Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Minimally Invasive Surgical Procedures ; methods ; Orthopedic Procedures ; methods

OBJECTIVETo explore the technique and clinical results of close reduction by manipulation and minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of supracondylar femur fractures.

METHODSA retrospective study was conducted to analyze 39 patients with the supracondylar femur fractures who had been treated with close reduction by manipulation and MIPPO. There were 24 males and 15 females. The average age of the patients was 47 years old (ranged, 19 to 81 years). According to AO fracture classification for the distal femur fractures, there were 14 patients with type A1, 16 patients with type A2 and 9 patients with type A3.

RESULTSAll the patients were followed up, and the period ranged from 12 to 24 months (averaged 16 months). All the fractures showed union. The time required for the bony union ranged from 3 to 10 months (averaged 4 months). The patients were evaluated according to Kolmert distal femoral fracture functional evaluation system. Twenty-eight patients obtained an excellent result, 10 good and 1 fair.

CONCLUSIONThis method for the treatment of supracondylar femur fracture can get satisfactory function, high rate of bone union and less complications. Familiar with the close reduction technique and the geometry shape of anatomic plate as well as femoral supracondyar area are important to treat the supracondylar femur fractures.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Female ; Femoral Fractures ; therapy ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Range of Motion, Articular ; Retrospective Studies

Anatomic structure of acetabular fractures are complex and operative exposure and fixation are extremely difficult. For those obviously displaced acetabular fractures, close reduction is doomed to cause deformed healing. Open reduction with internal fixation (ORIF) not only results in anatomic reduction, but also brings complications. No matter which method will be adopted, traumatic arthritis or avascular necrosis of femoral head might occur. In order to treat acetabular fractures more effectively, orthopedic surgeons should be required to fully master the acetabular anatomy, biomechanics, classification and the necessary knowledge for complication prevention.
Acetabulum ; diagnostic imaging ; injuries ; surgery ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; classification ; diagnostic imaging ; surgery ; Humans ; Orthopedic Procedures ; Radiography

OBJECTIVETo evaluate a new technique to treat severe maxillofacial deformity and dysfunction of occlusion after the maxillofacial fractures.

METHODSThirty-four consecutive patients, with delayed maxillofacial deformities and dysfunction of occlusion after the maxillofacial fractures, were treated by the use of x-ray cephalometric analysis, model surgery, open reduction and rigid internal fixation.

RESULTSThirty-three patients were successfully corrected the maxillofacial deformities, facilitated normal occlusal relationship. Only one patient with severe damage of the brain was presented a mild occlusion dysfunction one year after the operation.

CONCLUSIONSThe above-mentioned technique may be a viable and effective option for the management of the deformities of the face and dentition after the maxillofacial fractures.

Adult ; Aged ; Female ; Follow-Up Studies ; Fracture Fixation ; methods ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Maxillofacial Abnormalities ; surgery ; Maxillofacial Injuries ; surgery ; Middle Aged ; Oral Surgical Procedures ; methods ; Orthopedic Procedures ; methods ; Treatment Outcome

A 21 years old male patient was admitted with a complex trauma of metal penetrating wound in maxillo facial region,neck and chest because of a high falling accident one hour ago. General examination:the vital signs were stable. Specialized examination: metal foreign body penetrated from the front wall of the axilla ,passing left clavicle superficies, through the middle of neck into the posterior pharyngeal wall, then piercing out from the superciliary arch lateral. The patient had apparent tenderness in the right arch,right zygomatic bone and the front of right maxilla. the degree of mouth was about 1. 8cm. X-ray showed the foreign body: from left armpit to right temporal part. The admission diagnosis was : 1. metal penetrating wound in maxillo-facial,neck and chest; 2. right zygomatic maxillary and zygomatic arch fractures. Treatment: the foreign body was removed smoothly through the concurrent operation, and by scendary operation of open reduction and internal fixation of fractures, the finally result of patient was good.
Accidental Falls ; Face ; Facial Bones ; injuries ; Foreign Bodies ; Fracture Fixation, Internal ; Frontal Bone ; Humans ; Male ; Maxilla ; injuries ; Metals ; Neck ; Orthopedic Procedures ; Skull Fractures ; Wounds and Injuries ; Young Adult

OBJECTIVETo introduce a novel technique in which meniscal stitching needle is used as a puller to induct steel wire to secure the tibial eminence avulsion under arthroscopic visualization, and evaluate the clinical results.

METHODSFrom 1999 to 2005, fifteen cases of tibial eminence avulsion were treated with this new technique. Lysholm scoring scale system was used to assess knee function before and after surgery. Regular plain anteroposterior and lateral X-ray films were undertaken to detect the bony healing of avulsed fragment.

RESULTSThe operating time could be controlled within 30 minutes. No complications such as intraarticular infection, iatrogenic injury, fibroarthritis or nonunion of fracture occurred in this group. X-ray film revealed that bony healing in all 15 cases was achieved from 6 weeks to 12 weeks postoperatively. Lysholm score was improved from 19.1+/-15.2 (ranging from 10 to 56) preoperatively to 97.5+/-3.7 (ranging from 91 to 100) postoperatively on average in 12-54 months follow up (mean 23 months). The statistically significant difference was shown in Student's t test (t equal to 18.483, P equal to 3.100 x 10(-11), P < 0.01). Wire breakage was found in two patients whose wires were removed 8 months and 14 months after initial operation, respectively.

CONCLUSIONThis technique has many advantages, such as simplicity, wide indications from type II to type IV fractures, minimal invasion, short operating time and predictable satisfactory results.

Anterior Cruciate Ligament Injuries ; Arthroscopy ; Bone Wires ; Child ; Fracture Fixation ; methods ; Humans ; Needles ; Orthopedic Procedures ; Tibia ; Tibial Fractures ; surgery

Intramedullary is a form of The ability recovery is more surely in comparison with and reduce maximum infection ricks. The administration of Osteosynthesis with intramedullary nail by femoral nailing of Grosse and Kemf is broken of thigh from 1/3 high to 1/3 low, multi-bone broken. The administration of Osteosynthesis with intramedullary nail is
Fracture Fixation ; Intramedullary ; Fracture Fixation ; Internal ; Fractures ; Bone

OBJECTIVETo discuss the resection of tumors, reconstruction of defects.

METHODSSixty-one patients with tumors in ileum were treated surgically in People's Hospital from July 1998 to July 2004. The series comprised 38 males and 23 females with an average age of 43 years old (range from 12 to 78 years old). According to Enneking staging system, 36 cases had lesions in region I, 17 cases in region I and II, and 8 cases in region I and IV. After tumor resected, posterior fixation system of spine was applied to reconstruct the integrality of pelvic ring in series of region I cases. The four pedicle screws were implanted in the lumbar and sacrum superiorly, pubis and ischium inferiorly. For children patients, bone graft or bone cement and Steinmann's pins internal fixation was applied to reconstruct the pelvis.

RESULTSAmong all the 61 cases, 48 cases followed up from 16 months to 6 years. Thirty-three cases were survived and had no local recurrence or metastasis. Fifteen cases were dead. Oncology result: local recurrence were found in 19.4% patients with region I resection (7/36), the resection level was close to acetabulum (in order to reserve the acetabulum), and it might be the reason of recurrence. 35.3% of patients (6/17) with region I and II resection had local recurrence, the recurrence maybe related to residual tumor after curettage. 50.0% of the patients (4/8) with region I and IV resection had local recurrence, the tumor residual in sacrum might be the reason of recurrence. Functional result: all of the 36 cases received region I resection regained normal walking function. The hip joint function was normal in 17 cases received tumor curettage, bone cement or hip joint replacement.

CONCLUSIONSThe posterior fixation system of spine can be used to reconstruct the integrality of pelvic ring after resection of iliac tumors. Simple reconstruction is more favorable for child patients. Allograft or self-ileum can be implanted in the space of sacral wing and residual ileum, and the bone graft is fixed with compressional screw.

Acetabulum ; surgery ; Adolescent ; Adult ; Aged ; Arthroplasty, Replacement, Hip ; Bone Neoplasms ; surgery ; Female ; Follow-Up Studies ; Hemipelvectomy ; Humans ; Ilium ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; methods

Purpose; Delayed presentation of lateral condylar fractures of the humerus is relatively common in the developing regions of the world. These fractures are difficult to manage because of the displacement and fibrosis around the condylar fragment secondary to the delay. There is a paucity of literature concerning the management of these fractures. An oft repeated finding is the requirement of extensive dissection around the fragment for proper reduction. The purpose of this study was to assess the efficacy of surgical management of lateral condylar fractures with delayed presentation. Methods; We assessed the results of lateral condylar fracture fixation in 20 cases with delayed presentation. Results; The lateral condylar fractures in patients with a delayed presentation can be managed surgically with good results. Conclusions; Open reduction and internal fixation should continue to be the method of choice for the management of lateral condylar fractures which report late for management.
Orthopedic Procedures

Liability to vascular trauma in orthopedic procedures results from the close relation between bones and vessels and complicated use of sharp instruments and retractors. Prompt diagnosis and management are mandatory to avoid high mortality and morbidity. We report 6 vascular injuries secondary to orthopedic procedures performed between 1994 and 1998. Two injuries occurred as a consequence of intramedullary nailing and Ilizarov external fixation of a femur fracture, one injury from lumbar laminectomy, one injury as a result of total hip replacement, one from hip flexion contracture release and the other one secondary to knee flexion contracture release. Injury occurred to three femoral arteries, one femoral artery and vein, one popliteal artery, and one iliac artery and IVC. Four vascular injuries required bypass grafts, division was done in AV fistula following disc operation. Conservative treatment was given to one vascular injury. There was no significant complication and death in our series except one case of graft infection that was revised with extra-anatomic bypass. The goal of management of vascular trauma that occurs during the orthopedic procedure is to save the limb and even the life. Urgent management based on knowledge of vascular structure and skillful surgical technique are needed.
Arthroplasty, Replacement, Hip ; Contracture ; Diagnosis ; Extremities ; Femoral Artery ; Femur ; Fistula ; Fracture Fixation, Intramedullary ; Hip ; Iliac Artery ; Knee ; Laminectomy ; Mortality ; Orthopedic Procedures* ; Orthopedics* ; Popliteal Artery ; Transplants ; Vascular System Injuries ; Veins