ABSTRACT
<p><b>OBJECTIVE</b>To discuss feasibility and clinical effects of minimally invasive percutaneous plate osteosynthesis in treating acetabulum anterior column fracture with intact true pelvic brim.</p><p><b>METHODS</b>From May 2013 to December 2015, 8 patients with acetabulum anterior column fracture with intact true pelvic brim were reviewed retrospectively. According to Judet-Letournel classification, all were simple unstable acetabulum anterior column fracture. Among them, there were 5 males and 3 females with an average age of 42.8 years old ranging from 22 to 63. The injury was caused by crush in 4 cases, smash of heavy object in 3 cases, and falling down in 1 case. The time from injury to operation was ranged from 5 to 19 days with an average of 9.5 days. Preoperative CT showed high anterior column fracture of acetabulum with intact true pelvic brim, the fracture separation was less than 1 cm. All the patients were treated with closed reduction and minimally invasive percutaneous plate osteosynthesis. The quality of fracture reduction, operation time, blood loss, fracture healing time, hip function and postoperative complications were observed and recorded.</p><p><b>RESULTS</b>All patients were followed up from 10 to 19 months with an average of 14.5 months. The quality of reduction was classified as anatomical in 4 patients, imperfect in 3, poor in 1 by Matta's score system. The operation time was 30 to 80 min, averaged 51.3 min;the blood loss was 50 to 120 ml, averaged 86.2 ml; fracture healing time was 10 to 19 weeks, averaged 13.3 weeks. At the latest follow-up, the hip function was evaluated by Merle D'Aubigne scoring system, 5 cases got excellent results, 2 cases in good, and 1 case in fair. No vascular nerve injury, wound infection, bleeding, deep vein thrombosis and other complications occurred in 8 patients.</p><p><b>CONCLUSIONS</b>Minimally invasive percutaneous plate osteosynthesis in treating acetabulum anterior column fracture with intact true pelvic brim has advantages of less trauma, less bleeding, quick recovery and good curative effect, and it is a good surgical procedures for acetabulum anterior column fracture.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical effects of combined methods of minimally invasive percutaneous proximal humeral internal locking system (PHILOS) and injectable bone for the treatment of proximal humerus fractures in elderly patients.</p><p><b>METHODS</b>From January 2006 to January 2012, 80 patients with proximal humerus fractures were randomly divided into two groups (n = 40). The patients in the research group were treated with minimally invasive PHILOS fixation combined with injectable bone, including 20 males and 20 females, with an average age of (68.4 +/- 11.9) years; according to AO classification, 2 cases of type A1, 3 cases of type A2, 6 cases of type B1, 7 cases of type B2, 9 cases of type B3, 6 cases of type C1, 7 cases of type C2. The patients in the control group were treated with PHILOS fixation, including 18 males and 22 females, with an average age of (65.4 +/- 10.7) years; according to AO classification, 3 cases of type A1, 4 cases of type A2, 5 cases of type B1, 8 cases of type B2, 10 cases of type B3, 5 cases of type C, and 5 cases of type C2. The BMD, satisfactory rate, postoperative complications,bone healing time, Constant-Murley score in the two groups were reviewed and compared.</p><p><b>RESULTS</b>In the research group, no patients had necrosis of femoral head, 1 patient had shoulder varus, 1 patient had internal fixation loosening, 36 patients were satisfactory with the treatment results, BMD was (1.013 +/- 0.109) g/cm2, bone healing time averaged (12.00 +/- 3.79) weeks, and the Constant-Murley score was 97.2 +/- 4.6. In the control group, 3 patients had necrosis of femoral head, 5 patients had shoulder varus, 6 patients had internal fixation loosening, 32 patients were satisfactory with the treatment results, BMD was (0.812 +/- 0.089) g/cm2, bone healing time averaged (20.00 +/- 8.67) weeks,and the Constant-Murley score was 78.5 +/- 3.2. The results of BMD, satisfactory rate, postoperative complications, bone healing time, and Constant-Murley score in the research group were better than those of control group (P < 0.05).</p><p><b>CONCLUSION</b>PHILOS combined with injectable bone for the treatment of proximal humerus fractures in elderly patients has advantages of minimal wound, stable fixation, and earlier rehabilitation.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Bone Plates , Fracture Fixation, Internal , Methods , Humerus , General Surgery , Injections , Retrospective Studies , Shoulder Fractures , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship between variable influence factors and postoperative 2 week hospital special surgery (HSS) of knee joint, thus offer the treatment suggestion to patients with osteoarthritis, and judge the comprehensive effective prognosis to the clinical patient.</p><p><b>METHODS</b>From March 2008 to August 2010, 72 patients with 72 knees were treated with TKA (treatment group), including 30 males and 42 females with a mean age of (71.9 +/- 6.2) years (ranged, 60 to 86 years). Twenty-two patients with HoldenIV OA treated by arthroscopy were in the control group, including 10 males and 12 females with a mean age of (70.5 +/- 5.9) years. The index including height, weight, BMI, muscle strength,knee joint HSS score and ROM were evaluated before operation and at 1st, 2nd weeks after operation.</p><p><b>RESULTS</b>The HSS knee score and ROMs of patients in the treatment group improved. The pre-operative ROM, HSS score, knee pain, continous passive motion (CPM) at different level (i.e.CPM initial angle) had a prominent positive correlation with HSS score in postoperative 2 weeks. The factors such as patients' age, height, weight, BMI, muscular strength, etc. had no obvious relevant to HSS score in postoperative 2 weeks.</p><p><b>CONCLUSION</b>The pre-operative HSS score, knee pain, knee ROM, perioperative severe complications, and postoperative CPM initial angle have a positive correlation with the postoperative effects.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Knee , Case-Control Studies , Osteoarthritis, Knee , General Surgery , Range of Motion, ArticularABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical characteristics,diagnosis and treatment of intestinal heterotopic gastric mucosa resulting in alimentary tract hemorrhage.</p><p><b>METHODS</b>Eleven cases of intestinal heterotopic gastric mucosa with alimentary tract hemorrhage during the past 24 years in our hospital were reviewed and the clinical data were analyzed retrospectively.</p><p><b>RESULTS</b>The median age was 29 years old. Nine cases had abdominal pain, and radionuclide (99m)Tc-pertechnetate scan revealed bleeding lesion in 6 cases preoperatively. Segmental resection of the intestine with bleeding lesion were performed in all patients, postoperative pathology confirmed heterotopic gastric mucosa. The lesion was located in the jejunum in five cases and in the ileum in six cases. All lesions were complicated with diverticulum, or inflammatory mass on the intestinal wall, or abnormity of intestinal duplication.</p><p><b>CONCLUSIONS</b>Intestinal heterotopic gastric mucosa is difficult to be diagnosed preoperatively, and radionuclide (99m)Tc-pertechnetate scan plays a role in preoperative diagnosis.</p>