OBJECTIVETo evaluate the clinical effect of PCB (a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate) in treating traumatic cervical intervertebral disc herniation.

METHODSAnterior decompression and PCB internal fixation were used in 22 patients with traumatic cervical intervertebral disc herniation. They were followed up from 3 to 16 months and analyzed by symptom and image data. Among them, 16 patients underwent fixation at one level and 6 patients at two levels.

RESULTSThis technique did not cause intraoperative complications. After surgery no screw backout or device failure was found. Based on the JOA grade, 20 patients improved clinically and 2 gently because of serious cervical stenosis. The general excellent rate was 90.9%.

CONCLUSIONSPCB internal fixation is stable. Morbidity of donor and acceptor sites is less. No collars are needed after surgery.

Adult ; Bone Plates ; Cervical Vertebrae ; Equipment Design ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Male ; Middle Aged ; Orthopedic Fixation Devices ; Orthopedic Procedures

OBJECTIVETo study the advantage of fir bark splint for the treatmet of distal radius fracture.

METHODSFrom January 2006 to June 2008, 80 cases were randomly divided into two groups and treated by fir bark splint fixation or plaster fixation. There were 40 cases in the fir bark splint group, including 18 males and 22 females with an average age of 45.2 years ranging from 20 to 66 years. There were 40 cases in the plaster group, including 19 males and 21 females with an average age of 44.1 years ranging from 23 to 65 years. Four weeks after manipulative reduction and external fixation, the fixtion effect, function recovery, bone mineral density of secondly metacarpus were obsearved by X-ray film, and the clinical effect were evaluated according to healing time ahead of schedule.

RESULTSAs compared between the two groups, the fixation effect of the fir bark splint group was better than that of the plaster group (Z = -2.844, P = 0.004 < 0.05); the function recovery of the fir bark splint group was better than that of the plaster group (Z = -3.196, P = 0.001 < 0.05); the bone mineral density of secondly metacarpus of the fir bark splint group were better than that of plaster group (t = 4.56, P < 0.001); the curative effect of fir bark splint group was better than that of the plaster group (Z = -2.601, P = 0.009 < 0.05).

CONCLUSIONFir bark splint could effectively keep fixation stability and promote fracture healing as well as function recovery.

Adult ; Aged ; Bone Density ; Casts, Surgical ; External Fixators ; Female ; Humans ; Male ; Middle Aged ; Radius Fractures ; physiopathology ; surgery ; Splints

OBJECTIVETo investigate the therapeutic effects of closed reduction and external fixation (plaster or splint) for the treatment of displaced humeral supracondylar fractures in children.

METHODSFrom March 2007 to September 2009,33 children (15 female and 18 male) with humeral supracondylar fractures treated in our hospital, ranging from 3 to 12 years old with an average of 6.4 years old. All the fractures were extension-type injuries, the flexion injures were excluded in our study. The humeral supracondylar fractures were classified according to Gartland classification. There were 21 Type H and 12 type III. In the initial treatment, all the patients were treated with closed reduction and external immobilization. The blood supply of the damaged upper extremity was evaluated before and after treatment. Clinical assessment was obtained at final follow-up using Flynn criteria, and radiologic assessment was obtained using Baumann and lateral humerocapitellar angles.

RESULTSAll the children were treated successfully with closed reduction in the initial time; 24 children maintained limb alignment by external immobilization. Nine patients lost position due to the swelling around the elbow which affected unstable external fixation during the follow-up, 5 of which were treated with a repeated closed reduction and internal fixation with Kirschner wires, 4 of which were treated with traction. Thirty-one patients had a satisfactory outcome and 2 patients had an unsatisfactory outcome according to the Flynn criteria at the latest follows-up.

CONCLUSIONClosed reduction and external stabilization is an important method for the treatment of displaced humeral supracondylar fractures in children. Making regular follow-up visits after closed reduction and casting is important for patients to maintain acceptable alignment, avoid complications and diagnose any loss of reduction.

Casts, Surgical ; Child ; Child, Preschool ; External Fixators ; Female ; Fracture Fixation, Internal ; Humans ; Humeral Fractures ; surgery ; Male ; Splints

OBJECTIVETo study and compare the difference on the therapeutical effectiveness between paper splint adduction fixation and plaster abduction fixation in Bennett fracture.

METHODSIn the study, seventy outpatient were selected from October 2005 to April 2007, and devided into two groups randomly involving experiment group (35 cases with paper splint adduction fixation) and control group (35 cases with plaster abduction fixation). After the fracture clinical healed and removed fixation, the patients had been followed up 6 months. At the 6th, 8th, 12th, 16th, 20th, 24th week after fracture, the fracture hand had been scored and compared according to Gabriele's score system.

RESULTSAt the 8th, 12th, 16th and 20th week, the excellent rate of experiment group was higher than control group, there was significant difference (P<0.05) At 6th week and 24th week there was no significant difference (P>0.05). At 8th, 12th, 16th, 20th and 24th week, the functional score of experiment group was higher than control group, there was significant difference (P<0.05); At 6th week there was no significant difference (P>0.05).

CONCLUSIONThe paper splint adduction fixation could promote recovery of the hand function in Bennett fracture. In addition, the paper splint adduction fixation is comfortable to recipient. It could be spreaded in clinic as a effective fixation method.

Adolescent ; Adult ; Casts, Surgical ; External Fixators ; Female ; Fracture Fixation ; Fracture Healing ; Fractures, Bone ; therapy ; Humans ; Male ; Metacarpal Bones ; injuries ; Middle Aged ; Splints ; Treatment Outcome

BACKGROUND: The gaitaids are helpful for the patients of gait disturbance, but there was no study about the quantitative assessment of the effectiveness of gaitaids of several different types. But proper use of gaitaids is important for the disabled who is suffered from falls with or without trauma. The appropriate prescription of gaitaids is coming from the objective assessment for gaitaids. METHODS: We evaluated the 'balance index(BI)', which is originally suggested assessment scale by author, for the five different gaitaids :mono-cane, quad-cane, forearm crutch, axillary crutch, walker We assessed the difference of B.1 with or without using each gaitaids examined by 50 healthy adults and 20 stroke patients. RESULTS: The BI in the normal adult was 34.5+/-2.7, and 21.0+/-6.9 in the stroke patients. The balance index o( walker user was 37.6+/-1.4, which was the highest score. The BI of quad-cane was 30.1 +/-4.8, which was the next highest score and the BI of mono-cane, forearm crutch, axillary crutch were 25.5+/-5.6, 25.5+/-5.7, 25.5+/-5.4, which were lower than that of quad-cane. CONCLUSION: It can be suggested that the walker is the most effective for the support balance on gait and the quad-cane is more effective than mono-cane or crutches for balance support.
Adult ; Canes ; Crutches ; Forearm ; Gait ; Humans ; Prescriptions ; Stroke ; Walkers

PURPOSE: Patients who have a elbow flexion limitation from burn often contend with a severe functional problem in activity of daily living. Positional splint or serial casting have been invented to prevent from elbow contracture, which splint could not improved the range of motion more than 90 flexion. The purpose of this article is to present a dynamic forced elbow flexion orthosis with limited motion joint to overcome the problem of less effective function of correctability of conventional splints. METHODS: The cases were 3rd degree burned patients of upper extremities who had a elbow joint flexion limitation from the post burn skin or joint contracture. This dynamic elbow flexion brace device was fabricated with the dynamic force of the elbow joint, which was induced by a rubber band or spring device into the orthotic joint. The orthosis kept a lower grade constant corrective force with coustom made design and strong strap fixation with comfortable material. RESULTS: This dynamic elbow flexion brace device was fabricated for two burn patients who had 24% and 37% TBSA in a flame burn with extensive involvement of the upper extremities. They developed hypertrophic scar and skin contracture around both elbow joint. Both patients had moderate to severe elbow joint limitation of motion. Patients with elbow limitation had improved the range of motion more than 90 flexion by this dynamic elbow flexion brace. CONCLUSION: The dynamic forced elbow flexion orthosis with limited motion joint had improved the range of motion more than 90 flexion, however those has some problems which ought to be improved to more effective and comfortable function.
Braces ; Burns ; Cicatrix, Hypertrophic ; Contracture ; Elbow ; Elbow Joint ; Humans ; Joints ; Orthotic Devices ; Range of Motion, Articular ; Rubber ; Skin ; Splints ; Upper Extremity

Until now because there are many published journals with a variety of opinions so I will stratify these articles by giving weighted value on grade evaluation which depend on each institution (written author and co-authors) and external evaluate status (SCI, SCIE, impact factor) rather than the outcomes provided by each article. Consequently, before evaluating publicized papers, study quality assessment of each interesting paper should be performed by mean of gauging the quality of evidence. Reviewing these articles, a grade of medical literature was divided into the following 5 levels as level I (randomized controlled study), level II (non-randomized controlled study), level III (case-control study), level IV (case series), and level V (expert opinions). However, in present article I concluded only involved medical literatures with weighted value of level I and II evidence.
Adolescent* ; Braces ; Humans ; Orthotic Devices ; Scoliosis*

C1-C2 transarticular screw fixation has been a preferred method for the fixation of atlantoaxial subluxation caused by the rheumatoid arthritis or recurrent subluxation caused by postoperative non-union. However, it has required extensive occipitocervical fusion or rigid external orthoses such as halo brace after cable fixation especially when the patient has the prominent transverse foramen precluding the safe placement of the C1-C2 transarticular screw. The author applied a pair of Halifax interlaminar clamps from C1 to C3 following the C1-C2 cable fixation in one patient with rheumatoid atlantoaxial subluxation and the other with recurrent subluxation after postoperative non-union. The prominent transverse foramen in both patients precluded the safe passage of the C1-C2 transarticular screw. Both patients were maintained in semirigid external orthoses by using philadelphia collar for 3 months after surgery. One has been doing well for 1 year and the other for 5 months following surgery. In conclusion, the application of the Halifax interlaminar clamps from C1 to C3 in addition to the C1-C2 cable fixation can be a useful alternative procedure circumventing extensive occipitocervical fusion for patients with the prominent transverse foramen precluding the safe placement of the C1-C2 transarticular screw, thereby not sacrificing the motion between occiput and atlas.
Arthritis, Rheumatoid ; Braces ; Humans ; Orthotic Devices

OBJECTIVETo study the biomechanical characteristics of antegrade intramedullary fixation for metacarpal fractures.

METHODSFrom March to May 2008, both the 4th and 5th metacarpals from 25 formalin embalmed cadaver hands had three-point bending test after transverse osteotomy followed by randomly fixation with one of the following three methods: plate and screw, antegrade intramedullary K-wire, crossed K-wire. While, both the 2nd and 3rd metacarpals had torsional loading test after the same management as the 4th and 5th metacarpal had undergone.

RESULTSIn the three-point bending test, both the maximum bending moment (M(max)) and bending rigidity (EI) of the antegrade intramedullary K-wire were comparable with those of the plate and screw, and were significantly larger than those of the crossed K-wire. In the torsional loading test, the antegrade intramedullary K-wire had a statistically smaller maximum torque (T(max)) than the plate and screw, and had a comparable T(max) with the crossed K-wire; while, the torsional rigidity (GJ) of the intramedullary K-wire was statistically weaker than that of both the plate and screw and the crossed wire.

CONCLUSIONSOne single antegrade intramedullary K-wire can provide a satisfactory M(max) and EI for metacarpal fixation and shows relatively weak in the torsional loading test. The injured finger should be well protected to avoid torsional deformity in clinical practice.

Adult ; Biomechanical Phenomena ; Bone Plates ; Bone Screws ; Bone Wires ; Cadaver ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Metacarpal Bones ; injuries ; Osteotomy

OBJECTIVETo investigate the therapeutic effects of closed reduction and percutaneous Kirschner pin fixation combined with plaster support for the treatment of supracondylar humerus fractures in children.

METHODSFrom June 2007 to December 2008, 27 patients with Gartland III supracondylar fractures were treated with closed reduction and percutaneous Kirschner wire fixation combined with plaster support. Among the patients, 18 patients were male and 9 patients were female, ranging in age from 6 to 12 years,with an average of 8.1 years. Fifteen patients were extension type, 12 patients were buckling type; fourteen patients were ulnar deviation, 13 patients were radial deviation. The duration from injury to treatment ranged from 0.5 to 8 days, averaged 3.6 days.

RESULTSTwenty-seven patients were followed up, and the duration ranged from 6 to 24 months, averaged 13.5 months. The healing time ranged from 4 to 6 weeks after surgery, with a mean of 4.5 weeks. Complications including implants loosening, fracture re-displacement, Volkmarm contraction, needle point or deep infection, ulnar nerve injury, myositis ossificans were found during follow-up. Two patients had postoperative elbow varus, but the varus angle was not more than 15 degree,which may be due to inappropriate functional exercise or early removal of external fixation. According to Flynn criteria, 19 patients got an excellent result, 5 good, 2 poor and 1 bad.

CONCLUSIONClosed reduction and percutaneous Kirschner wire fixation combined plaster support for the treatment of unstable supracondylar fractures in children has advantages including little trauma, reliable fixation, good elbow function and appearance.

Bone Wires ; Casts, Surgical ; Child ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; surgery ; Male