Objective: To analyze the clinical outcomes of the locking compression plate(LCP) fixation for the unstable sacral fracture. Methods: Nine patients with unstable sacral fracture were treated with locking compression plate fixation in our department,including 7 males and 2 females,with an average age of 34.8 years (ranged from 25 to 49 years). AO classification system found 1 B1, 4 B2, 2 B3 and 2 C1 type. Dennis classification found 6 I section sacral fracture and 3 II section sacral fracture. Incisions (6-8 cm) were made from each side of superior iliac spine to ipsilateral inferior iliac spine along iliac crest. After the fractures or dislocations were exposed and reduced, LCPs were chosen and remodeled. The iliosacral posterior ligaments were restored if injured. The LCP was pushed cutaneously to the other incision, placed on both dorsal ilia and fixed with locking screws. Each side of postal LCP was fixed with 3 locking screws for effective fixation. The reduction and fixation of fractures or dislocation were assured by radiostereoscopy. The operations lasted 45 min averagely (ranged from 30-80 minutes) and no patient needed blood transfusion. The average X-ray exposure period was 4 min(from 2-10 minutes). Results: All the patients were followed-up for a mean of 13.8 months,ranged from 6 months to 21 months. There was no iatrogenic nerve injury. The function and the feeling of sacroiliac joint and low extremities recovered to normality. According to the Majeed standards, the results were excellent in 4,good in 4,and fair in 1. Conclusion: The locking compression plate fixation is a simple and effective treatment for the unstable sacral fractures, with less trauma and complications.

Adult ; Epithelioid Cells ; pathology ; Fatal Outcome ; Female ; Humans ; Hysterectomy ; Middle Aged ; Trophoblastic Neoplasms ; pathology ; surgery ; Uterine Neoplasms ; pathology ; surgery

Objective:To evaluate the efficacy of proximal humerus internal locking system (PHILOS) via the minimally invasive plate osteosynthesis (MIPO) in the treatment of proximal humeral fractures.Methods:This retrospective study analyzed 30 elderly patients with proximal humeral fracture who had been treated by PHILOS via MIPO from September 2016 to March 2020 at Department of Orthopedic Surgery, People’s Hospital of Zhuxi County. They were 19 females and 11 males with an average age of 60.96 years (from 45 to 80 years). All patients were treated by closed reduction. After fracture reduction was confirmed by fluoroscopy, a minimally invasive incision was made below the acromion, with a couple of suture wires reserved at the rotator cuff attachments. A PHILOS plate was inserted at 4 mm lateral to the intertubercular sulcus, with the suture wires passing through the proximal suture holes on the PHILOS. After a lag screw was first screwed up into the compression hole on the PHILOS plate, the crossing suture wires were tightened up to resist the rotator cuff stress and maintain the internal inclination of the humeral head. Kirschner wires were used to temporarily stabilize the reduction. After satisfactory reduction and fine plate positions were confirmed by fluoroscopy, locking nails were screwed up. The internal inclination of the affected humeral head was compared between preoperation and the last follow-up. The therapeutic efficacy was evaluated by the shoulder Neer scoring system, and the visual analogue scale (VAS) pain scores and complications were recorded at the last follow-up.Results:All the 30 patients were followed for 6 to 18 months (average, 12 months). There was no incision infection, neurovascular injury, or internal fixation failure. Anatomical reduction was achieved in 25 patients and functional reduction in 5. The inclination of the humeral head was significantly improved. The VAS scores at the last follow-up averaged 1.9. Follow-up X-ray examination showed that bony union was achieved after 6 to 18 months (average, 9 months) for all patients. At the last follow-up, the inclination angle of the affected humeral head was 130°±5°, significantly improved compared with the preoperative 90°±11.2° ( P<0.05). All patients had good functional recovery of the shoulder. The efficacy was, according to the Neer shoulder scores at the last follow-up, excellent in 22, good in 6 and fair in 2 cases. Conclusions:Treatment of proximal humeral fractures using PHILOS via MIPO technique is suitable for patients with osteoporotic fracture, and may lead to fine therapeutic efficacy.

Objective To summarize the clinical effects and experiences of rapid pore cranial drilling and ventricular drainage treatment on ventricular hemorrhage to evaluate the performance of rapid pore cranial drilling. Methods The clinical data of 3571 patients with ventricular hemorrhage performed the rapid pore cranial drilling and ventricular drainage treatment from 13 hospitals of Shandong province since 1977 were retrospectively analyzed and concluded; these data were compared with those in patients received traditional Dandy's device. Results In these 3571 patients, the cure rate was 27.1%, the improvement rate was 49.1%, and the death rate was 23.8%. Rapid pore drilling needed no scalp incision, no suction, no coagulation, or no special lighting, only needed puncturing the scalp, drilling through the cranium and dura matter, implanting drainage tube and stitching it up; one can manage it in about 5 minutes at bedside; while the traditional Dandy's drilling occupied 3 people in the operating room, needed more than 20 procedures, and plus the time transporting the patient, it needed at least 60 minutes or more to finfish the procedures. Rapid pore cranial drill device is superior to Dandy's cranial drill device in operating procedures, technical performance, operation conditions, personnel and time-consuming. Conclusion Rapid pore cranial drilling greatly simplifies the operating procedures, saves precious time for the seriously ill patients, reduces the mortality and improves the effectiveness of the treatment. After 35 years of clinical practice, to those patients seriously ill needed ventricular drainage treatment to rescue their lives, rapid pore cranial drilling is superior to traditional Dandy's drill technic, and is an effective method treating such diseases.

Objective To investigate the setting property and compressive strength of β-TCP (β-tricalcium phosphate)/α-CSH (α-calcium sulphate hemihydrate) combined bone graft. Method β TCP/α CSH combined bone graft and distilled water were mixed with different ratio: 1 g∶0.1 mL、1 g∶0.2 mL、1 g∶0.3 mL、1 g∶0.4 mL、1 g∶0.5 mL, respectively. The initial setting time (Ti), final setting time (TF), compressive strength were recorded, and the X-ray diffraction (XRD) and the scanning electron microscope (SEM) were examined. Results The initial and final setting time of combined bone graft increased along with the increase of solid/liquid ratio. The Ti and TF were (4.6±1.3) min and (13.1±2.9) min respectively when the solid/liquid ratio was 1 g∶0.2 mL. The average compressive strength was 7.86 MPa in one day after setting, which was about two times higher than that of β-TCP alone. The XRD results showed that no other materials were produced except that α-CSH was transformed to CSD in the setting process. The SEM results indicated that thick CSD granules were adhered to the porous surfaces of β-TCP granules after setting. Conclusions The setting time and compressive strength of β-TCP/α-CSH combined bone graft could be adjusted by the different solid/liquid ratio.