OBJECTIVE: To explore the efficacy and safety of human epidermal growth factor gel in the treatment of pin tract infections after surgery in patients with severe spinal deformity. METHODS: A retrospective case-control study was conducted to analyze the clinical data of 26 patients with pin tract infections after skull-pelvic ring traction for severe spinal deformity admitted from February 2019 to May 2022. Among them, 11 were male and 15 were female;the age ranged from 18 to 31 years, with an average of (24.1±4.3) years;the Cobb angle ranged 80.3° to 120.7°, with an average of (88.6±10.2)°;there were 52 iliac traction pins, 104 pin tract openings, and 38 pin tract infections. According to the Checketts-Otterbum classification, there were 11 infections of gradeⅠ, 13 infections of gradeⅡ, 10 infections of grade Ⅲ, and 4 infections of grade Ⅳ. The patients were divided into the conventional dressing change group (13 cases) and the growth factor group (13 cases) by coin flipping. Clinical efficacy was evaluated by recording the visual analogue scale(VAS) score during dressing change, duration of dressing change, cost of dressing change, positive rate of bacterial culture, wound improvement rate, and wound improvement time. RESULTS: There were no statistically significant differences in VAS or duration of dressing change between the two groups (P>0.05). The cost of dressing change was (800.0±59.5) yuan in the conventional dressing change group and (1 179.5±80.9) yuan in the growth factor group, with a statistically significant difference (P<0.05). There was no statistically significant difference in the positive rate of bacterial culture between the two groups (P>0.05). In the conventional dressing change group, within 20 pin tract infections, 2 infections achieved wound healing, 7 infections showed improvement, and 11 infections were ineffective;in the growth factor group, within 18 pin tract infections 5 infections achieved wound healing, 8 infections showed improvement, and 5 infections were ineffective, with a statistically significant difference between the two groups (P<0.05). The wound healing time was (22.8±4.9) days in the conventional dressing change group and (14.2±2.5) days in the growth factor group, with a statistically significant difference (P<0.05). No complications occurred in either group. CONCLUSION The application of human epidermal growth factor gel in the treatment of pin tract infections after skull-pelvic ring surgery in patients with severe spinal deformity is easy to operate, does not increase patient pain, and has significant efficacy. It shortens wound healing time, effectively promotes wound healing, and has good safety and high cost-effectiveness.
Humans ; Male ; Female ; Adult ; Adolescent ; Retrospective Studies ; Case-Control Studies ; Young Adult ; Epidermal Growth Factor/therapeutic use* ; Traction/adverse effects* ; Gels ; Bone Nails/adverse effects* ; Surgical Wound Infection/drug therapy*

OBJECTIVETo compare clinical effects between Pavlik harness and Bryant traction in treating femoral shaft fractures in infants,including the time of hospitalization, expense of treatment, complications,time of bone union.

METHODSFrom May 2005 to August 2010,the clinical data of 42 infants with femoral shaft fractures were retrospectively analyzed. Among the patients, 23 cases were treated with Pavlik harness(Pavlik harness group),there were 14 males and 9 females,ranging in age from 1 to 12 months with an average of (5.5+/-2.4) months,including upper 1/3 segment of 16 cases and middle segment of 7 cases; transverse fracture of 18 cases and oblique fracture of 5 cases. The other 19 patients were treated with Bryant traction (Bryant traction group),there were 15 males and 4 females,ranging in age from 2 to 12 months with an average of (6.7+/-2.8) months,including upper 1/3 segment of 13 cases and middle segment of 6 cases;transverse fracture of 12 cases and oblique fracture of 7 cases. The time of hospitalization,expense of treatment,complications,time of bone union were analyzed in the patients.

RESULTSAll patients were followed up with an average of 25.3 months (ranging from 19 to 30) in Pavlik harness group and 23.7 months (ranging from 17 to 28) in Bryant traction group. Time of hospitalization, expense of treatment in Pavlik harness group were respectively (0.4+/-0.7) d, (2147.7+/-64.9) yuan; and in Bryant traction group were respectively(27.1+/-2.2) d, (2741.3+/-227.6) yuan;there was significant difference between two groups(P<0.05). No complication was found in Pavlik harness group and 8 cases complicated with skin hydroa in Bryant traction group, there was significant difference between two groups (P<0.05). Time of bone union,difference of both lower extremities in Pavlik harness group were respectively (4.1+/-0.3)weeks, (6.3+/-4.1) mm;and in Bryant traction group were respectively (3.9+/-0.3) weeks, (7.6 +/-4.3) mm; 20 cases got bone healing in Pavlik harness group and 18 cases got bone healing in Bryant traction group;there was no significant difference between two groups (P>0.05).

CONCLUSIONCompared with Bryant traction method,Pavlik harness method has obvious advantages in time of hospitalization, expense of treatment, complications in treating femoral shaft fractures in infants.

Female ; Femoral Fractures ; therapy ; Humans ; Infant ; Male ; Orthotic Devices ; adverse effects ; Traction ; adverse effects ; methods

OBJECTIVE: To evaluate the safety and effect of foley catheter traction for hemorrhage after postmicrochannel percutaneous nephrolithotomy (mPCNL). METHODS: Eighty-eight patients with upper urinary calculi were collected prospectively at the Department of Urology of Xiangya Hospital of Central South University from November 2010 to June 2011. The patients underwent mPCNL, and were divided into 2 groups randomly: 45 patients with 16F foley catheter but without traction served as the control group, and the other 43 patients with 16F foley catheter traction served as the experiment group. Blood loss was estimated by the mass of hemoglobin in the draining liquid and urine during postoperative duration through the HiCN. The blood loss and bleeding time were compared in the 2 groups, and analyzed by Wilcoxon rank sum test. RESULTS: There was statistical difference in the average blood loss between the control group (13.830 g) and the experiment group (7.959 g, P<0 .001). The mean bleeding time was 4 and 3 days in the control group and the experiment group respectively. CONCLUSION Foley catheter traction for mPCNL can reduce the blood loss, suggesting that Foley catheter traction is safe, effective and feasible.
Adolescent ; Adult ; Aged ; Blood Loss, Surgical ; prevention & control ; Child ; Female ; Hemostatic Techniques ; Humans ; Kidney Calculi ; surgery ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; adverse effects ; methods ; Postoperative Hemorrhage ; therapy ; Prospective Studies ; Traction ; Ureteral Calculi ; surgery ; Urinary Catheterization ; Young Adult

OBJECTIVETo explore the effect of external fixators on the intertrochanteric fracture in the advanced age patients.

METHODSFrom June 2008 to September 2010,32 cases who failed to be operated by the regular open-sugery were divided into two groups randomly, 16 of those were put in traction and conservative treatment;and the other 16 patients were treated by external fixation under anesthetization. In the traction group, there were 9 males and 7 females with an average age of (79.19 +/- 1.83) years ranging from 78 to 85. In the external fixation group, there were 10 males and 6 females with an average age of (79.69 +/- 2.41) years ranging from 78 to 88 years. Acoording to the Evans-Jensen classification,in the traction group, there were 6 cases of type I ,6 cases of type II, 7 cases of type III and lieing in bed 45 days in average; in the external fixation group, there were 6 cases of type I ,5 cases of type II, 2 cases of type III, 2 cases of type IV, and non-weight loading walking after surgery in a week in average.

RESULTSIn the traction group, 3 of them had decubitus, 3 of them had cardiopulmonary insufficiency, 2 of them had infection from traction needles, and 1 of them had pneumonia; in the external fixatioin group, only 2 of them had coxa vara. Based on the Harris scoring for the assessment of the function of hip join,in the traction group, the results were excellent in 4 cases,good in 3,fair in 3,poor in 6; in the external fixation group,the results were excellent in 10 cases, good in 3, fair in 2, poor in 1.

CONCLUSIONThus, the use of external fixation on the intertrochanteric fracture is a strong safe and effective method in treating intertrochanteric fracture of the advanced age patients.

Aged ; Aged, 80 and over ; External Fixators ; adverse effects ; Female ; Hip Fractures ; surgery ; Humans ; Male ; Traction ; adverse effects

OBJECTIVETo compare clinical effects between bridge wire splint fixation and traditional Bryant traction for the treatment of femoral shaft fractures in children.

METHODSFrom June 2006 to June 2009,38 children with femoral shaft fractures were treated with bridge wire splint fixation and Bryant traction. In bridge wire splint group, there were 15 males and 6 females, ranging in age from 8 months to 5.3 years, with an average of (2.3 +/- 0.6) years. According to fracture site classification, 5 patients were upper 1/3 femoral fractures, 9 patients were middle 1/3 femoral fractures,and 7 patients were lower 1/3 femoral fractures. In Bryant traction group,there were 10 males and 7 females, ranging in age from 10 months to 3.2 years, with an average of (2.2 +/- 0.4) years. According to fracture site classification, 4 cases were upper 1/3 femoral fractures, 10 patients were middle 1/3 femoral fractures, 3 patients were lower 1/3 femoral fractures. The clinical features, X-ray healing time,weight-bearing time and complications of the two groups were compared.

RESULTSComparison of fracture healing time: bridge wire splint group was (6.0 +/- 0.3) weeks and Bryant traction group was (6.2 +/- 0.4) weeks; the time of weight-bearing in bridge wire splint group was (6.1 +/- 1.0) weeks and in Bryant traction group was (6.4 +/- 1.2) weeks; there was no significant difference between two groups. There was a significant difference in soft tissue complication between bridge wire splint group occurred in 3 cases and 13 cases in Bryant traction group. According to the criteria of clinical efficacy,in Bryant traction group, 12 patients got an excellent result, 4 good and 1 fair; in bridge wire splint group, the data were 17, 3 and 1 respectively,and there was no significant difference between the two groups.

CONCLUSIONBoth of bridge wire splint fixation and traditional Bryant traction for the treatment of femoral shaft fractures in children have good efficacy. Compared with Bryant traction,bridge wire splint fixation is simple, safe and has reliable effect.

Child, Preschool ; Female ; Femur ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Fracture Fixation ; adverse effects ; instrumentation ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Infant ; Male ; Postoperative Complications ; Splints ; Time Factors ; Tomography, X-Ray Computed ; Traction ; methods ; Treatment Outcome ; Weight-Bearing

OBJECTIVETo explore the clinical features and treatment results of brachial plexus palsy caused by halo traction before posterior correction in patients with severe scoliosis.

METHODSA total of 300 cases of severe scoliosis received halo traction before posterior correction in our department from July 1997 to November 2004. Among them, 7 cases were complicated with brachial plexus palsy. The average Cobb angle was 110 degree (range, 90 degree-135 degree). Diagnoses were made as idiopathic scoliosis in 1 case, congenital scoliosis in 3 cases, and neuromuscular scoliosis in 3 cases. Additionally, diastematomyelia and tethered cord syndrome were found in 3 cases and thoracolumbar kyphosis in 2 cases. Weight of traction was immediately reduced when the patient developed any abnormal neurological symptoms in the upper extremity, and rehabilitation training was undertaken. Simultaneously, neurotrophic pharmacotherapy was applied, and the neurological function restoration of the upper limbs and the recovery time were documented.

RESULTSTraction was used for an average of 3.5 weeks (range, 2-6 weeks) before spinal fusion for these 7 patients. The average traction weight was 8 kg, which was 19% on average (range, 13%-26%) of the average body weight (40.2 kg). These 7 patients had long and thin body configuration with a mean height of 175 cm. The duration between symptoms of brachial plexus paralysis and the diagnosis was 1-3 hours. All of these 7 patients presented various degrees of numbness in the ulnar side of the hand and forearm. Median nerve paresis was found in 3 cases and ulnar nerve paresis in 4 cases. Complete recovery of the neurological function had been achieved by the end of three months.

CONCLUSIONSThe clinical features of brachial plexus palsy caused by halo traction include median nerve paresis, ulnar nerve paralysis, and numbness in the ulnar side of the hand and forearm, which may be due to the injury of the inferior part of the brachial plexus, i.e., damage of C8 and T1 nerve roots. Complete recovery of neurological function can be expected when the patient is kept under careful observation for recognizing this complication as soon as possible, then immediately reducing or removing the traction weight, and adopting rehabilitation training and neurotrophic pharmaceutical treatment.

Adolescent ; Adult ; Brachial Plexus Neuropathies ; etiology ; therapy ; Child ; Female ; Humans ; Male ; Paralysis ; etiology ; therapy ; Prognosis ; Scoliosis ; therapy ; Traction ; adverse effects

OBJECTIVETo reduce the complication by transurethral vaporesection of prostate (TUVP) using adjustable urethral tractor.

METHODSOne hundred and six cases with benign prostate hypertrophy underwent TUVP and catheter traction after operation by an adjustable tractor. The results by catheter traction were compared with those by rubberized cloth paste and carbasus compression.

RESULTThe urethral stricture occurred in 2.7%, 6.7%, 30.4% of cases by the catheter traction, rubberized cloth paste and carbasus compression respectively, which had statistical significance (P <0.01).

CONCLUSIONThe incidence of urethral stricture can be reduced by catheter traction after TUVP.

Aged ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; surgery ; Traction ; instrumentation ; Transurethral Resection of Prostate ; adverse effects ; Urethral Stricture ; etiology ; prevention & control ; Urinary Catheterization