ABSTRACT
Objective:To evaluate the clinical efficacy of minimally invasive treatment of Fraser type Ⅱ floating knee by homeopathic reduction.Methods:From November 2016 to July 2018, 7 patients with Fraser type Ⅱ floating knee were treated by homeopathic reduction and minimally invasive surgery at Trauma Emergency Center, The Third Hospital of Hebei Medical University. They were 5 males and 2 females, aged from 30 to 82 years (average, 52 years). They all suffered from tibial plateau fracture complicated with floating knee, with 5 cases of Fraser type ⅡA (tibial plateau fracture complicated with femoral shaft fracture) and 2 cases of Fraser type ⅡC (tibial plateau fracture complicated with femoral condyle fracture). The femoral and tibial plateau fractures were reduced with a bidirectional traction reduction device, followed by minimally invasive implantation of internal fixators. The operation time, length of a single incision, blood loss and fluoroscopic frequency were recorded. The anteroposterior and lateral X-ray films of the lower limb were taken and fracture healing time was recorded during follow-up. The function of knee joint was evaluated by Hospital for Special Surgery (HSS) scoring system at the last follow-up.Results:For the 7 patients, operation time averaged 87.2 min, length of a single incision 2.8 cm, blood loss 471 mL, and fluoroscopy frequency 37 times. The postoperative X-ray films showed fine alignment and force line and smooth articular surface in all patients. All the incisions healed by grade A. The follow-up time for 7 patients ranged from 12 to 21 months (average, 15.6 months). All the fractures healed after an average time of 12.8 weeks. The HSS scores at the last follow-up showed that 6 cases were excellent and one was good.Conclusion:The fractures of the femur side and of the tibia side can be treated separately by closed reduction and internal fixation using a homeopathic bidirectional traction reduction device so as to obtain better knee joint function.
ABSTRACT
Objective To compare the outcomes of homeopathic bidirectional-traction reduction device and traction table in surgical treatment of femoral intertrochanteric fractures.Methods A retrospective case control study was made on 94 cases of femoral intertrochanteric fractures treated from July 2015 to December 2015.There were 26 males and 68 females,aged 60-75 years.According to the Evans classification,the fractures were type Ⅱ in 24 cases,type Ⅲ in 32 and type Ⅳ in 38.Fifty-seven cases sustained chronic diseases.According to the random number table,the subjects were assigned to receive homeopathic bidirectional-traction reduction (homeopathic reduction group,48 cases) and traction table reduction (control group,46 cases).All fractures were fixed with proximal femoral nail antirotation.Operation time,reduction time,tluoroscopy time,blood loss and rate of closed reduced cases were recorded.Fracture union and rotation of the affected femur to the tibia were detected after operation.Functional outcome was evaluated using the Harris score at the final follow-up.Results All fractures were reduced closely in homeopathic reduction group,while 15 fractures in control group were reduced via a small-incision anterior approach.Operation time,reduction time and fluoroscopy time in homeopathic reduction group were (62.9 ± 12.1) min,(6.8 ± 1.5) min and (11.3 ± 5.6) s respectively,significantly less than the corresponding data in control group (all P ＜ 0.05).One month after operation,rotation of the affected femur to the tibia was (2.8 ± 1.2) ° in homeopathic reduction group,significantly less than that in control group [(11.5 ± 4.7) °] (P ＜ 0.05).Bone union was observed in all cases.At the final follow-up,Harris hip score was (92.6 ± 7.6)points in homeopathic reduction group,significantly higher than that in control group [(87.3 ± 6.5) points] (P ＜ 0.05).Conclusion For the elderly patients with intertrochanteric fractures,homeopathic bidirectional-traction device has advantages of high rate of closed reduction,shorter operation time,less radiological exposure and satisfactory function recovery of the affected hip joint.
ABSTRACT
Objective To study the correlation between maternal serum 25‐OH‐VitD concentration and early‐onset severe pre‐eclampsia(EOSPE) .Methods 5 000 early singleton pregnancy women with gestational age 8-12+6 weeks and without any compli‐cations in the outpatient department of the hospital from January 2013 to January 2015 were enrolled in the study .The levels of ser‐um 25‐OH‐VitD were measured by using chemiluminescence method .Only 2 988 women with Vitamin D deficiency went through regular prenatal care and delivery .The 2 988 women were divided into two groups intervention group and non intervention group whose age ,BMI and gestation age were matched .Intervention group(n=1 490) received vitamin D supplementation ,the non inter‐vention group did not received the supplementation .Those patients who developed EOSPE were counted .Finally ,Patients diagnosed with EOSPE and were Vitamin D deficient(n=118) were divided into two groups late intervention group and non late intervention group .The late intervention group were treated with vitamin D supplementation ,The non late intervention group were only treated routinely .Results Patients with Vitamin D deficiency accounted for 63% ,insufficiency 32% ,normal 5% .The levels of serum 25‐OH‐VitD and VEGF in patients with EOSPE were significantly lower than those in normal control group(P<0 .05) .The occur‐rence rate of EOSPE in 2 988 women was 4 .1% (123 women) .The occurrence rate of EOSPE in intervention group and no interven‐tion group were 2% (30/1 490) and 6% (93/1 498) respectively ,which were statistically different(P<0 .05) .The outcome of ma‐ternal and perinatal infant in late intervention group were not significantly different from those in non late intervention group .Con‐clusion Vitamin D deficiency or insufficiency is a common problem in early pregnant women .The risk of EOSPE increases in early pregnant women with Vitamin D deficiency .Vitamin D supplementation in the first trimester in women with Vitamin D deficiency could significantly decrease the occurrence rate of EOSPE .Vitamin D supplementation in women diagnosed with EOSPE could not change the outcome of maternal and perinatal complications .