OBJECTIVETo investigate a new classification and treatment of zygomatic complex fractures (ZCF) by clinical and radiographic studies.

METHODSStandard radiographs with Waters, submental vertex views had been obtained before and after operation in 206 patients (212 sides) with ZCF. Patients with complicated fractures underwent two and three dimensional CT. Computer-assisted measuring system was used to measure the degree of displacement.

RESULTSZCF were classified into 3 types and 6 subtypes according to the degree of displacement of segments and facial deformities. Treatment principles were proposed. The results were satisfied through clinical application and measurement of post-operative images.

CONCLUSIONSThe treatment for ZCF should be selected according to the fracture types. The key of operation is to recover the malar prominence. Remodeling the length and radian of zygomatic arch guarantee the recovery of malar prominence. Zygomatic-sphenoid and zygomatic-maxillary fissures are very important reference marks for reduction and fixation.

Adolescent ; Adult ; Child ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Male ; Maxillary Fractures ; surgery ; Middle Aged ; Multiple Trauma ; surgery ; Radiography ; Zygomatic Fractures ; classification ; diagnostic imaging ; surgery

BACKGROUND: This study evaluated the outcomes of surgical management of ipsilateral femoral and tibial fractures in adults. METHODS: Fifteen patients (13 men, 2 women; mean age, 34.8 years; range, 18 to 65 years) were enrolled in this study. The fractures types were classified according to the classification by Fraser et al. as follows: type I (5), type IIa (3), IIb (4), IIc (3). Femur fractures were treated using locked intramedullary nails, plate-screws, or dynamic condylar screws, and tibia fractures were treated with an external fixator (in open fractures), or plate-screws, and locked intramedullary nailing. The mean follow-up duration was 2.2 years (range, 1.3 to 4 years). RESULTS: The extent of bony union according to the Karlstrom criteria was as follows: excellent, 8; good, 4; acceptable, 2; poor, 1. CONCLUSIONS: The associated injuries and type of fracture (open, intra-articular, comminution) are prognostic factors in a floating knee. The best management of the associated injuries for good final outcome involves intramedullary nailing of both the fractures and postoperative rehabilitation.
Adolescent ; Adult ; Aged ; Female ; Femoral Fractures/radiography/*surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary/instrumentation/*methods ; Humans ; Male ; Middle Aged ; Multiple Trauma/radiography/*surgery ; Orthopedic Fixation Devices ; Prognosis ; Tibial Fractures/radiography/*surgery ; Treatment Outcome ; Young Adult

Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation.
Accidental Falls ; *Bone Wires ; Child ; Fracture Fixation ; Humans ; *Humeral Fractures ; Male ; Multiple Trauma ; Radiography ; *Radius Fractures ; *Upper Extremity/diagnostic imaging/injuries/surgery

OBJECTIVETo evaluate the results of reconstructive intramedullary interlocking nail in the treatment of ipsilateral hip and femoral shaft fractures.

METHODSFrom August 1997 to November 2001, 13 patients were treated with the reconstructive intramedullary interlocking nail. Nine patients were associated with ipsilateral femoral neck fractures, three with ipsilateral intertrochanteric fractures, and one with subtrochanteric fracture.

RESULTSThe follow-up time was from 6 to 38 months with an average of 14 months. All the femoral shaft and hip fractures healed up well. There was no nonunion of the femoral neck, and only one varus malunion. No patient had avascular necrosis of the femoral head. The average healing time for femoral neck fracture was 4.6 months and for shaft fracture 5.8 months. The joint movement and other functions were fairly resumed.

CONCLUSIONSThe reconstructive intramedullary interlocking nail, with less trauma, reliable fixation, and high rate of fracture healing, is an ideal method of choice in the treatment of ipsilateral hip and femoral shaft fractures.

Adolescent ; Adult ; Bone Nails ; Female ; Femoral Fractures ; diagnostic imaging ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fracture Healing ; physiology ; Hip Fractures ; diagnostic imaging ; surgery ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Multiple Trauma ; diagnostic imaging ; surgery ; Prognosis ; Radiography ; Recovery of Function ; Retrospective Studies ; Risk Assessment ; Sampling Studies ; Treatment Outcome

OBJECTIVETo investigate the influence of hip and pelvic fracture, especially acetabular fracture complicated by sciatic nerve injury on clinical features and prognosis of sciatic nerve injury.

METHODSFrom January 1987 to January 2000, 17 patients (14 male and 3 female) who had hip and pelvic fractures complicated by sciatic nerve injury were treated with operative reduction and internal fixation and followed up from 10 months to 5 years. The average age was 38 years (ranging 23-56 years). The left extremities were involved in 11 patients and the right in 6. Twelve patients underwent primary exploration and neurolysis and 5 patients underwent secondary operation.

RESULTSPreoperatively, 8 patients were treated with large doses of oral narcotics to control their severe sciatic pain. Three of the 8 patients underwent patient-controlled analgesia and epidural analgesia. After operation, excellent and good rates of reduction and functional recovery of sciatic nerve were 94.1% and 88% respectively. Four patients still had sciatic pain and 2 patients failed to recover. Sciatic nerve function improved within 3-6 months after surgery in 11 patients.

CONCLUSIONSHip and pelvic fractures can result in sciatic nerve injury, especially common peroneal nerve injury and prognosis is poor. Open reduction and internal fixation combined with nerve exploration and neurolysis should be used as early as possible for severe sciatic pain.

Adult ; Analgesics ; therapeutic use ; Cohort Studies ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; rehabilitation ; Hip Fractures ; complications ; diagnostic imaging ; surgery ; Humans ; Intraoperative Complications ; Joint Dislocations ; complications ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Multiple Trauma ; diagnostic imaging ; rehabilitation ; surgery ; Pain Measurement ; Pelvic Bones ; injuries ; surgery ; Radiography ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Risk Assessment ; Sciatic Nerve ; injuries ; Sciatic Neuropathy ; complications ; diagnosis ; drug therapy ; Treatment Outcome