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 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

The software of 3D-Modeling(UG NX 10.0) was used to design a new external fixator model for proximal femoral fracture, and fresh femoral cadaver specimens were used to simulate experimental operation. The results showed that the external fixator designed with the proximal femoral locking plate shape can improve the accuracy of Kirschner wire penetration into the femoral neck, reduce fluoroscopic and soft tissue incision injuries, and make a good stability and is easy to operate, which has a certain value for patients with proximal femoral fracture, such as intolerant surgery and poor physical condition.
Bone Plates ; External Fixators ; Femoral Fractures/surgery* ; Fracture Fixation, Internal/methods* ; Humans

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

OBJECTIVETo compare the clinical effects and safety of dynamic external fixtor combined with limited internal fixation and cross K-wires fixation for the treatment of close Pilon fractures of the proximal interphalangeal joint.

METHODSFrom June 2012 to June 2014, totally 41 patients (45 fingers) with close interphalangeal joint Pilon fracture were treated by dynamic external fixtor combined with limited internal fixation or cross K-wires fixation, and all the patients were followed up. In the dynamic external fixtor combined with limited internal fixation group (group A), there were 21 patients with 22 fingers, including 12 males and 9 females, with an average of (30.6±5.6) years old. In the cross K-wires fixation group (group B), there were 20 patients with 23 fingers, including 11 males and 9 females, with an average of (30.1±5.3) years old. Regular re-examination of X-ray was performed to evaluate the active range of joint motion, fracture healing time, infection rate and postoperative joint motion pain.

RESULTSAccording to the evaluation criteria of upper extremity function issued by the Hand Surgery Society of Chinese Medical Association, the excellent and good cases of group A was up to 19 and 13 for group B. The evaluation results has significant differences (Z=2.558, P=0.011). The excellent and good rate of group A was obviously higher than that of group B. The average bone union time of group A was (7.9±2.1) weeks, and (8.1±2.3) weeks for group B. There was no significant difference on the mean healing time (t=-0.304, P=0.762). The infection fingers of group A was 5, and 1 for group B. The difference between the results was statistically significant (χ2=3.287, P<0.05). The infection rate of group A was higher than that of group B. The postoperative joint motion pain was evaluated by VAS score, the mean score was 0.18±0.50 in group A, and 0.65±0.88 in group B. The difference between the results was statistically significant (t=-2.207, P<0.05). The postoperative joint motion pain was lower than that of group B.

CONCLUSIONDynamic external fixtor combined with limited internal fixation is a reliable and effective method to treat Pilon fractures of the proximal interphalangeal joint. It allows early postoperative functional rehabilitation and restores the joint function.

Adolescent ; Adult ; Bone Wires ; Case-Control Studies ; External Fixators ; Female ; Finger Joint ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

Adult ; Aged ; Bone Wires ; Combined Modality Therapy ; External Fixators ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Radius Fractures ; surgery

INTRODUCTIONIntra-articular fractures of the distal radius represent high energy, complex, unstable injuries and the optimal method of treatment remains controversial.

MATERIALS AND METHODSThe aim of the paper is to compare the outcomes of external fixation (EF) with open reduction internal fixation (ORIF) with plates and screw fixation in the treatment of intra-articular fractures of the distal radius. Thirty-five patients were enlisted from December 2003 to September 2005 after a failure of initial conservative treatment. The patients were randomised into EF or ORIF groups. The patients were followed-up at 1 week, 3, 6, 12 and 24 months. Clinical and radiological outcomes were measured. They were scored using the Green and O'Brien or the Gartland and Wertley score.

RESULTSOf the 35 patients, 5 defaulted the 6-month follow-up and were excluded. We found that the clinical and radiological outcomes for the 2 groups were not significantly different. Complication rates were also similar.

CONCLUSIONThere is no significant difference in the outcome of intra-articular distal radius fractures treated with either EF or ORIF.

Adult ; Bone Plates ; Bone Screws ; External Fixators ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Radiography ; Radius Fractures ; diagnostic imaging ; surgery ; Range of Motion, Articular ; Recovery of Function ; Wrist Injuries ; diagnostic imaging ; surgery ; Young Adult

Bone Plates ; Bone Screws ; Humans ; Internal Fixators ; Mandible ; surgery

Casts, Surgical ; Humans ; Internal Fixators ; Spine ; surgery ; Tuberculosis, Spinal ; surgery

OBJECTIVE: To compare clinical efficacy and safety of plate internal fixation (ORIF) and external fixator (EF) in treating distal radius fractures by Meta-analysis. METHODS: From establishment of database to August, 2019, randomized controlled trial (RCT) about open reduction and internal fixation (ORIF) and external fixation (EF) in treating distal radius fractures was conducted by using computer-based databases, including CNKI, VIP, Wanfang Data, Medline, Cochrane library databases. Data extraction and quality evaluation of included study according to inclusion and exclusion criteria, RevMan 5.3 software was used to perform Meta-analysis. Palm angle, ulnar deflection angle, radius height, grip strength, ulnar variation, disabilities of arm, shoulder and hand (DASH) score, total complication rate, infection rate and tendon rupture between two groups were compared. RESULTS: Totally 19 RCT were included with 1 730 patients, 873 patients in ORIF group and 857 patients in EF group. Meta analysis result showed that after operation at 12 months, there were no significant difference in radial height [ CONCLUSION Compared with EF in treating distal radius fracture, ORIF has better clinical effects in postoperative complications, palm angle, ulnar deviation angle, ulnar variation rate and infection rate. While there were no significant difference between in DASH score, radial height, tendon rupture and carpal tunnel syndrome better EF and ORIF. For the patient pursue rapid recovery of function, ORIF is better choice.
Bone Plates ; External Fixators ; Fracture Fixation ; Fracture Fixation, Internal ; Humans ; Radius Fractures/surgery* ; Range of Motion, Articular ; Treatment Outcome