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OBJECTIVE@#To explore the clinical effect of Kirschner wire intramedullary fixation in the treatment of both-bone forearm fractures in children of high altitude area.@*METHODS@#From August 2020 to December 2021, 19 children were treated with Kirschner wire intramedullary fixation including 11 males and 8 females, aged from 4 to 13 years old with an average of (8.16±2.71) years old. The course of disease was 1 to 10 days, with a mean of (4.11±2.51) d. First, close reduction was performed. If the reduction was unsuccessful, limited open reduction was performed, followed by Kirschner wire intramedullary fixation of the radius and ulna. The fracture healing was evaluated by X-ray after operation, and the curative effect was evaluated by Anderson forearm function score standard.@*RESULTS@#The wound healed well after operation, 2 cases had clinical manifestations of needle tail irritation after operation, and the symptoms disappeared after removing the internal fixation. The average follow-up time was(7.68±3.50) months (3 to 14 months). X-ray showed that all fracture healing in follow-up, Anderson forearm function score showed excellent in 16 cases, good in 2 cases and fair in 1 case at the final follow-up.@*CONCLUSION@#Children with fractures in plateau areas often have delayed medical treatment, lack of medical conditions and insufficient compliance. Based on these characteristics, Kirschner wire intramedullary fixation for the treatment of children's double forearm fractures has the advantages of small injury and rapid recovery. It is a kind of operation method that can be popularized.
Subject(s)
Male , Female , Humans , Child , Child, Preschool , Adolescent , Bone Wires , Forearm , Altitude , Treatment Outcome , Fractures, Bone/surgery , Fracture Fixation, Internal/methods , Radius Fractures/surgery , Fracture Fixation, Intramedullary/methodsABSTRACT
OBJECTIVE@#To analyze the clinical outcomes of mini-plate combined with wireforms in the treatment of Type C distal radial fractures with marginal articular fragments.@*METHODS@#This retrospective study included a total of 10 cases, including 5 males and 5 females, with 6 cases involving the left side and 4 cases involving the right side, of Type C distal radial fractures with marginal articular fragments. The age of the patients ranged from 35 to 67 years old. All patients underwent surgical treatment utilizing mini-plate combined with wireforms for internal fixation.@*RESULTS@#The follow-up period ranged from 6 to 18 months. Complete fracture healing was observed in all cases, with healing times ranging from 10 to 16 weeks. During the entire follow-up period, patients reported high levels of satisfaction with the treatment outcomes, and there were no incidences of incision infection, chronic wrist pain, or wrist traumatic arthritis. At the final follow-up assessment, the Mayo score for the wrist joint ranged from 85 to 95, with 7 cases rated as excellent and 3 cases as good.@*CONCLUSION@#Mini-plate combined with wireforms proves to be an effective fixation method for Type C distal radial fractures with marginal articular fragments. The early initiation of wrist joint exercises, strong fixation, maintenance of proper reduction, minimal complications, and high rates of excellent and good outcomes demonstrate the reliability and efficacy of this treatment approach.
Subject(s)
Male , Female , Humans , Adult , Middle Aged , Aged , Retrospective Studies , Reproducibility of Results , Radius Fractures/surgery , Fracture Fixation, Internal/methods , Treatment Outcome , Wrist Fractures , Wrist Joint , Bone Plates , Range of Motion, ArticularABSTRACT
Abstract Distal radial fractures are very common. Vicious consolidation can occur in up to one third of these fractures, resulting in wrist pain, restricted movement, and, eventually, physical limitation or disability. The treatment of this condition consists in corrective osteotomy, which requires careful preoperative planning due to its three-dimensional complexity, especially in injuries with joint involvement. Recently, prototyping based on three-dimensional (3D) reconstruction of computed tomography (CT) scans has been used for osteotomy planning in a 3D anatomical model. It allows a better understanding of the deformity in a realistic surgical approach, leading to safer, faster, and more predictable procedures. The aim of the present study is to present this technique and show its use in two clinical cases.
Resumo As fraturas da porção distal do rádio estão entre as mais comuns do esqueleto. A consolidação viciosa pode ocorrer em até um terço dessas fraturas e acarretar restrição de movimento e dor no punho, com consequente limitação ou incapacidade laboral. O tratamento desta condição implica em osteotomia corretiva das deformidades, o que necessita de um planejamento pré-operatório criterioso em virtude de sua complexidade tridimensional, notadamente naquelas em que há acometimento articular. Assim, recentemente, tem sido utilizada a prototipagem a partir da reconstrução 3D da tomografia computadorizada (TC), o que permite o planejamento com realização da osteotomia em modelo anatômico tridimensional, com o melhor entendimento da deformidade, aproximando-se da situação realística da cirurgia, o que torna o procedimento mais seguro, ágil e previsível. O objetivo do presente estudo é apresentar esta técnica e seu emprego em dois casos clínicos.
Subject(s)
Humans , Male , Female , Middle Aged , Osteotomy , Radio , Tomography, X-Ray Computed , Fractures, Bone , Printing, Three-Dimensional , Models, AnatomicABSTRACT
Abstract Objective The present paper aims to present results from radiographic evaluations of patients with extra-articular distal radius fractures submitted to percutaneous fixation with a 3.5 mm solid screw. Methods Analytical, descriptive and retrospective case series of 16 patients with evaluation of the radiographic parameters. Results The average age of the study population was 46.5 years old (25-60 years old); 81.25% of the sample was female. The average time until surgery was 8.8 days (4-14 days). The mean preprocedural volar tilt was - 7.41° (−23.48°-5.29°, standard deviation [SD] ± 6.59°). The mean volar tilt immediately after surgery was 5.93° (SD ± 6.23°, p< 0.001). There was no statistical difference in volar tilt values after 6 months of follow-up. The mean preprocedural radial height was 4.13 mm (−7.8 mm-9.5 mm, SD ± 5.06 mm). There was a statistically significant increase at the immediate postoperative period to 10.04 mm (p= 0.002), and a significant reduction at 6 months to 9.55 mm (p= 0.012). The consolidation rate was 100% with the technique used, with a minimal complication rate. No patient had infection or required a reoperation. Conclusion The technique was effective for the treatment of distal radial extra-articular fractures at 6 months, with a low complication rate; radiographic parameters values were acceptable and close to the anatomical ones.
Resumo Objetivo Apresentar o resultado das avaliações radiográficas dos pacientes com fraturas extra-articulares do rádio distal submetidos a fixação percutânea com parafuso maciço de 3.5mm. Métodos Série de casos, analítica, descritiva e retrospectiva de 16 pacientes com avaliação dos parâmetros radiográficos da técnica utilizada. Resultados A média de idade da população estudada foi de 46,5 anos (25-60 anos), sendo 81,25% do sexo feminino. O tempo de espera até a cirurgia foi de 8,8 dias (4-14 dias). O tilt volar médio pré-procedimento foi - 7,41° (−23,48°-5,29°, desvio padrão [DP] ± 6,59°). O tilt volar imediatamente após o procedimento cirúrgico foi de 5,93° (DP ± 6,23°, p< 0,001). Sem diferença estatística nos valores de tilt volar ao final de 6 meses de evolução. A altura radial pré-procedimento foi de 4,13 mm (−7,8°-9,5°, DP ± 5,06°). Aumento estatisticamente significativo no pós-operatório imediato para 10,04 mm (p= 0,002). Redução significativa ao final de 6 meses para 9,55 mm (p= 0,012). Atingimos 100% de consolidação com a técnica utilizada, com índice mínimo de complicações. Nenhum paciente apresentou infecção ou precisou ser reoperado. Conclusão A técnica mostrou-se eficaz para o tratamento de fraturas extra-articulares da extremidade distal do rádio ao final de 6 meses, com baixo índice de complicações e parâmetros radiográficos aceitáveis e próximos dos valores anatômicos.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Radius Fractures/surgery , Radius Fractures/diagnostic imaging , Bone Screws , Fracture Fixation, Internal/methods , Radius/anatomy & histology , Retrospective Studies , Range of Motion, Articular , Minimally Invasive Surgical ProceduresABSTRACT
Distal radius fractures are one of the common injuries for which orthopedic consultations are sought. These injuries make up to 10-15% of all bony injuries in adult population. High energy trauma as seen in road traffic accidents is common cause of these injuries. Noncomminuted extra-articular fractures of distal radius are common in adult males following vehicular accidents. Majority of the patients with distal radial fractures are managed by closed reduction and immobilization. Poor functional outcome and complications such as malunion has made many researchers to look for alternative methods of managing these patients. An attractive alternative for managing these cases consist of Percutaneous pinning followed by immobilization of the fracture for 3 weeks. This method is simple and affordable and reported to have excellent functional outcome.Methods:This was a prospective cohort study conducted in the department of orthopedics of a tertiary care medical college situated in an urban area. 40 adult patients with Noncomminuted extraarticular fractures of distal radius were included in this study on the basis of a predefined inclusion and exclusion criteria. All patients were treated by closed reduction followed by percutaneous pinning using K-wires. Below elbow plaster cast was given for 3 weeks after which plaster was removed and physiotherapy was started. Follow up X-rays were taken at 3 and 6 weeks. Functional outcome was assessed by Quick DASH scores. SSPE 21.0 was used for statistical analysis and p value less than 0.05 was taken as statistically significant.Results: Out of the 40 studied cases there were 34 (85%) males and 6 (15%) females a M:F ratio of 1:0.17. The most common affected age group was found to be <30 years (55%) and most common mechanism of injury was motor vehicular accidents (65%). All patients were treated by closed reduction followed by percutaneous pinning using K-wires. Excellent or good functional outcome was seen in 34 (85%) patients. 4 (10%) patients were found to have fair functional outcome and remaining 2 (5%) patients were found to have poor functional outcome as assessed by Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.Conclusion:Percutaneous pinning followed by immobilization of the fracture is an effective treatment for Non-comminuted extra-articular fractures of distal radius having excellent functional outcome.
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ABSTRACT Objective: This study aims at analyzing retrospectively the clinical-functional and radiographic results of surgical treatment of the terrible elbow triad, with at least 12 months of postoperative follow-up evaluating elbow function. Methods: A group of patients for retrospective analysis from 2004 to 2015 was defined, in which 12 patients were studied. They underwent surgery due to fracture of the radial head, coronoid fracture, and elbow dislocation; they were evaluated by the Disabilities of the Arm, Shoulder and Hand (DASH) score, the degree of patient satisfaction, the degree of trauma energy, radiographic images, range of motion, and complications. Results: There was a higher incidence of Regan and Morrey type II coronoid process fractures; in relation to the injuries, nine patients had deinsertion of the brachialis. Half of the patients suffered a fall from their own height as the mechanism of trauma. The extent of elbow flexion and extension averaged 126.6 and 24.1 degrees, respectively; the averages for pronation and supination were 64.1 and 62.0 degrees, respectively. All patients presented muscle strength of grade IV or V. The mean DASH score was 14.3, the mean pain score was 2.5, and a majority of the patients were satisfied with the treatment. Conclusion: Despite the total loss of range of motion of the elbow, especially in extension, the treatment was satisfactory for most patients.
RESUMO Objetivo: Este estudo tem o objetivo de analisar, retrospectivamente, os resultados clínico- funcionais e radiográficos do tratamento cirúrgico da tríade terrível do cotovelo, com no mínimo doze meses de acompanhamento pós-operatório, avaliando a função do cotovelo. Métodos: Definimos um grupo de pacientes para avaliação retrospectiva no período de 2004 a 2015, no qual foram estudados 12 pacientes, submetidos a procedimento cirúrgico devido a fratura da cabeça do rádio, fratura do processo coronoide e luxação do cotovelo; sendo avaliados pelo escore Disabilities of the Arm, Shoulder and Hand (DASH), grau de satisfação do paciente, grau de energia do trauma, radiografias, arco de movimento e complicações. Resultados: Observou-se maior incidência de fraturas do processo coronoide do tipo II de Regan e Morrey; em relação às lesões, nove pacientes apresentaram desinserção do músculo braquial. Metade dos pacientes apresentou queda da própria altura como mecanismo de trauma. Os graus de flexão e extensão do cotovelo tiveram respectivamente as médias: 126,6 e 24,1 graus; e as médias em graus de pronação e supinação foram respectivamente: 64,1 e 62,0 graus. Todos os pacientes apresentaram grau de força muscular IV ou V. Obtivemos escore DASH médio de 14,3, a escala de dor teve média de 2,5, e a maioria dos pacientes se disse satisfeita com o tratamento. Conclusão: Apesar da perda de amplitude total de movimento do cotovelo, principalmente em extensão, o tratamento mostrou-se satisfatório para a maioria dos pacientes.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Orthopedics , Joint Dislocations , Elbow/injuries , Elbow JointABSTRACT
Objective To compare volar plating and nonoperative treatment for senile comminuted fractures of the distal radius. Methods From October 2012 to June 2015, 46 senile comminuted fractures of the distal radius ( AO types B and C ) were treated surgically or conservatively. Twenty old patients were managed by open reduction and fixation with a volar locked plate. They were 7 men and 13 women, with an average age of 67. 9 ± 10. 7 years, including 7 cases of AO type 23-B and 13 cases of AO type 23-C. Twenty-six patients were managed with closed reduction and plaster cast. They were 8 men and 18 women, with an average age of 66. 2 ± 11. 5 years, including 10 cases of AO type 23-B and 16 cases of AO type 23-C. The 2 groups were compared in terms of follow-up time, union time and wrist functional scores and complica-tions. Results There was no significant difference between the 2 groups in follow-up time ( P > 0. 05 ) . Fractures in the 2 groups all united about 11 weeks after surgery. According to Dienst scoring for reduction, the volar plating group had 13 excellent cases, 4 good ones, 2 fair ones and one poor case, with an excellent to good rate of 85. 0％ while the nonoperative group had 5 excellent cases, 10 good ones, 5 fair ones and 6 poor ones, with an excellent to good rate of 57. 7％. A significant difference was shown between the 2 groups ( P <0. 05 ) . At final follow-ups, the volar plating group had significantly lower Gartland & Werley wrist functional score ( 2. 16 ± 1. 82 ) and complication rate ( 30. 0％, 6/20 ) than the nonoperative group [ 6. 62 ± 3. 78 and 53. 8％( 14/26 ) , respectively ] ( P <0. 05 ) . Conclusion In treatment of senile comminuted fractures of the distal radius, volar locked plating may lead to better functional recovery and fewer complications than nonoper-ative management. However, one should take full account of the physical condition and preference of the patient when surgery is chosen.
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Objective To investigate whether a 3D printed model of the contrlateral healthy distal radius, especially its articular accuracy, helps anatomical reduction and precise reconstruction of the fractured distal radius. Methods The CT data of bilateral radii were collected from 15 normal volunteers ( 11 males and 4 females with an average age of 22. 8 years ) between November and December 2016. After 3D reconstruction of the bilateral distal 1/3 radii, solid 3D models of left radius were mirrored and generated by 3D printing. The data of right radii ( reference group ) were compared with the data of the solid 3D models of left radius acquired through a 3D scanner ( test group ) using deviation analysis. Results The maximum volume difference between the 3D printed model and the contralateral radius was 6. 86％. The average volume of the reference group was 19, 165. 82 ± 3, 250. 50 mm3 and that of the test group 19, 310. 65 ± 3, 305. 15 mm3, showing no statistically significant difference between the 2 groups ( t= -0. 941, P=0. 363 ) . The maximum surface area difference was 3. 84％ between the 2 groups. The average surface area of the reference group was 5, 075. 80 ± 549. 34 mm2 and that of the test group 5, 139. 43 ± 572. 48 mm2, showing a signifi-cant difference ( t= -2. 451, P=0. 028 ) . The 3D deviation analysis showed a mean positive deviation of 0. 37 ± 0. 10 mm and a mean negative deviation of 0. 30 ± 0. 07 mm. The maximum mean square root was 0. 65. The 3D deviation was distributed mainly within 1 mm interval, with a distribution frequency of 96. 27％. Conclusions A 3D printed model prepared by high precision equipment is accurate enough to guide reconstruction of distal radius fractures in adults. In the treatment of complex fractures of the distal radius, a 3D printed model of the contralateral healthy distal radius can be used as a reference to achieve anatomical reduction and precise reconstruction of the fractured distal radius.
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<p><b>OBJECTIVE</b>To compare the complications and clinical outcome of titanium elastic nail(TEN) versus K-wire fixation(KW) for the treatment of displaced radial neck fractures in children.</p><p><b>METHODS</b>From January 2009 to December 2014, 56 children with displaced radial neck fractures were studied retrospectively according to the inclusion criteria. Based on the different methods of internal fixation, patients were divided into two groups: titanium elastic nail (TEN group) and K-wire fixation (KW group). Among 25 patients(15 males and 11 females, aged from 3 to 12 years old with an average of 8.6±2.1) treated with TEN, 16 patients had type III fractures, 19 patients had type IV fractures according to Metaizeau-Judet modified classification; 20 patients were treated with closed reduction and 5 patients were treated with open reduction; the time from injury to treatment ranged from 1 to 8 days with an average of (3.6±1.7) days. Among 31 patients (20 males and 11 females, aged from 3 to 11 years old with an average of 9.1±1.9 years old) treated with KW, 19 patients had type III fractures, 12 patients had type IV fractures; 22 patients were treated with closed reduction, and 9 patients were treated with open reduction; the time from injury to treatment ranged from 2 to 7 days with an average of (3.7±1.5) days. No significant differences between two groups were found in general data. Operative time, hospitalization time, healing time of fracture, internal fixation time, postoperative complications and function recovery of the two groups were compared and evaluated.</p><p><b>RESULTS</b>The average follow-up period of the patients was 22.1 months in TEN group(ranged, 16 to 48 months), and 21.9 months in KW group(ranged, 13 to 48 months). There were no significant differences between these 2 groups in follow-up duration, average hospitalization time and fracture healing time. The operation time, hospital costs and internal fixation time in TEN group were (56.6±11.8) min, (18 000±3 000) Yuan(RMB), (9.1±2.5) weeks respectively; and in KW group were(45.5±10.3) min, (8 000±1 000) Yuan(RMB), (4.8±1.6) weeks respectively, there were significant differences between two groups(<0.05). Outcome scores according to Metaizeau and Tibone-Stoltz had no significant differences between two groups(>0.05).</p><p><b>CONCLUSIONS</b>There is no significant difference of therapeutic effects between TEN and KW for children with displaced radial neck fractures. Because the removal of TEN fixation requires the secondary anesthesia, and the TEN costs significantly more than KW, TEN still can't replace the traditional KW for the treatment of radial neck fracture in children.</p>
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Objective: To test the null hypothesis that patients with the terrible triad of the elbow (dislocation together with fractures of the radial head and coronoid process) who are treated with open reduction and internal fixation of the radial head have final results that are comparable with those of patients treated with arthroplasty or partial resection of the radial head. Methods: Twenty-six patients with the terrible triad of the elbow who were operated by a single surgeon were evaluated on average 23 months after the surgery (range: 16–36 months). There were 17 men and nine women of mean age 41 ± 13.4 years. The fractures of the radial head were treated by means of osteosynthesis (12 patients), arthroplasty (nine) or resection of a small fragment or no treatment (five). Fixation of the coronoid process/anterior capsule was performed in 21 patients. The lateral ligament complex (LLC) was repaired in all the patients, while the medial ligament complex (MLC) was repaired in three patients whose elbows remained unstable after treatment for the radial head and LLC, but without fixation of the coronoid process. Results: The mean final range of flexion and extension was 112°. The mean pronation was 70° and supination, 6°. The mean DASH score (Disabilities of the Arm, Shoulder & Hand) was 12 and mean MEPI (Mayo Elbow Performance Index) was 87. According to the MEPI scores, 21 patients (80%) had good and excellent results. There was no statistically significant difference in the results between the patients who underwent fixation of the radial head and those who underwent arthroplasty or resection of a small fragment. Conclusion: There was no difference between the patients treated with arthroplasty of the radial head and those treated with other techniques. .
Objetivo: Testar a hipótese nula de que os pacientes com a tríade terrível do cotovelo (luxação associada a fraturas da cabeça do rádio e do processo coronoide) tratados com redução aberta e fixação interna da cabeça do rádio têm resultado final comparável aos pacientes tratados com artroplastia ou ressecção parcial da cabeça do rádio. Métodos: Foram avaliados, em média aos 23 meses (16 a 36) após a cirurgia, 26 pacientes com a tríade terrível do cotovelo operados por um único cirurgião. Eram 17 homens e nove mulheres, com média de idade de 41 anos (± 13,4). As fraturas da cabeça do rádio foram tratadas com osteossíntese (12 pacientes), ou artroplastia (nove), ou ressecção de um fragmento pequeno ou nenhum tratamento (cinco). Fixação do processo coronoide/cápsula anterior foi feita em 21 pacientes. O complexo ligamentar lateral (LCL) foi reparado em todos os pacientes, enquanto que o complexo ligamentar medial (LCM) foi reparado em três pacientes cujos cotovelos persistiam instáveis após o tratamento da cabeça do rádio e do LCL, mas sem fixação do processo coronoide. Resultados: O arco final médio de flexão e extensão foi de 112°. A pronação média foi de 70° e a supinação, de 6°. O escore Dash (Disabilities of Arm, Shoulder & Hand) médio foi de 12 e o Mepi (Mayo Elbow Performance Index) médio foi de 87. De acordo com o Mepi, 21 pacientes (80%) tiveram bons e excelentes resultados. Não houve diferença estatisticamente significativa entre os resultados dos pacientes submetidos a fixação da cabeça do rádio e aqueles submetidos a artroplastia ou ressecção de um fragmento pequeno. Conclusão: Não há diferença ...
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Humans , Male , Female , Adolescent , Adult , Elbow Joint , Elbow/injuries , Joint DislocationsABSTRACT
Objective To compare the clinical effects of the volar locking compression plate (LCP) and external fixator in the treatment of the AO type-C distal radial fractures.Methods From October 2007 to October 2010,64 cases of AO type-C distal radial fractures which had been treated with volar LCP and external fixator were retrospectively analyzed respectively.LCP group consisted of 38 patients,including 13 males and 25 females with an average age of 45.1 years.According to AO/OTA classification,there were 15 type-C1,18 type-C2,and 5 type-C3.External fixator group consisted of 26 patients,including 12 males and 14 females with an average age of 47.1 years.There were 11 type-C1,13 type-C2,and 2 type-C3.Outcomes were assessed by radiographic parameters,function parameters,and Gartland-Werley functional score.Results All the patients were followed up.X-rays showed all fractures healed.LCP group was followed up for an average of 23.8 months.External fixator group was followed up for an average of 31.2 months.According to the Gartland-Werley score,the excellent and good rate was 81.6％ in the LCP group and 76.9％ in the external fixator group,with a Gartland-Werley score of 4.50±3.55 and 5.04±3.74 respectively.There were no significant differences in wrist flexion,extension,ulnar deviation,radial deviation,pronation,supination,the parameter of ulnar inclination and radial height and the Gartland-Werley score.The volar tilt was better in the LCP group than in the external fixator group.There were 2 cases of wound infection,1 case of median nerve injury,1 case of plate loosening in LCP group; 3 cases of pin tract infection,1 case of fixator loosening,and 2 cases of wrist stiffness in the external fixator group.Conclusion LCP group had better imaging outcomes with a reliable fixation,but both of the groups can achieve satisfactory clinical results.The choices of treatment method depend on the patient's clinical conditions.
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ObjectiveTo explore the anatomy and clinical significance of fixation combined with limited outside cut restoration gram needle internal fixation for distal radial fractures. MethodsBased on the anatomical observation and measurement of the forearm and hand. Found out the distal radial fractures fixed bracket screws and gram needle safety area and the needle into the body, and made reasonable angle respectively, to formulate standardized orientation, and applied to clinical procedures, and the clinical cases were followed up. The clinical curative effect was observed. ResultsThe place for the fixed bracket screws of the second metacarpal was the nail parts of radial dorsal partial ends. The proximal fracture for external fixation stents bolt into the nail near abductor muscle and manipulation long in the thumb short extensormuscles. Its feet side for stabbing abductor muscle and refers to a long stretch of radial side for tendon, radial side wrist short stretch muscles. The farthest distance between the lister nodule was (63.69 ±3.00) mm,nearest distance between the lister nodule was(123.64 ±5.00)mm. Gram needle do limited internal fixation security clearance for thumb long stretch tendon and refers to stretch tendons,radial side wrist length stretch tendons, thumb short extensor tendons, stretch retinaculum and this gap proximal distance lister nodule for ( 33. 52 ± 4.20) mm, remote distance lister nodule for( 8.81 ± 0. 88) mm. In clinical applications, wrist imaging recovery, function of ratings had no significant difference ( P ＞ 0.05). But the postoperative complications of the two sets of patients had statistically significant difference ( P ＜ 0. 05 ). ConclusionAccording to the anatomy of distal radial fractures,from the results of our research applied in fixation distal radial fractures in the operation,it had the advantages of simple operation,reset good,fixed firmly,and small trauma. It was worth of used widely in clinical.
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There is some evidence to suggest superior results of surgical treatment that includes open reduction internal fixation (ORIF) or percutaneous pin fixation (not including Kapandji pinning) to stabilize fracture fragments and improve functional ability compared with conservative treatment. However, larger studies with longer follow-up are needed to verify these results.
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Objective To evaluate advantages of the Herbert screw in treating displaced radial head fractures. Methods The Herbert screw was used to treat 25 segmental fractures of the radial head from since 1991 and the results were compared with those of other treatment methods mentioned in the literature. Results A follow up averaging 6 years and 8 months showed that postoperative function was all excellent or good and that most cases recovered to normal absolutely, without complications. Conclusions The Herbert screw provides such rigid internal fixation for displaced radial head fractures that, after operation, a plaster cast is rarely required and most patients are able to return to work within a few weeks. This method of treatment appears to offer significant advantages over conventional techniques.
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Objective To study the biomechanical strength of calcium phoshphate cement (CPC) in fixating distal radial fractures. Methods A total of 18 human distal radius fracture models were made and randomly divided into three groups: fixed with Kirschner wire (Kirschner group), CPC (CPC group) or CPC combined with Kirschner wire (combination group). Compression test was performed to measure compression rigidity and rotational angle of distal fragment at 100 N and anticompression strength and maximum compression strength at 2 mm displacement. Results Compression rigidity, distal fragment rotation angle in coronal or sagittal plate had no significant statistical difference at 100 N of compression in three groups. Compression strength at 2 mm displacement in CPC group (average 375 N) and combination group (average 386 N) exceeded that in Kirschner group (average 116 N), with significantly statistical difference (P