OBJECTIVETo investigate the treatment of comminuted superior tibial fracture in complex injury according to damage control orthopaedic.

METHODSFrom Jan. 2007 to Jun. 2009,11 patients suffered from comminuted superior tibial fracture with complex injury, including 8 males and 3 females with an average age of 35.2 years. The external fixator were used to fix tibial fracture in emergency treatment, after 6 weeks when the condition of patients were improved, fix the external tibia by LISS plate through litter incision, fix interior tibia by reconstructed plate or sustained plate. The effect evaluated by Lysholm standard, marking system on the basis of limp, walking stick, angina, knee unsteady, pain, swell, up and down floor, squat.

RESULTSAll the postoperative CR showed that the superior tibial fractures were acquired functional reduction, the incision got well and no infection occurred. All 11 patients were followed-up for 12 to 18 months with an average of 14.7 months. According to an evaluation standard of Lysholm, the results were excellent in 5 cases, good in 4 cases, fair in 1 case, poor in 1 case.

CONCLUSIONAccording to damage control orthopaedic, the treatment of comminuted superior tibial fracture by external fixation and LISS plate is a suitable method for the patient with complex injury who undergo comminuted superior tibial fracture.

Adult ; Female ; Fractures, Comminuted ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Tibial Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

OBJECTIVESTo investigate and discuss the role of CT in the diagnosis and treatment of comminutive distal radius fractures.

METHODSOne hundred and eleven consecutive patients (118 cases of fractures) who were admitted to Jishuitan hospital from January 2003 to January 2005 were included in this study. These patients all need operative treatment and accepted CT scans for better understandings of these injuries and helping to make operation plans.

RESULTSafter comparing the results of X planes and CT scans, considerable differences existing between the two examinations were found in the measurements of articular compression and step-off, gapping, comminution degree and subdislocation. This difference was manifested not only in the alteration of quantity but also in the change of quality.

CONCLUSIONSComputed tomography can provide more vivid and detailed information of fractures for practitioners. Undoubtedly, CT is especially valuable in the evaluation of severity degree and stability of comminutive distal radius fractures, thus it helps us to determine whether operation is obligatory and choose the best method and approach of operation. Moreover, CT can also clearly show the important parts of fractures which need special attention in the process of operation. At the same time, practitioners are required to understand the indications of CT examination completely and know how to choose scan planes properly.

Adolescent ; Adult ; Aged ; Female ; Fractures, Comminuted ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radius Fractures ; diagnostic imaging ; surgery ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo explore the clinical effects of closed reduction and less invasive stablization system for the treatment of proximal tibial multi-segment comminuted fractures, and to discuss the influence of LISS on reduction and bone union.

METHODSFrom 2003.7 to 2007.12, 19 patients with proximal tibial multi-segment comminuted fractures were treated with closed reduction and LISS fixation. Fourteen patients were male, 5 patients were female, ranging in age from 21 to 49 years, with an average of 39.2 years. Fifteen patients were injured with direct violence, 4 indirect violence. The reasons of the injuries were vehicle crashes for 14 cases and falling from high places for 3 cases and falling to the ground for 2 cases. All the patients were followed up postoperatively. Callus formation and bony union were recorded by X-ray.

RESULTSAll the patients were followed up for a period averaged 12.2 months (ranged 8 to 21 months). No failure of fixation and nonunion. No deformation of plates and screws occurred in patients,no superficial wound infection. According to the criteria of Merchan, 14 patients got an excellent result, 3 good, and 2 poor.

CONCLUSIONClosed reduction and less invasive stabilization systems can provide rigid internal fixation for proximal tibial multi-segment comminuted fractures. The LISS provides stable fixation, a high rate of union, and a low rate of infection for proximal tibial multi-segment comminuted fractures.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Tibia ; diagnostic imaging ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVE: To evaluate the application of MSCT and post-processing images to fractures of nasal bone in forensic identification. METHODS: 134 cases were examined by thin slice scanning with MSCT and all of the data were sent to workstation for MPR and SSD. The result of MSCT was compared with that of X-ray. RESULTS: There are 55 (41.04%) cases of linear fracture, 46 (34.33%) cases of comminuted fracture, 27 (20.15%) cases of depressed fracture and 6 (4.48%) cases of no fracture in this sample. With X-ray or CR, 48 (35.82%) cases were misdiagnosed or underdiagnosed. 133 (99.25%) cases were confirmed by MSCT. Significance difference was found between X-ray and MSCT (chi2= 45.0816, P<0.001). CONCLUSION MSCT and post-processing images might be the chief evidence for nasal fractures in forensic identification.
Adolescent ; Adult ; Chromatography, Thin Layer ; Female ; Forensic Medicine/methods* ; Fractures, Comminuted/diagnostic imaging* ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Nasal Bone/injuries* ; Skull Fractures/diagnostic imaging* ; Tomography, Spiral Computed/methods* ; Young Adult

OBJECTIVETo study the therapeutic effect of collapsed and comminuted distal radius fracture.

METHODSTwenty-six patients with collapsed and comminuted distal radius fracture were hospitalized from July 1998 to June 2003. All fractures were treated by the methods of open reduction, sustained bone grafting and passing joint external fixator to restore the anatomic shape of distal radius.

RESULTSAll 26 cases were followed up, and the results showed that the fractures have been united radiographically. The joint surfaces were intact and there was no length discrepancy occurred in patient's radius. The average volar tilt was 6 to 15 degrees and the average ulnar tilt was 18 to 25 degrees. According to the Dieust criterion, 19 cases were rated as excellent and 7 as good.

CONCLUSIONSThe method that applying passing joint external fixator and bone grafting for the treatment of collapsed and comminuted distal radius fracture could maintain the stability of fracture and restore the length of radius and the intact of joint surface.

Adult ; Aged ; Bone Transplantation ; methods ; Cohort Studies ; Combined Modality Therapy ; External Fixators ; Female ; Follow-Up Studies ; Fracture Fixation ; instrumentation ; methods ; Fracture Healing ; physiology ; Fractures, Comminuted ; diagnostic imaging ; surgery ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Radiography ; Radius Fractures ; diagnostic imaging ; surgery ; Recovery of Function ; Retrospective Studies ; Risk Assessment