Manual reduction and traction fixation for the treatment of metacarpal neck fractures under ultrasound-guided / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical efficacy of manual reduction and traction fixation for the treatment of metacarpal neck fracture under ultrasound-guided.</p><p><b>METHODS</b>From April 2013 to August 2016, 30 patients with metacarpal neck fractures were treated with manual reduction and traction fixation under ultrasound-guided, including 26 males and 4 females aged from 14 to 56 years old with an average of (25.6±1.6) years old, the courses of diseases ranged from 7 h to 5 d with an average of (2.7±0.6) d. Twenty patients were the fifth metacarpal neck fracture, 7 patients were the 4th and 5th metacarpal neck fractures, 3 patients were the second metacarpal neck fracture. Fracture healing, angle of bilateral head shaft angle and active range of metacarpophalangeal joints was measured, and DASH score was applied to evaluate function.</p><p><b>RESULTS</b>Twenty-seven patients were followed up from 6 to 11 months with an average of(7.2±0.8) months. Fracture were healed from 5 to 8 weeks with an average of (5.6±0.4) weeks. The affected shaft angle was (15.1±1.8)°, and health head shaft angle was (13.5±2.8)°, while there was no significant difference (=1.54, >0.05). The affected range motion of metacarpophalangealjoint was(86.3±2.6)°, health active range motion of metacarpophalangeal joint was(91.8±1.6)°, and no significant difference between both side (=1.16, >0.05). DASH score was 4.3±1.5 at 7 months after operation.</p><p><b>CONCLUSIONS</b>Manual reduction and traction fixation for the treatment of metacarpal neck fracture under ultrasound-guided could dynamic observe fracture position in time, high patients' acceptability and is a feasible method for the treatment of metacarpal neck fracture.</p>

Hhigh-frequency ultrasound research on the normal adult sciatic nerve / 中国骨伤

<p><b>OBJECTIVE</b>To explore the application value of the high-frequency ultrasound examination of the normal adult sciatic nerve.</p><p><b>METHODS</b>The high frequency ultrasound was used to examine 60 cases ,a total of 120 normal adult sciatic nerve (28 males and 32 females ranging in age from 19 to 38 years old, averaged 23.8 years old). The age between men and women, height and weight showed no significant difference. The cross-sectional scanning and longitudinal scanning, if necessary, Panoramic Imaging were conducted. The cross section area of sciatic nerve was measured at the hip line, the middle of the thigh, the edge of the popliteal fossa, and the relationship betwen the sciatic nerve and surrounding muscle group was observed in each cross-section. Probe was rotated 90 degree to display the long axis of sciatic nerve, to get the longitudinal section along the long axis from top to bottom. So the sciatic nerve in the vertical axis and the surrouunding muscles was displayed by above method combined with panoramic imaging. The data of coss-sectional area of sciatic nerve were obtained at the central of hip line, the middle of the thigh, the edge of the popliteal fossa, and then were divided into different groups by gender and sides to do statistical analysis.</p><p><b>RESULTS</b>The applicatic nerve in thigh can be clearly displayed by high-frequency ultrasound in this group of 60 people with 120 nerves, but low display rate of sciatic nerve in hip, approximatley 31.4% (21/66). The longitudinal section of the sciatic nerve displayed as the banded isoechoic or slightly hyperechoic, parallel partial hyperechoic line could be seen in it; in the cross-section, it showed a clear edge of the sieve-like isoechoic or slightly hyperechnie, which could be oval ,trapezoidal, triangular and irregular in shape; the sciatic nerve bad visible passive movement and shape change when muscle contracted. There were statistically significant differences of cross-sectional area of sciatic nerves at the hip line ,the middle of thigh and edge of the popliteal fossa between 56 sciatic nerves in 28 males and 64 sciatic nerves in 32 females (P< 0.05); but there were no significant differences between left and right sides (P>0.05).</p><p><b>CONCLUSION</b>High frequency ultrasound can be used as the first choice of the sciatic nerve when an imaging method preferred.</p>