the instance of deep venous thrombosis(DVT) complicated by preoperative lower extremity close fracture.

METHODSRetrospectively analyzed the clinical data of 54 patients with DVT (through color Doppler to final diagnosis) complicated by preoperative lower extremity close fracture from March 2008 to February 2009, and explored the concomitant reason of DVT. There were 23 males and 31 females with age for 23-95 years old.

RESULTSDVT including thrombus of ilio-venae external, thrombus of femoral vein, thrombus of popliteal vein, thrombus of posterior tibial veins and thrombus of soleus venae. The instance of DVT complicated by preoperative lower extremity close fracture: (1) The age of 23 cases (42.59%) more than 70 years. (2) 11 cases (20.37%) combined with syndrome, 2 cases had hypertension, 3 cases had hypertension and diabetes, 2 cases hypertension and cerbral infarction, 4 cases had hypertension, diabetes and coronary heart disease. (3) 10 cases (18.51%) were multi-fractures. (4) 28 cases (51.85%) occurred DVT at 7-14 days after lower extremity close fracture.

CONCLUSIONAdvanced age, complicating hypertension, diabetes, coronary heart disease, cerbral infarction, multi-fractures may be lead to DVT. Multitudinous DVT occurred at 7-14 days after fracture, as early as possible operation has important significance on prevention DVT to decrease risk of pulmonary embolism.

Adult ; Aged ; Aged, 80 and over ; Female ; Fractures, Closed ; complications ; diagnostic imaging ; surgery ; Humans ; Leg ; blood supply ; Leg Bones ; injuries ; Male ; Middle Aged ; Preoperative Period ; Retrospective Studies ; Ultrasonography ; Venous Thrombosis ; complications ; Young Adult