Case-control study on the treatment of patellar fracture with "8" tension band wire fixation either by percutaneous or open reduction / 中国骨伤

<p><b>OBJECTIVE</b>To study the clinical efficacy of the treatment of patellar fracture percutaneous or open reduction with "8" tension band wire fixation.</p><p><b>METHODS</b>From July 2007 to April 2010,96 patients with patellar fracture were treated by percutaneous or open reduction with "8"tension band wire fixation. In percutaneous group,there were 28 males and 20 females with an average age of (53.8 +/- 4.7) years old (ranged, 21 to 84); there were 27 transverse fractures and 21 comminuted fractures. In open reduction group, there were 26 males and 22 females with an average age of (49.1 +/- 4.2) years old (ranged, 19 to 86); there were 25 transverse fractures and 23 comminuted fractures. The operation time, hospital stay, and pain score on the first day and one week after operation were compared, and Böstman score was compared too.</p><p><b>RESULTS</b>All patients were followed up with an average of 13 months ranging from 6 to 19 months. The mean operation time of percutaneous group was (53.0 +/- 4.3)min and the open reduction group was (49.0 +/- 3.1) min, and there was no statistic differences between two groups (P > 0.05). The hospital stay, healing time in percutaneous group was shorter than that of open reduction group; VAS score on first day and the first week after operation in percutaneous group was lower than that of open reduction group. The mean Böstman score in percutaneous group (28.8 +/- 4.7) was lower than open reduction group (24.6 +/- 4.3).</p><p><b>CONCLUSION</b>Percutaneous internal fixation for the treatment of patellar fracture has advantages of minimally invasive, quick recovery. The clinical effectiveness of this method is superior to the open reduction.</p>

Comparison between open reduction internal fixation with kirschner nails and mini-plates in treatment of Mason type II and III fractures of radial head: a case-control study / 中国骨伤

<p><b>OBJECTIVE</b>To compare the effect between open reduction internal fixation with Kirschner nails and miniplates in the treatment of Mason type II and III fractures of radial head.</p><p><b>METHODS</b>From May 2004 to March 2010, 50 cases of Mason type II and III fractures of radial head were treated with Kirschner nails or mini-plates. In Kirschner nail group, there were 13 males and 10 females (mean age 42.5 +/- 0.7 years), and 14 cases of Mason type II and 9 cases of Mason type III fracture. In mini-plate group, there were 17 males and 10 females (mean age 41.7 +/- 0.5 years), and 16 cases of Mason type II and 11 cases of Mason type of III fracture. The excellent and good rates according to the Broberg and Morrey Elbow Score, and the rate of ectopic ossification were compared.</p><p><b>RESULTS</b>All the patients were followed up for 12-24 (mean 16.5 +/- 1.3) months. The Broberg and Morrey Elbow Score of mini-plate group was (90.5 +/- 11.6), and that of Kirschner nail group was (70.6 +/- 11.3). The result of mini-plate group was excellent in 15 cases, good in 9 cases, fair in 2 cases, and poor in 1 case; The result of Kirschner nail group was excellent in 8 cases, good in 9 cases, fair in 3 cases and poor in 3 cases. The effect of mini-plate group was better than that of Kirschner nail group. There was no statistic difference in the rate of ectopic ossification between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Fractures of radial head can be well treated with open reduction and internal fixation by mini-plates, which offer better results than Kirschner nails.</p>

Clinical observation on percutaneous autologous bone marrow grafting for treatment of fracture nonunion / 中国骨伤

<p><b>OBJECTIVE</b>To observe the effectiveness of percutaneous bone marrow grafting for treatment of fractures nonunion.</p><p><b>METHODS</b>From June 2001 to December 2007, 29 consecutive cases of fractures nonunion were treated with percutaneous autologous bone marrow grafting included 20 males and 9 females, ranging in age from 20 to 71 years, with an average of 40 years. All the cases were traumatic fractures involving 13 of tibia, 10 of femur, 3 of humerus, 2 of ulna, 1 of radius, 11 cases of them were open fractures. All the cases were performed internal or external fixation before marrow grafting, intramedullary pin in 15 cases, plate in 12 cases, external fixator in 2 cases. The time from injury to therapy were from 6 to 12 months, with an average of 8.5 months. The type of nonunion included atrophic in 26 cases,hypertrophic in 3 cases. All the cases were performed 3 times injection, the interval was 1 month. According to the different fracture, the amount of bone marrow was from 6 to 15 ml.</p><p><b>RESULTS</b>All the 29 cases were followed-up for from 5 to 22 months with an average of 14 months. Four of them were not observed obvious callus after 3 months from the 3rd injection, judged unsuccessful therapy, changed to perform autologous bone grafting (3 of them re-internal fixation), the follow-up ended. The other 25 cases obtained bone union during 3 to 8 months with an average of 4.5 months, the follow-up ended at the time of internal fixation removal.</p><p><b>CONCLUSION</b>Percutaneous autologous bone marrow grafting is an effective, easy and economic therapy for fracture nonunion. But stable internal or external fixation is the premise. Excessive bone defect, the gap more than 5 mm and mal-align requiring rectification is not appropriate for this therapy.</p>

Early diagnosis and therapy of osteofascial compartment syndrome of the foot / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effects of decompresion through double-incision of foot dorsum on the treatment of osteofascial compartment syndrome of the foot under the monitoring of saturation of blood oxygen.</p><p><b>METHODS</b>From January 2000 to June 2007, 26 cases of osteofascial compartment syndrome of the foot were decompressed through double-incision of foot dorsum under the monitoring of saturation of blood oxygen, and relaxation suture or skin grafting were operated within 3 to 10 days after decompressing. Among them, 22 patients were males and 4 were females, with an average age of 36.3 years old ranging from 22 to 68 years. According to AOFAS system, the pain, function, autonomic activities and support were evaluated.</p><p><b>RESULTS</b>All patients were followed-up for from 6 to 43 months with the average of 19 months. All patients were healed. According to AOFAS system, the total scores increased from preoperative (30.4 +/- 8.02) to postoperative (92.5 +/- 5.0) (t = 3.13, P < 0.01); the results were excellent in 21 cases, good in 4 and poor in 1.</p><p><b>CONCLUSION</b>The patients of fracture-dislocated, swelling and injured in the soft tissue because of severe violence should observed closely on osteofascial compartment syndrome of the foot early. Feet are operated and thoroughly decompressed as soon as it is diagnosed as the compartment syndrome. Osteofascial compartment syndrome of the foot decompressed by foot dorsum double-incision is convenient and satisfied, and the operation is performed by internal fixation if it is displacedly fractured at the same time.</p>