RESUMO
<p><b>OBJECTIVE</b>To retrospectively explore the effects of damage control orthopaedics concept on coagulation and curative effects in unstable pelvic fractures and multiple fractures of limbs.</p><p><b>METHODS</b>From March 2014 to December 2015, 40 patients with unstable pelvic fractures and limbs multiple fractures in treatment group included 22 males and 18 females with an average age of (39.00±4.12) years old were treated with the damage control orthopaedics concept, the ISS score was (25.36±10.81) on average;Other 40 patients with the same trauma in conventional group included 25 males and 15 females with an average age of (38.00±3.24) years old were treated with conventional method from January 2012 to January 2014 served as control, the average ISS score was 26.56±11.44. Matta criteria and Majeed function standard were used respectively to evaluate the fracture reduction and therapeutic effects postoperatively. Coagulation function on the 7th day postoperatively was compared between two groups.</p><p><b>RESULTS</b>All patients were followed up for 6 to 24 months. According to Matta criteria, the fracture reduction of the treatment group and the conventional group were (7.38±5.09) mm and (10.11±6.53) mm, respectively (<0.05). Majeed functional results of the treatment group and the conventional group were (86.12±6.84) points and (77.53±8.30) points, respectively (<0.05). On the 7th day after surgery, PT, APTT, TT of the treatment group were significantly higher than that of the control group;and Fib of the treatment group was also significantly lower than that of the conventional group(<0.05).</p><p><b>CONCLUSIONS</b>The concept of damage control orthopaedics could effectively improve coagulation function of the patients with unstable pelvic fractures and limbs multiple fractures, thus are beneficial to the functional recovery as well as improve the curative effect postoperatively.</p>
RESUMO
<p><b>OBJECTIVE</b>To study the therapeutic effects of combined anterior-posterior (small incision or micro-incision) approach for complex tibial plateau and posterior condylar fractures.</p><p><b>METHODS</b>From 2000 to 2008, 79 patients (81 limbs) with complex tibial plateau and posterior condylar fractures were reviewed. There were 45 males and 34 females, ranging in age from 19 to 66 years, with an average of 40.6 years. Thirty-nine limbs were treated using small incision through combined anterior-posterior approach, in which 13 limbs were Schatzker type IV, 15 limbs were type V ,and 11 limbs were type VI. Other 42 limbs were treated using micro-incision through combined anterior-posterior approach, in which 18 limbs were Schatzker type IV, 16 limbs were type V, and 8 limbs were type VI. The Rasmussen scores for knee joint and radio scores were used to evaluate therapeutic effects after the treatment. The complications such as cutaneous necrosis and incision infection were observed.</p><p><b>RESULTS</b>All the patients were followed up. According to Rasmussen criterion, in small incision group, 16 limbs got an excellent result, 13 good, 7 fair and 3 bad; in micro-incision group,above data were 19, 11, 8 and 4 respectively. Comparison between the two groups, P = 0.924. Comparison of complications such as cutaneous necrosis and incision infection: in small incision group,10 limbs had the complications, and in micro-incision group were 4 limbs; the occurrence rate of small incision group were higher than that of micro-incision group (P = 0.047).</p><p><b>CONCLUSION</b>There are no significant differences between the two groups in the knee joint function rehabilitation; however, there is smaller rate for cutaneous necrosis and incision infection in micro-incision group.</p>