Bone Plates ; Bone Screws ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Humans

Calcaneus ; injuries ; surgery ; Fracture Fixation, Internal ; Humans ; Intra-Articular Fractures ; surgery

OBJECTIVETo explore methods of treating middle and distal tibia nonunion with the treatment of advanced bone graft combined with locking compression plate.

METHODSFrom January 2011 to December 2012, 12 patients with middle and distal tibia nonunion were treated with advanced bone graft combined with locking compression plate. Among patients, there were 8 males and 4 females aged from 20 to 69 with an average of 47 years old. The time from first injuries to bone nonunion was from 9 months to 5 years, avergaed 19 months. Four cases were treated with external fixation, 6 cases were treated with plate fixation, 2 cases of 12 patients occurred broken of plate and nail. Eleven patients were non-infective bone nonunion and 1 patient was infective bone nonunion. Preoperative X-ray and CT showed all patients had sequestration and formation of ossified bone with different degrees. Operative time, blood loss, wound healing were observed, fracture healing time was evaluated by postoperative X-ray. Johner-Wruhs scoring standards was used to evaluate ankle joint function after operation at 10 months.

RESULTSOperative time ranged from 90 to 185 min with an average of (125.00±20.15) min; blood loss ranged from 225 to 750 ml with an average of (415.00±120.00) ml. All patients were followed up from 10 months to 2.5 years with an average of 1.5 years. Postoperative X-ray showed bone union was formed around fracture after operation at 4 months in all patients, 3 cases obtained bone healing within 6 months after operation, 9 cases obtained from 8 to 12 months. No infection, injury of nerve and vessles, and broken of plate and nail were ocurred. According to Johner-Wruhs scoring at 10 months after operation, 10 cases obtained excellent results, 1 good and 1 moderate.

CONCLUSIONAdvanced bone graft combined with locking compression plate, which can build fracture multi-point supporting based on full compression of bone nonunion to get effective fixation, is an effective method in treating middle and distal tibia nonunion.

Adult ; Aged ; Bone Plates ; Bone Transplantation ; Female ; Fracture Healing ; Fractures, Ununited ; surgery ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

Arthroplasty, Replacement, Hip ; Hip Prosthesis

OBJECTIVETo investigate clinical results of percutaneous reduction and hollow screw internal fixation for the treatment of calcaneal fractures, and to compare therapeutic effects between close reduction hollow screw internal fixation and open reduction plate internal fixation.

METHODSFrom August 2007 to May 2010, 53 patients with calcaneal fractures were retrospectively analyzed. All the patients were divided into two groups, 25 patients in group A (PR group) treated with percutaneous reduction and hollow screw internal fixation, including 17 males and 8 females, with an average age of (39.4 +/- 9.9) years. While 28 patients in group B (OR group) treated with open reduction and plate internal fixation, including 18 males and 10 females, with an average age of (38.6 +/- 10.2) years. According to Sanders classification, there were 18 patients with type II fractures, 29 patients with type III and 6 type IV. In both groups, operative time, blood loss, postoperative complications and radiology were recorded. Functional recovery was evaluated by Maryland score.

RESULTSAll the patients were followed up, and the duration ranged from nine months to thirty-five months (averaged 20.4 months). There were no significant differences in sex, age, fracture type, fracture classification, initial Böhler angle, or late complications between the two groups. But significant difference can be seen between operative time, blood loss, and skin complications (in group A no nonunion and skin complications occurred, but subtalar posttraumatic arthritis occurred in 1 case; in group B, 3 patients had complications of skin necrosis, 1 patient suffered from a delayed union due to large defect filled with artificial bone, and 1 patient got subtalar posttraumatic arthritis). No difference were found in the latest X-ray film. According to Maryland score, in group A, 8 got an excellent result and 12 good. In group B, 10 got an excellent and 14 good. There were no significant differences between the two groups in Margland score.

CONCLUSIONThe results of this study suggest that in comparison with open reduction, percutaneous reduction and hollow screw internal fixation minimizes complications and achieves good results. Further study of this technique is needed.

Adolescent ; Adult ; Aged ; Bone Screws ; Calcaneus ; surgery ; Case-Control Studies ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo explore a new method for the treatment of ankle joint fractures, and to evaluate its therapeutic effects.

METHODSAmong 42 patients with ankle joint fractures, 34 patients had complete data for analysis, 19 patients were male and 15 patients were female, ranging in age from 21 to 61 years, with an average of 37 years. According to Weber-AO classification, there are 28 patients of B-type and 6 patients of C-type. The Baird and Jackson Rating System was used to evaluate therapeutic effects, and the relationship between the final function and fracture type, fracture fixation and, the time of functional training after operation were analyzed. Thirty-four patients with ankle joint fractures of B and C type were treated with internal fixation of posterior fibula plate to avoid injury of articular facet by the nails. The patients combined with the fractures of posterior malleolus were treated with fixation of both fibula and posterior malleolus through the same incision.

RESULTSAll the patients were followed up ranging from 1.2 to 3.2 years, with an average of 1.8 years. According to evaluation criterion, 24 patients got an excellent result, 6 good and 4 fair, the excellent and good rate was 88.2%.

CONCLUSIONThe internal fixation of posterior fibula plate, as a treatment for ankle joint fractures, successfully avoids the injury of articular facet by the nails. Not only does it enhance the pullout strength of the nails, but it is able to treat the fracture of lateral malleolus and posterior malleolus with a single incision. It has provided a new way for the treatment of ankle fractures.

Adult ; Ankle Injuries ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Bone Plates ; Female ; Fibula ; diagnostic imaging ; physiopathology ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Radiography ; Recovery of Function ; Treatment Outcome

OBJECTIVETo explore operative method in the treatment of syndesmosis injury of ankle fractures.

METHODSTwenty-four patients with ankle fractures and syndesmosis diastasis were treated with shape memory fracture staples, including 10 males and 14 females ranging in age from 19 to 71 years, with an average of 43 years. All patients were diagnosised with history, body examination and image data and were operated according to classification of Lauge-Hansen.

RESULTSAll patients were followed up from 6 to 28 months with an average of 16 months, and all fractures healed, with a mean time 9.2 (8 to 14) weeks. Only one case had radiological and clinical manifestations of traumatic arthritis, but no breakage of shape memory fracture staple in all cases. Sixteen patients got excellent results, good in 5, fair in 2, poor in 1.

CONCLUSIONShape memory staple fixation for the treatment of syndesmosis diastasis in ankle fractures not only can perseve the physical motion of ankles, but also be remove earlier before weight bearing.

Adult ; Aged ; Ankle Fractures ; Ankle Injuries ; complications ; diagnostic imaging ; surgery ; Ankle Joint ; diagnostic imaging ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Radiography ; Treatment Outcome ; Young Adult

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; China ; Disasters ; statistics & numerical data ; Earthquakes ; Female ; Fractures, Open ; psychology ; surgery ; Humans ; Leg Injuries ; psychology ; surgery ; Male ; Middle Aged

OBJECTIVETo explore the therapeutic strategies of the aged wounded patients evacuated from Wenchuan earthquake area.

METHODSThe characteristics of traumatic conditions and therapeutic methods of 14 aged wounded patients evacuated from Wenchuan earthquake area were retrospectively analyzed.

RESULTSAll cases accepted the effective treatment for 4 to 8 weeks and attained good recovery. There was no anesthetic and surgical complications, deep venous thrombosis, hypostatic pneumonia, pulmonary embolism, bed sore, stroke and other complications happened. When discharged, all medical disorders of the patients were under control and both psychological condition and nutritional status were improved obviously.

CONCLUSIONAssessment of traumatic condition and general status,cooperative nursing, active nutritional support, positive symptomatic treatment and necessary psychological intervention are the key to improve effectively the curative effect of the aged wounded patients in earthquake.

Aged ; Aged, 80 and over ; China ; Earthquakes ; Emergency Treatment ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Wounds and Injuries ; complications ; psychology ; therapy