الملخص
Background@#Available research about the anatomic patterns of intertrochanteric fractures is lacking, and fracture mapping has not previously been performed on intertrochanteric fractures. This study aimed to determine the major trajectories of intertrochanteric fracture lines using computed tomography data from a series of surgically treated patients.@*Methods@#In this study, 504 patients with intertrochanteric fractures were retrospectively analyzed. Fracture patterns were graded according to Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification. Fracture lines were transcribed onto proximal femoral templates and graphically superimposed to create a compilation of fracture maps that were subsequently divided into anterior, posterior, lateral, and medial fracture maps to create a three-dimensional (3D) pattern by reducing fragments in the 3D models. The fracture maps were then converted into frequency spectra. The major fracture patterns were assessed by focusing on the lateral femoral wall, lesser trochanter, intertrochanteric crest, and inner cortical buttress.@*Results@#Anterior, posterior, lateral, and medial fracture maps were created. The majority of fracture lines (85.9%, 433/504) on the anterior maps were along the intertrochanteric line where the iliofemoral ligament was attached. In the medial plane, the majority of fracture lines (49.0%, 247/504) shown on the frequency spectrum included the turning point involving the third quadrant. In the posterior plane, the majority of fracture lines (52.0%, 262/504) involved the intertrochanteric crest from the greater to the lesser trochanter. In the lateral plane, the majority of fracture lines (62.7%, 316/504) involved the greater trochanter at the gluteus medius attachment.@*Conclusions@#The fracture patterns observed in the present study might be used to describe morphologic characteristics and aid with management strategies. Further classifications or modifications that incorporate the fracture patterns identified in this study may be used in future research.
الملخص
BACKGROUND@#Available research about the anatomic patterns of intertrochanteric fractures is lacking, and fracture mapping has not previously been performed on intertrochanteric fractures. This study aimed to determine the major trajectories of intertrochanteric fracture lines using computed tomography data from a series of surgically treated patients.@*METHODS@#In this study, 504 patients with intertrochanteric fractures were retrospectively analyzed. Fracture patterns were graded according to Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification. Fracture lines were transcribed onto proximal femoral templates and graphically superimposed to create a compilation of fracture maps that were subsequently divided into anterior, posterior, lateral, and medial fracture maps to create a three-dimensional (3D) pattern by reducing fragments in the 3D models. The fracture maps were then converted into frequency spectra. The major fracture patterns were assessed by focusing on the lateral femoral wall, lesser trochanter, intertrochanteric crest, and inner cortical buttress.@*RESULTS@#Anterior, posterior, lateral, and medial fracture maps were created. The majority of fracture lines (85.9%, 433/504) on the anterior maps were along the intertrochanteric line where the iliofemoral ligament was attached. In the medial plane, the majority of fracture lines (49.0%, 247/504) shown on the frequency spectrum included the turning point involving the third quadrant. In the posterior plane, the majority of fracture lines (52.0%, 262/504) involved the intertrochanteric crest from the greater to the lesser trochanter. In the lateral plane, the majority of fracture lines (62.7%, 316/504) involved the greater trochanter at the gluteus medius attachment.@*CONCLUSIONS@#The fracture patterns observed in the present study might be used to describe morphologic characteristics and aid with management strategies. Further classifications or modifications that incorporate the fracture patterns identified in this study may be used in future research.
الملخص
<p><b>OBJECTIVE</b>TFo compare the efficacy and complications rate of intramedullary (IM) nailing or K-wire versus plating fixation for clavicular fractures.</p><p><b>METHODS</b>Pubmed, Embase, Cochrane Library databases, CNKI, VIP and Wangfang databases were searched to find all randomized or quasi-randomized controlled trials of clavicle fractures using plating versus IM nailing or K-wire. The methodologic quality of the studies was assessed. After independent study selection by 2 authors ,data were collected and extracted independently. Outcomes of postoperative shoulder functional measurement, the efficacy and information of the operation and complications rate were meta-analyzed using RevMan 5 software.</p><p><b>RESULTS</b>Nine hundreds and seventy-six patients in 10 randomized controlled trials (RCTs) and 3 quasi-RCTs were involved in the meta-analysis,of which 5 studies compared the K-wire and the plating fixations and 8 studies compared the IM nailing and the plating fixations. The overall odds ratio(OR) (with 95% CI) of the operation efficacy for K-wire versus the plating was 3.79 (1.93, 7.46). The overall weighted mean difference (with 95% CI) of Constant Shoulder score for plating versus IM fixation was -1.39 (-3.43, 0.65) in 6 studies. The overall OR of the plating versus IM nailing was 9.34(2.70, 32.32) for the overall major complications in 5 studies and 5.04 (1.52,16.77) for the revision rate in 5 studies.</p><p><b>CONCLUSION</b>The current limited evidences suggested that the IM fixation could reduce the incidences of the overall major complications and the revision surgery, while the post-operative efficacy of the plating was superior to the K-wire. More high quality RCTs are still needed in the future.</p>
الموضوعات
Humans , Bone Nails , Bone Wires , Clavicle , Wounds and Injuries , General Surgery , Fracture Fixation, Intramedullary , Methods , Fractures, Bone , General Surgery , Randomized Controlled Trials as Topicالملخص
This paper describes automatic registration of the serial cross-sectional images of Chinese digital human by projective registration method based on the landmarks using the commercially available software Photoshop and Matlab. During cadaver embedment for acquisition of the Chinese digital human images, 4 rods were placed parallel to the vertical axis of the frozen cadaver to allow orientation. Projective distortion of the rod positions on the cross-sectional images was inevitable due to even slight changes of the relative position of the camera. The original cross-sectional images were first processed using Photoshop software firstly to obtain the images of the orientation rods, and the centroid coordinate of every rod image was acquired with Matlab software. With the average coordinate value of the rods as the fiducial point, two-dimensional projective transformation coefficient of each image was determined. Projective transformation was then carried out and projective distortion from each original serial image was eliminated. The rectified cross-sectional images were again processed using Photoshop to obtain the image of the first orientation rod, the coordinate value of first rod image was calculated using Matlab software, and the cross-sectional images were cut into images of the same size according to the first rod spatial coordinate, to achieve automatic registration of the serial cross-sectional images. sing Photoshop and Matlab softwares, projective transformation can accurately accomplish the image registration for the serial images with simpler calculation processes and easier computer processing.