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find Keyword "粉碎性" 22 results
  • 锁骨粉碎性骨折合并锁骨下静脉损伤二例

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    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • Mini locked-plate trans-carpometacarpal joint internal fixation for treating comminuted fracture of base of the fifth metacarpal

    Objective To evaluate the effectiveness of open reduction and trans-carpometacarpal joint internal fixation with mini locked-plate for treatment of comminuted fracture of base of the fifth metacarpal. Methods Between July 2015 and December 2017, 8 cases of comminuted fractures of base of the fifth metacarpals were treated with open reduction and trans-carpometacarpal joint internal fixation with mini locked-plate. There were 7 males and 1 female with an age of 19-45 years (mean, 32.5 years). The causes of injury included 2 cases of hitting hard objects while clenching fist, 6 cases of falling injury. There were 2 cases of subluxation of fifth carpal joints and 1 case of dislocation. The time from injury to operation was 1-5 days (mean, 3.5 days). The stability of fracture ends could not be maintained by preoperative evaluation without over articular fixation or short time over articular fixation. Postoperative complications and fracture healing were observed, and hand function was evaluated at last follow-up according to the total active motion (TAM) recommended by the Branch of Hand Surgery of Chinese Medicine Association. Results All the incisions healed by first intention without complications such as wound infection, cutaneous necrosis, tendon or nerve injury. All the patients were followed up 6-18 months (mean, 12 months). All fractures healed with the healing time of 12-16 weeks (mean, 13 weeks). Within 4 months after operation, all patients were able to return to pre-injury job. At last follow-up, according to the TAM recommended by the Branch of Hand Surgery of Chinese Medicine Association, the results were excellent in 7 cases, good in 1 case, with the excellent and good rate of 100%. Conclusion Applying of mini locked-plate for treatment of comminuted fractures of base of the fifth metacarpal, of which cannot obtain stable fixation through non-transarticular or short-time transarticular fixation, can achieve satisfactory functional results with very few complications through trans-carpometacarpal joint approach, thus the procedure can be used as an alternative operation scheme.

    Release date:2018-10-31 09:22 Export PDF Favorites Scan
  • TREATMENT OF COMMINUTED FRACTURES AT DISTAL FEMUR AND PROXIMAL TIBIA WITH LESS INVASIVE STABILIZATION SYSTEMS

    Objective To study the clinical outcome of comminuted factures at distal femur and proximal tibia treated with AO less invasive stabilization systems (LISS). Methods The clinical data of 14 cases of distal femoral fracture and proximal tibial fracture from September 2003 to May 2005 were analyzed retrospectively. The injury was caused by traffic accident in 9 cases, by fall in 3 cases and by slipping in 2 cases. Of 14 cases, there were 5 open fractures and 9 close fractures, including 5 cases of distal femoral comminuted fracture and 9 cases of proximal shaft comminuted fractures. According to AO/OTA classification, the fractures were classified as 33C2 in 3 cases,33C3 in 2 cases,41A2 in 2 cases,41A3 in 2 cases,41B2 in 3 cases and 41C2 in 2 cases. All patients were treated by the internal fixation with LISS-distal femur or with LISS-proximal tibia. Healing of wounds, the X-ray films before and after operations, and therecovery of joint function were observed. Results The patients were followed up from 1 month to 20 months (11 months on average). Twelve cases achieved solid osseous unions from 3 months to 5 months postoperativly; 2 cases had a good reduction and recovered smoothly 2-3 months postoperatively. The results were excellent in 10 cases, good in 3 cases and fair in 1 case according to Johner-Wruhs knee scoring. The range of knee flexion-extension was 110-130° in 11 cases, 100° in 2 cases and 80° in 1 case. Conclusion LISS is an effective method of internal fixation for treating comminntedfracture of distal femur or proximal tibia. It has the advantages of less injury, satisfied reduction and reliable fixation.

    Release date:2016-09-01 09:26 Export PDF Favorites Scan
  • PRELIMINARY APPLICATION OF THREE-DIMENSIONAL PRINTING PERSONALIZED EXTERNAL FIXATOR IN SERIOUS TIBIOFIBULA FRACTURES

    ObjectiveTo explore a new method of treating serious tibiofibula comminuted fracture by using three-dimensional (3-D) printing personalized external fixator. MethodsIn April 2015, a male patient (aged 18 years with a height of 171 cm and a weight of 67 kg) with left tibiofibula comminuted fracture was included in the study. Computer-assisted reduction technique combined with 3-D printing was used to develop a customised personalized external fixator for fracture reduction. The effectiveness was observed. ResultsThe operation time was about 10 minutes without fluoroscopy, and successful reduction was obtained. The patient had equal limb length after operation. X-ray films showed that the posterior angulation of distal fracture was corrected 37°, and the eversion angle was corrected 4°. The tibial fractures had good paraposition or alignment, and the lower limb force line was corrected completely. No new fracture displacement occurred. The clinical healing time of fracture was 3.5 months and the bone union was achieved after 8 months. The function of affected limb recovered well after operation. ConclusionA personalized external fixator for serious tibiofibula comminuted fracture reduction made by 3-D printing technique has the merits of easy manipulation, high individuation, accurate reduction, stable fixation, and no need of fluoroscopy.

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  • TREATMENT OF COMMINUTED INFERIOR FEMORAL FRACTURES WITH COMBINATION OF SUPRACONDYLAR LOCKED INTRAMEDULLARY NAIL AND SHAPE MEMORY BLOCK HOOP INTERNAL FIXATOR UNDER ARTHROSCOPY

    Objective To investigate the advantages and the clinical outcomes of the treatment of comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. Methods From June 2002 to December 2004, 12 cases of comminuted inferior femoral fractures were treated(9 males, 3 females). Of them, 5 cases were classified as type B and 7 cases as type C according to AO classification . All cases were treated with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. In 12 cases of one-stage bone grafting, there 5 of autologous cancellous bone grafting and 7 allo-freeze drying bone grafting.Results With a follow-up of 6 to 18 months, all fractures healed within 3 to 6 months. There were no infection and nonunion. The function of all the knees joint was excellent. According to Noye’s criterion for knee scoring, the results were excellent in 9 cases and good in 3 cases; the excellent and good rate was 100%. Conclusion It is a good method to treat comminuted inferior femoral fractures with combination of supracondylar locked intramedullary nail and shape memory block hoop internal fixator under arthroscopy. It has many advantages of less injury to knee joint, good anatomic reduction and reliable fixation. 

    Release date:2016-09-01 09:26 Export PDF Favorites Scan
  • EFFECTIVENESS OF DIGITAL CUSTOMIZED STEEL PLATE IN TREATMENT OF COMPLEX FRACTURES OF LIMBS

    ObjectiveTo observe the effectiveness of digital customized plate in the treatment of complex limb fracture. MethodsBetween January 2012 and May 2013, CT raw data of complex limb fracture were used to establish the fracture three-dimensional simulation model after reduction, and a customized personalized anatomic plate was designed and used for internal fixation after open reduction in 42 cases. There were 22 males and 20 females, aged 16-53 years (average, 37.4 years). The causes of injury were traffic accident in 21 cases, falling from height in 18 cases, crush by heavy objects in 3 cases, including 26 cases of fresh closed fracture and 16 cases of open fracture (9 cases of type Ⅰ and 7 cases of type Ⅱ according to Gustilo classification). According to AO classification, there were 15 cases of humerus comminuted fracture, 4 cases of radial comminuted fracture, 8 cases of femoral comminuted fracture, and 15 cases of tibia comminuted fracture. The interval of injury and operation was 6-28 days (mean, 10 days). ResultsReduction and internal fixation of fracture were successfully performed on 42 patients. The length and position of digital customized plate, direction and length of screw implant, number of screw were basically identical with preoperative design. The operation time was 35-120 minutes (mean, 70 minutes); the blood loss volume was 30-500 mL (mean, 180 mL); and X ray fluoroscopy frequency was 2-6 times (mean, 3 times). Superficial infection occurred in 2 cases, and was cured after dressing change; primary healing of incision was obtained in the other patients. Forty-two cases were followed up 6-24 months with an average of 11.5 months. The fracture healing time was 8-19 weeks (mean, 14 weeks) in 41 cases; delayed union occurred in 1 case at 44 weeks after operation. The fracture anatomical reduction was achieved in 19 cases, malunion in 3 cases, and functional reduction in the other patients. At last follow-up, no plate and screw loosening and breakage was observed. ConclusionDigital customized plate in treatment of complex fractures of limbs, especially for the multiple comminuted fracture of long bones of the limbs has the advantages of convenient operation, less trauma, fewer complications, and good effectiveness.

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  • 可吸收线缝扎结合解剖钢板内固定治疗尺骨鹰嘴近中段粉碎性骨折

    目的 总结可吸收线缝扎结合解剖钢板内固定治疗尺骨鹰嘴近中段粉碎性骨折的临床疗效。 方法2005年10月-2010年8月,采用可吸收线缝扎结合解剖钢板内固定治疗12例尺骨鹰嘴近中段粉碎性骨折患者。男7例,女5例;年龄17~62岁,平均37.2岁。致伤原因:摔伤8例,交通事故伤3例,高处坠落伤1例。骨折按AO分型标准:21-B1型骨折9例,21-C1型骨折3例。受伤至手术时间4 h~18 d。 结果术后发生切口浅表感染2例,其余患者切口均Ⅰ期愈合;骨关节炎一过性加重1例,异位骨化1例,余均无相关并发症发生。患者均获随访,随访时间6~18个月,平均7.7个月。X线片示骨折均达临床愈合,愈合时间为2~4个月,平均2.6个月。无骨不连、内固定物松动及断裂发生。末次随访时肘关节功能根据X线片及Mayo肘关节功能评分标准,获优7例,良3例,可2例。 结论可吸收线缝扎结合解剖钢板内固定治疗尺骨鹰嘴近中段粉碎性骨折符合生物力学特点,固定可靠,有利于骨折愈合及早期功能锻炼。

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • 闭合复位带锁髓内钉固定治疗股骨干粉碎性骨折

    目的 评价应用闭合复位带锁髓内钉固定治疗股骨干粉碎性骨折的临床疗效。 方法 1999年8月~2005年4月,采用闭合复位顺行带锁髓内钉固定技术治疗股骨干粉碎性骨折70例。男54例,女16例;年龄17~58岁。骨折均位于股骨转子下2 cm至股骨髁上5 cm。按AO分型: B型17例,C型53例。受伤至手术时间为1~12 d,平均5.8 d。 结果 B型骨折患者手术时间为90~250 min,C型骨折患者60~180 min。70例失血量50~450 ml,平均230 ml。术中3例发生骨劈裂,1例C型骨折远端1枚锁钉锁入失误,7例肢体短缩1.0~1.5 cm。68例获随访10~60个月,平均19个月。63例于术后3~10个月骨折愈合,5例于术后3~4个月行远端锁钉取出动力化后4~10个月骨折愈合。60例髋、膝关节功能活动优良, 余8例髋或/和膝关节功能受限。 结论 闭合复位带锁髓内钉固定是治疗股骨干粉碎性骨折有效方法之一,具有损伤小、失血少、骨折愈合率高、功能恢复好的优点。

    Release date:2016-09-01 09:23 Export PDF Favorites Scan
  • 上颌骨粉碎性骨折整复治疗的临床分析

    目的 探讨上颌骨粉碎性骨折的病因、并发症、检查方法及骨折整复的治疗时机、手术入路、整复材料和预后。方法 1998年5月~2005年12月,收治48例上颌骨粉碎性骨折患者。男40例,女8例;年龄16~50岁。车祸伤36 例,暴力伤 6 例,坠落伤6例。主要表现咬牙合关系障碍,张口受限,面中部凹陷畸形。20例采用钢丝内固定术,28 例采用钛板坚强内固定术 (rigid internal fixation, RIF)。结果 48例中Ⅰ类伤口31处、Ⅱ类伤口38处,术后均甲级愈合。48例患者均获随访1~3年。术前临床症状明显改善或消失。疗效评估:行钢丝固定患者满意8例,一般12例;行RIF患者满意24例,一般4例,两种方法比较差异有统计学意义(Plt;0.05)。结论 引起功能障碍和畸形的上颌骨粉碎性骨折均应行外科整复治疗, RIF为目前理想的固定技术之一。

    Release date:2016-09-01 09:22 Export PDF Favorites Scan
  • DUAL PLATING FIXATION FOR DISTAL FIBULAR COMMINUTED FRACTURES

    ObjectiveTo evaluate the technique and effectiveness of dual plating fixation for distal fibular comminuted fractures. MethodsBetween November 2010 and November 2011, 16 patients with distal fibular comminuted fractures were treated, including 10 males and 6 females with an average age of 49.8 years (range, 35-65 years). All the patients had closed injury, which was caused by sprain in 9 cases, by traffic accident in 5 cases, and by falling in 2 cases. The average interval from injury to admission was 8 hours (range, 1-48 hours). Routine X-ray and CT scan were taken for confirmation of classification and involvement. According to Weber classification system, 11 cases were rated as type A, and 5 as type B; 5 cases had bimalleolar fractures with medial malleolar fracture, and 2 cases had trimalleolar fractures with posterior and medial malleolar fracture. Open reduction and dual plating fixation were performed after swelling was subsided. The X-ray films were taken during follow-up. The effectiveness was evaluated with visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot and ankle score system at last follow-up. The range of motion (ROM) of the ankle and complications were also been recorded. ResultsDelayed healing of incision occurred in 1 patient with diabetes, who was cured after changing dressing; primary healing was obtained in the other patients. Twelve patients were followed up 18 months on average (range, 12-24 months). Radiographic examination demonstrated the mean time of bone healing was 12 weeks (range, 10-14 weeks). No complication of implant failure, malunion, nonunion, or post-traumatic arthritis occurred during follow-up. The AOFAS hindfoot and ankle score was 79.6±6.5, and the VAS score was 1.3±1.5. The ROM of the ankle was (70.0±8.0)° of flexion and (84.0±5.1)° of extension. ConclusionDual plating fixation for distal fibular comminuted fractures can obtain a rigid stabilization with a low complication incidence, so it is a safe and effective method.

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