Comparative Analysis of Intramedullary Nail versus Plate Fixation for Fibula Fracture in Supination External Rotation Type IV Ankle Injury.

BACKGROUND Lateral malleolus fractures, typically from trauma, sports, or accidents, are common, with supination external rotation (SER) injuries being most prevalent. SER injuries involve complex joint mechanics and often necessitate surgical intervention for instability. This study compares intramedullary nail and plate fixation for fibula fractures in SER type IV ankle injuries, considering their biomechanical properties and influence on fracture healing. MATERIAL AND METHODS A prospective, randomized study was conducted between January 2021 and December 2021. A total of 81 patients with SER injuries were included in the study. Surgical procedures were performed using either intramedullary nails or plates. The following parameters were recorded and analyzed: postoperative complications, operation times, bone healing times, American Orthopaedic Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS) scores for pain, and ankle range of motion. RESULTS Out of the 81 cases, 42 were treated with intramedullary nails, while 39 received plate fixation. Statistical analysis revealed a significantly lower rate of postoperative complications in the intramedullary nail group than in the the plate fixation group (9.52% vs 30.77%, P<0.0164). However, there were no significant differences between the 2 groups in terms of operation time, bone healing time, AOFAS scores, VAS scores, and functional evaluations (P>0.05). CONCLUSIONS Plate fixation and intramedullary nail fixation are effective techniques for treating fibula fractures in SER type IV injuries. However, intramedullary nail fixation demonstrates a lower rate of complications. Therefore, intramedullary nails may be preferable to plate fixation for the management of fibula fractures in SER type IV ankle injuries.

Study on the Modification of Silty Soil Sites Using Nanosilica and Methylsilicate.

The special particle grading properties of silt lead to the strong water sensitivity and low soil strength of silt sites, many of which are severely damaged and urgently need to be repaired. This article takes the powder soil from a certain burial site area in Xizhu Village, Luoyang as the research object, which is improved by adding nanosilica and potassium methylsilicate. The modified soil is studied through mechanical and waterproof performance tests, and the mechanism of action of the modified material is analyzed through SEM and XRD. The experimental results show that the mechanical properties and waterproof properties of the composite modified soil were improved when the nanosilica content was 2% and the potassium methylsilicate content was 0.5%; the durability of the composite modified soil is improved, making this the optimum ratio. The mechanical properties and water resistance of the silty soil were significantly improved by adding the appropriate amount of nanosilica and potassium methylsilicate. Nanosilica can be evenly dispersed in the soil matrix, absorb a small amount of water to form a gel state, fill the pores in the silt aggregates, and improve soil compactness. In addition, nanosilica aggregates can attach to the surface of the soil particles and extend from the particle surface to the particle edge. By increasing the contact between soil particles and increasing the particle size, the mechanical properties of the modified soil are improved. When potassium methylsilicate solution is added to the soil, it reacts with water and carbon dioxide, decomposes into methylsilicate, and quickly generates a polymethylsiloxane film to cover the surface of soil particles, forming a waterproof film on the surface and thereby improving the waterproof performance of modified soil. Our research results can provide a reference for the restoration and protection of silty and silt-like sites. The next step is to apply the composite modified soil in engineering restoration through field tests in order to study the repairing ability of composite modified soil and its actual protective effects.

Curative effect and prognosis of 3D printing titanium alloy trabecular cup and pad in revision of acetabular defect of hip joint.

Curative effect and prognosis of 3D printing titanium alloy trabecular cup and pad in revision of acetabular defect of hip joint were investigated. Forty-two patients who underwent acetabular revision in the Second Affiliated Hospital of Luohe Medical College were divided into observation and control groups according to different methods of acetabular revision and revision materials. 3D printed titanium alloy trabecular cups and pads were used in the observation group, and non-3D printed titanium trabecular cups and pads were used in the control group. Preoperative and postoperative pain visual analog scale (VAS score), hip Harris scores and quality of life Health Survey Scale (SF-36) scores were compared between the groups. At 3, 6 and 12 months after operation, Harris score and SF-36 score of the observation group were significantly higher than those of the control group, and VAS score was significantly lower than that of the control group (P<0.05). Stability and bone ingrowth of prosthesis in the observation group were better than those in the control group. Revision of the hip prosthesis with 3D printed titanium trabecular metal cups and pads resulted in satisfactory outcomes. Short-term prognosis is satisfactory but the long-term prognosis remains to be further investigated.

Clinical feasibility and application value of computer virtual reduction combined with 3D printing technique in complex acetabular fractures.

This study investigated the clinical feasibility and application value of computer virtual reduction combined with three-dimensional (3D) printing technique in patients with complex acetabular fracture. Ninety-six patients diagnosed with complex acetabular fracture in the Orthopedics Department in The Second Affiliated Hospital of Luohe Medical College from January 2016 to June 2017 were selected and randomly divided into the routine operation group (n=48) and the 3D model group (n=48) according to the admission number of the patients. In the 3D model group, computed tomography (CT) scan was performed preoperatively, and the model was made using the virtual technique and 3D printing technique. The surgical scheme was designed according to the model. Patients in the routine operation group were diagnosed with the conventional CT scan without using the computer virtual technique and 3D printing technique. During operation, the operation time, amount of intraoperative bleeding and times of intraoperative fluoroscopy were recorded in both groups. After operation, the incidence rate of such complications as inflammatory response, iatrogenic neurological symptoms and loss of reduction were recorded in both groups. Moreover, the reduction quality of acetabular fracture was evaluated according to the Matta imaging score at 3 days after operation, and the hip joint function was evaluated based on the Hariss score at 6 months after operation. In the 3D model group, the operation time was significantly shorter than that in the control group, the amount of intraoperative bleeding and times of intraoperative fluoroscopy were significantly less than those in the routine operation group, and the incidence rate of postoperative complications was obviously lower than that in the routine operation group (P<0.05). In conclusion, computer virtual reduction combined with the 3D printing technique can significantly reduce the operation time, amount of intraoperative bleeding, times of intraoperative fluoroscopy and incidence rate of postoperative complications without adverse effects on the reduction quality of acetabular fracture and hip joint function of patients, which has a higher clinical application value and greater social significance.