OBJECTIVE: To evaluate the effectiveness and safety of minimally invasive treatment for bilateral tibial plateau fractures using the double reverse traction reducer. METHODS: The clinical data of 4 patients with bilateral tibial plateau fractures who met the selection criteria and treated between January 2016 and April 2024 were retrospectively analyzed. The cohort included 3 males and 1 female, aged 30-65 years (mean, 52.5 years). Injury mechanisms comprised traffic accidents (2 cases) and falls (2 cases). According to the Schatzker classification, 2 limbs were type Ⅱ and 6 were type Ⅵ. The time from injury to surgery ranged from 5 to 9 days (mean, 7 days). All patients underwent minimally invasive reduction using the double reverse traction reducer. Surgical duration, intraoperative blood loss, and hospitalization time were recorded. Functional outcomes were assessed at last follow-up using the Hospital for Special Surgery (HSS) knee score and range of motion (ROM), while fracture reduction quality was evaluated using the Rasmussen radiological score. RESULTS: All 4 patients successfully completed the procedure without conversion to open reduction. The total mean operation time was 80.25 minutes (range, 73-86 minutes), with a mean total intraoperative blood loss of 132.5 mL (range, 100-150 mL). The mean hospitalization time was 13.5 days (range, 11-16 days). All incisions healed primarily without neurovascular complications. X-ray film at 1 day after operation confirmed satisfactory reduction and articular surface alignment. Follow-up time ranged from 12 to 26 months (mean, 17.0 months). Fractures achieved clinical union at an average of 13 weeks (range, 12-16 weeks). No complication, such as deep vein thrombosis, joint stiffness, post-traumatic arthritis, or implant failure, was observed. At last follow-up, the mean HSS score was 92.9 (range, 90-97), mean knee ROM was 128.1° (range, 115°-135°), and mean Rasmussen radiological score was 16.4 (range, 15-19), with 2 limbs rated as excellent and 6 as good. CONCLUSION The double reverse traction reducer facilitates minimally invasive treatment of bilateral tibial plateau fractures with advantages including minimal trauma, shorter surgical duration, precise reduction, and fewer complications, effectively promoting fracture healing and functional recovery of the knee joint.
Humans ; Tibial Fractures/diagnostic imaging* ; Middle Aged ; Male ; Minimally Invasive Surgical Procedures/instrumentation* ; Female ; Adult ; Retrospective Studies ; Aged ; Traction/methods* ; Treatment Outcome ; Fracture Fixation, Internal/instrumentation* ; Range of Motion, Articular ; Operative Time ; Tibial Plateau Fractures

BACKGROUND: Total hip arthroplasty (THA) for severe developmental dysplasia of the hip (DDH) is a technically demanding procedure for arthroplasty surgeons, and it is often difficult to reduce the hip joint without soft tissue release due to severe flexion contracture. We performed two-stage THAs in irreducible hips with expected lengthening of the affected limb after THA of over 2.5 cm or with flexion contractures of greater than 30 degrees in order to place the acetabular cup in the true acetabulum and to prevent neurologic deficits associated with acute elongation of the limb. The purpose of this study is to evaluate the outcomes of cementless THA in patients with severe DDH with a special focus on the results of two-stage THA. METHODS: Retrospective clinical and radiological evaluations were done on 17 patients with Crowe type III or IV developmental DDH treated by THA. There were 14 women and 3 men with a mean age of 52.3 years. Follow-ups averaged 52 months. Six cases were treated with two-stage THA followed by surgical hip liberalization and skeletal traction for 2 weeks. RESULTS: The mean Harris hip score improved from 40.9 to 89.1, and mean leg length discrepancy (LLD) in 13 unilateral cases was reduced from 2.95 to 0.8 cm. In the patients who underwent two-stage surgery, no nerve palsy was observed, and the single one-stage patient with incomplete peroneal nerve palsy recovered fully 4 weeks postoperatively. CONCLUSIONS: The short-term clinical and radiographic outcomes of primary cementless THA for patients with Crowe type III or IV DDH were encouraging. Two-stage THA followed by skeletal traction after soft tissue release could provide alternative solutions to the minimization of limb shortenings or LLD without neurologic deficits in highly selected patients.
Adult ; Aged ; Arthroplasty, Replacement, Hip/*instrumentation/*methods ; Female ; Femur/radiography/surgery ; Hip/radiography/surgery ; Hip Dislocation, Congenital/pathology/radiography/*surgery ; Hip Joint/pathology/radiography/surgery ; Hip Prosthesis ; Humans ; Ilium/radiography/surgery ; Male ; Middle Aged ; Orthopedic Fixation Devices ; Retrospective Studies ; Traction

OBJECTIVETo observe the curative effect of self-made eccentric traction belt as a manipulative reduction tool in the treatment of the distal radial fracture.

METHODSFrom February 2011 to June 2012,62 patients with distal radial closed fractures were treated by manipulative reduction with self-made wristlet-eccentric traction belt and combined with the small splint and plaster external fixation. Among them, 59 cases were Colles fractures, 2 were Smith fractures, 1 was Barton fracture. After the reduction, lateral X-ray imaging was used to evaluate curative effect immediately.

RESULTSAll the patients obtained excellent and good reduction in standard of fractures, only 1 case didn't. According to functonal assessment of Dienst, the results were excellent in 49 cases, good in 11, fair in 1, and poor in 1.

CONCLUSIONSelf-made wristlet-eccentric traction belt as a manipulative reduction tool to treat distal radius fractures, can make fractures close to the anatomic reduction, and can significantly improve the manual reduction success rate.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Radius Fractures ; therapy ; Traction ; instrumentation ; Young Adult

Child ; Extraoral Traction Appliances ; Humans ; Molar ; Orthodontic Wires ; Orthodontics, Interceptive ; instrumentation ; Prognosis ; Time Factors ; Tooth Crown ; surgery ; Tooth Eruption, Ectopic ; surgery ; therapy ; Tooth Movement Techniques ; instrumentation ; methods

In a patient with a distal common bile duct stone, a fracture of the traction wire of the basket occurring during the performance of mechanical lithotripsy resulted in the impaction of the lithotripter basket with a stone. The impacted lithotripter basket combined with a fracture of the traction wire is a rare complication of endoscopic stone removal. We were able to pull the impacted basket using an Amplatz goose-neck snare inserted via the percutaneous transhepatic route, which resulted in the freeing of the entrapped stone into the dilated supra-ampullary bile duct. The fractured traction wire and basket could be safely removed by pulling the traction wire from the mouth. The present report is the first to describe the safe and effective use of an Amplatz goose-neck snare for the management of a lithotripter basket impacted with a stone and a fractured traction wire.
Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Device Removal/*methods ; Diagnosis, Differential ; Equipment Failure ; Gallstones/radiography/*therapy ; Humans ; Lithotripsy/*instrumentation ; Male ; Radiography, Interventional ; Tomography, X-Ray Computed ; Traction/instrumentation

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 develop a traction reductor for the reduction of lower limb fractures during the minimally invasive surgery and explore its safety and efficacy.

METHODSFrom February 2007 to March 2009, closed or limited open reduction plus percutaneous plate and screw internal-fixation were conducted in 34 patients with fracture of distal femur and tibia metaphysic, among which there were 3 distal femoral fractures (2 33-B, 1 33-C), 14 proximal tibial fractures (9 41-A, 3 41-B, 2 41-C) and 17 distal tibial fractures (9 43-A, 5 43-B, 3 43-C, 2 Gustilo I a), according to the Association for Osteosynthesis-Orthopaedic Trauma Association (AO-OTA) classification. Besides, closed reduction plus interlocking intramedullary nailing on tibial shaft fracture were applied in 36 patients (7 42-A, 21 42-B, 8 42-C, 2 Gustilo I a). All the 70 patients, with an average age of 37.6 years (range: 17 to 63 years) and average time before surgery of 4.7 d (range: 0.7 to 12.0 d), underwent reduction by self-designed traction reductor for lower limb fracture in the surgery. The reduction duration and C-arm fluoroscopy time were recorded. Recovery of the force line of affected limbs after surgery was determined by whether the line from anterior superior iliac spine to the interdigit between the first and second toe-web passed the patella center. And the distance from bilateral anterior superior iliac spine to medial malleolus tip as well as the difference between lower limbs were recorded to determine the recovery of length after surgery. Meanwhile, the varus-valgus and anteroposterior angulations after reduction were measured by AP and lateral X-ray.

RESULTSThe reduction duration was 12.7 min (range: 7 to 31 min); X-ray fluoroscopy time, 1.3 min (range: 0.4 to 3.0 min); length difference between both lower limbs (6.5 ± 1.1) mm; and axial alignment difference (7.0 ± 1.8) mm. The X-ray result showed that varus-valgus angle was (2.75 ± 0.16)°; and anteroposterior angulation (5.13 ± 0.51)°.

CONCLUSIONThe traction reductor for lower limb fracture could achieve satisfying fracture reduction in the minimally invasive surgery of distal femur, tibia metaphysic and tibial shaft fracture.

Adolescent ; Adult ; Equipment Design ; Female ; Fractures, Bone ; surgery ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Traction ; instrumentation ; Young Adult

Child ; Dental Implantation, Endosseous ; Extraoral Traction Appliances ; Humans ; Male ; Malocclusion, Angle Class III ; therapy ; Maxilla ; abnormalities ; Orthodontic Anchorage Procedures ; instrumentation ; Orthodontic Appliance Design ; Orthodontics, Corrective ; instrumentation

OBJECTIVETo study the clinical effect of tractive reduction with external fixator and arthroscopically assisted treatment for tibial plateau fractures.

METHODSFrom February 2003 to January 2005, a total of 26 cases with tibial plateau fractures were reviewed. There were 4 cases of type I fracture, 5 type II, 4 type III, 6 type IV, 5 type V and 2 type VI based on Schatzker criteria. Before operation, X-ray examination and CT scanning were done. During operation, the dissociative fragments were reconstructed by tractive reduction with external fixator arthroscopically and fixated with screws or plates.

RESULTSAll the fractures were healed within 1.5 - 4 months, with no severe complications such as poor wound healing, infection or osteofascial compartment syndrome. All patients that were followed up for 7 - 21 months (mean, 16 months) showed no traumatic osteoarthritis, inversion or eversion of the knee. According to the Rasmussen scoring system, the outcome was excellent in 11 cases, good in 13 and fair in 2, with total score of 27 +/- 2.

CONCLUSIONSAs for Schatzker type I - VI tibial plateau fractures, tractive reduction with external fixator and arthroscopically assisted treatment is characterized by minimal invasion, fast fracture healing. It broadens operative interspace of articular cavity, improves accuracy of reduction, is beneficial for knee joint function to recover.

Adult ; Arthroscopy ; methods ; External Fixators ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Fractures, Closed ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery ; Traction ; instrumentation ; methods ; Treatment Outcome

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