Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Resultados 1 - 20 de 54
Filtrar
1.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 36(1): 73-79, 2019 Feb 25.
Artículo en Zh | MEDLINE | ID: mdl-30887779

RESUMEN

Internal fixator is usually adopted in the treatment of bone fractures. In order to achieve anatomical reduction and effective fixation of fractures, the placement of internal fixators should comply with the biology force line of the bone and adapt to the specific anatomical morphological characteristics of the cortical bone. In order to investigate the distribution characteristics and formation regularity of biology force line and cortical thickness of human bone, three-dimensional model of proximal femur is established by using three-dimensional reconstruction technique in this paper. The normal physiological stress distribution of proximal femur is obtained by finite element analysis under three kinds of behavior conditions: one-legged stance, abduction and adduction. The structural topology optimization method is applied to simulate the cortex of the proximal femur under the combined action of three kinds of behavior conditions, and the anatomic morphological characteristics of the proximal femur are compared. The distribution trend of biology force line of proximal femur and the characteristics of cortex are analyzed. The results show that the biology force lines of bone structure and the morphological characteristics of cortex depend on the load of human activities. The distribution trend of biology force line is related to the direction of trabecular bone and the ridge trend and firmness of cortex when bone is loaded physiologically. The proposed analytical method provides a solution to determine the biology force line of bone and the distribution characteristics of cortex. The conclusions obtained may guide the reasonable placement of internal fixator components of fracture.

2.
BMC Musculoskelet Disord ; 14: 368, 2013 Dec 26.
Artículo en Inglés | MEDLINE | ID: mdl-24369897

RESUMEN

BACKGROUND: Heterotopic ossification is a common postoperative complication of acetabular fracture. However, functionally significant heterotopic ossification with associated late bone defects in the posterior wall of the acetabulum is rare and challenging to treat. When heterotopic ossification is a late complication of failed acetabular fracture operation, it is disabling and may only be treated by THA. THA is highly susceptible to premature failure in young and active patients and may require numerous revisions. CASE PRESENTATION: This article describes a 40-year-old man with massive heterotopic ossification associated with late bone defects in the posterior wall of the acetabulum after a failed acetabular fracture operation. The primary fracture type was a 62-A2.3 fracture according to the AO/OTA Classification.Surgical excision and anatomical reconstruction of the acetabular wall using heterotopic ossific bone were performed 10 months after the fracture repair. Postoperatively, indomethacin was administered for prophylaxis against recurrence of heterotopic ossification, and hip range of motion was progressively increased. At 5 years and 6 months follow-up, the patient's pain was relieved and hip function had recovered. Though radiography and CT showed minimal subchondral cysts and mild joint-space narrowing, there was no evidence of graft resorption, progressive posttraumatic osteoarthritis or necrosis of the femoral head. CONCLUSION: To the authors' knowledge, this is the first case of such a challenging condition. Although it is an extremely rare case, it provides an attractive option for avoiding THA, as the long-term follow-up shows a satisfactory outcome.


Asunto(s)
Acetábulo/lesiones , Fracturas Óseas/cirugía , Osificación Heterotópica/etiología , Complicaciones Posoperatorias/etiología , Acetábulo/diagnóstico por imagen , Adulto , Fracturas Óseas/complicaciones , Humanos , Masculino , Osificación Heterotópica/diagnóstico por imagen , Osificación Heterotópica/terapia , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/terapia , Radiografía , Insuficiencia del Tratamiento
3.
BMC Musculoskelet Disord ; 14: 355, 2013 Dec 17.
Artículo en Inglés | MEDLINE | ID: mdl-24341860

RESUMEN

BACKGROUND: Our preliminary retrospective study assessed outcomes after the use of Ni-Ti arched shape-memory connector (ASC) combined with partially threaded cancellous screws (PTCS) to repair coronal plane supracondylar-condylar femoral fractures. METHODS: Twenty-one patients (16 men and 5 women) with a mean age of 34.1 years (range, 28 to 44 years) with coronal plane supracondylar and condylar fractures of the distal femur were included in this study. Each patient underwent open reduction and internal fixation using the ASC and PTCS. Active functional exercises with restricted weight bearing were initiated the first postoperative day. A gradual increase in weight bearing status and range of motion was permitted and subjects progressed to full weight bearing by 8 weeks. Surgical time, blood loss, postoperative knee range of motion, American Knee Society Scores (KSS), and postoperative complications were assessed. RESULTS: The mean surgical time was 75 mins (range, 45 to 100 mins) and average blood loss was 105 ml (range, 35 to 130 ml). Mean follow-up was 65 months (range, 22 to 90 months). No subjects demonstrated evidence of osteonecrosis or arthritis at the final follow-up. The mean KSS was excellent (≥85) in 8 subjects, good (70-84) in 11 subjects, and fair (60-69) in 2 subjects. The mean active range of motion of knee flexion at final follow-up was 100 degrees (range, 85 to 110 degrees). CONCLUSIONS: ASC combined with PTCS can serve as an effective means for managing comminuted femoral fractures that extend from the condyle to the supracondylar region. However, further prospective comparative studies and biomechanical analyses are needed to evaluate long-term outcomes using these materials.


Asunto(s)
Fracturas del Fémur/cirugía , Fijación Interna de Fracturas/instrumentación , Fracturas Conminutas/cirugía , Adulto , Tornillos Óseos , Femenino , Humanos , Masculino , Níquel , Estudios Retrospectivos , Titanio , Adulto Joven
4.
Int Orthop ; 37(6): 1039-44, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23549842

RESUMEN

PURPOSE: Dislocation following total hip arthroplasty (THA) with the posterior approach has been quite a common and bothering complication. Previous researches suggest that careful repair of the posterior structures significantly reduces this risk. The purposes of the present study were to describe a modified posterior soft tissue repair procedure in THA using a suture anchor (TwinFix Ti 5.0, Smith & Nephew, Andover, MA) and evaluate the early postoperative dislocation rate. METHODS: From July 2004 to June 2008, 220 consecutive primary total hip arthroplasties were performed using the modified surgical approach. The average age in the group was 46.4 years (range from 21 to 90) at the time of the procedure. The rate of postoperative hip dislocation, as well as any signs of complications related to the technique, has been observed and analyzed in this study. RESULTS: There was no postoperative dislocation following primary THA in 220 cases, and no signs of complications related to the technique, such as greater trochanteric fractures and sciatic nerve palsy, have been noted in any of the cases at their most recent follow-up. CONCLUSIONS: These initial results demonstrate that the modified repair in THA using the suture anchor can serve as an effective and reliable mean for prevention of early postoperative dislocation.


Asunto(s)
Artroplastia de Reemplazo de Cadera/instrumentación , Artroplastia de Reemplazo de Cadera/métodos , Luxación de la Cadera/prevención & control , Articulación de la Cadera/cirugía , Anclas para Sutura , Adulto , Anciano , Anciano de 80 o más Años , Luxación de la Cadera/epidemiología , Fracturas de Cadera/epidemiología , Humanos , Incidencia , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Retrospectivos , Factores de Riesgo , Neuropatía Ciática/epidemiología , Resultado del Tratamiento
5.
Int Orthop ; 37(6): 1099-105, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23595232

RESUMEN

PURPOSE: We carried out this study to test the efficacy of the olecranon memory connector (OMC) in olecranon fractures. METHODS: We designed a prospective randomised controlled trial involving 40 cases of olecranon fractures. From May 2004 to December 2009, 40 patients with olecranon fractures were randomly assigned into two groups. Twenty patients were treated with OMC, while another 20 patients were fixed with locking plates in our hospital. The DASH score, MEP score, range of motion and radiographs were used to evaluate the postoperative elbow function and complications. RESULTS: For MEP score, OMC was better than the locking plate; for DASH score, complication rate, and range of elbow motion, the two methods presented no significant difference. CONCLUSION: The study showed that OMC could be an effective alternative to treat olecranon fractures.


Asunto(s)
Diseño de Equipo , Fijación Interna de Fracturas/instrumentación , Fijación Interna de Fracturas/métodos , Fijadores Internos , Níquel , Olécranon/lesiones , Titanio , Fracturas del Cúbito/cirugía , Adulto , Anciano , Placas Óseas , Hilos Ortopédicos , Articulación del Codo/fisiología , Articulación del Codo/cirugía , Femenino , Estudios de Seguimiento , Curación de Fractura/fisiología , Humanos , Masculino , Persona de Mediana Edad , Olécranon/diagnóstico por imagen , Olécranon/cirugía , Estudios Prospectivos , Radiografía , Rango del Movimiento Articular/fisiología , Resultado del Tratamiento , Fracturas del Cúbito/diagnóstico por imagen , Lesiones de Codo
6.
Arch Orthop Trauma Surg ; 133(6): 773-80, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23572115

RESUMEN

INTRODUCTION: Bone and cartilage deficits in the posterior acetabular wall are severe complications resulting from the unsuccessful management or delayed treatment of acetabular fracture. This potentially disastrous condition cannot be treated reliably with the use of reconstruction plates and screws alone. Therefore, this technical report describes a modified anatomical reconstruction method that uses a structural iliac crest autograft and an acetabular tridimensional memory alloy fixation system (ATMFS) to treat late-stage deficits in the posterior wall of the acetabulum. This paper also describes a clinical study of 22 patients with an average of 6.3 years follow-up to evaluate the clinical outcomes of this method. METHODS: Twenty-two patients, who had an acetabular reconstruction between January 2000 and December 2011 that used a structured free iliac crest autograft to treat late-stage bone and cartilage deficits in the posterior acetabular wall were followed annually with clinical and radiographic evaluations. The average age of the patients was 36.4 years at the time of the procedure, and the average time of follow-up was 6.3 years. RESULTS: None of the patients in this study lost reduction after surgery, and there were no cases of implant failure. Radiographic analysis using Matta's X-ray evaluation criteria were excellent in eleven cases, good in eight, and fair on three. The Merle D'Aubigné and Postel clinical outcomes at the final follow-up were as follows: seven cases were excellent, ten cases were good, three cases were fair and two cases were poor. CONCLUSIONS: The use of a modified iliac crest grafting and ATMFS fixation, as a biological method to reconstruct the acetabulum anatomically may offer better congruence of the joint surface and may ensure good hip joint stability during early postoperative exercise. The medium to long-term results of this method are encouraging.


Asunto(s)
Acetábulo/lesiones , Trasplante Óseo , Fracturas Óseas/cirugía , Procedimientos Ortopédicos/métodos , Acetábulo/cirugía , Adolescente , Adulto , Humanos , Ilion , Masculino , Persona de Mediana Edad , Adulto Joven
7.
J Shoulder Elbow Surg ; 21(8): 985-91, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21982349

RESUMEN

BACKGROUND: Our preliminary study retrospectively assessed outcomes after the use of autogenous iliac bone grafts combined with internal fixation to repair refractory bone nonunions and bone defects associated with supracondylar or intracondylar humeral fractures, or both. MATERIALS AND METHODS: We identified 22 patients (14 men and 8 women) with a mean age of 33.8 years (range, 17-60 years) with bone nonunion and severe bone defects associated with supracondylar or intercondylar humerus fractures, or both. The humeral condyle in each patient was anatomically reconstructed using autologous iliac bone grafts and internal fixation. Active functional exercise was initiated 3 to 4 weeks after surgery. The following variables were assessed: preoperative and postoperative elbow range of motion, Mayo Elbow Performance Score (MEPS), and postoperative complications. RESULTS: Mean follow-up was 38.6 months. Mean duration until bone union was 5.6 months. Preoperatively, 16 patients had a fair or poor MEPS (<75). At final follow-up MEPS was excellent (>90) in 8, good (75-90) in 9, fair (60-74) in 4, and poor (<60) in 1 patient. Postoperative heterotopic ossification anterior to the elbow joint occurred in 2 patients. CONCLUSIONS: Our preliminary results suggest that anatomic reconstruction of the humeral condyle using autogenous iliac bone grafting with internal fixation can improve elbow joint function in patients with bone nonunion and bone defects associated with supracondylar or intracondylar humeral fractures, or both. Larger scale studies are warranted to confirm our findings and compare the efficacy of this vs other surgical approaches.


Asunto(s)
Trasplante Óseo/métodos , Fijación Interna de Fracturas/métodos , Fracturas no Consolidadas/cirugía , Fracturas del Húmero/cirugía , Ilion/trasplante , Fracturas Intraarticulares/cirugía , Adolescente , Adulto , Placas Óseas , Estudios de Cohortes , Articulación del Codo/diagnóstico por imagen , Articulación del Codo/cirugía , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas/rehabilitación , Curación de Fractura/fisiología , Fracturas no Consolidadas/diagnóstico por imagen , Rechazo de Injerto , Supervivencia de Injerto , Humanos , Fracturas del Húmero/diagnóstico por imagen , Fracturas Intraarticulares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Cuidados Posoperatorios/métodos , Radiografía , Rango del Movimiento Articular/fisiología , Procedimientos de Cirugía Plástica/métodos , Recuperación de la Función , Estudios Retrospectivos , Medición de Riesgo , Trasplante Autólogo , Resultado del Tratamiento , Adulto Joven
8.
Arch Orthop Trauma Surg ; 131(7): 885-91, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21165632

RESUMEN

BACKGROUND: Nonunion of long bones in lower limbs is a common complication of orthopedic trauma that can be extremely debilitating. This retrospective study describes our experience using expandable intramedullary nails and autologous bone grafting in treating lower limb long bone nonunion with bone defects. METHODS: Nineteen patients (mean age 38.9 years, range 18-61) with lower limb long bone nonunion and defects caused by femoral or tibial fracture types were as follows: A2 (3 femoral, 1 tibial), A3 (1 femoral, 2 tibial), B2 (3 femoral, 4 tibial), and B3 (1 femoral, 4 tibial). Expandable intramedullary nailing and autologous bone (iliac and/or fibular) grafting were used for the treatment. Postoperative bone healing as determined by analysis of standard anteroposterior and lateral X-ray films every 4 weeks. Complications were noted. RESULTS: The average number of previous surgeries was 1.9 (range 1-4). The mean duration from original injury to treatment was 17.6 months (range 9-40 months). Femoral shaft nonunion healed on average of 26.5 weeks (range 16-60 weeks) after surgery, while tibial shaft nonunion healed on average of 23.6 weeks (range 12-40 weeks) after surgery. Class I healing occurred in all but two patients who experienced chronic postoperative osteomyelitis and delayed wound healing, respectively. Two patients complained of postoperative donor site pain. CONCLUSIONS: The use of expandable intramedullary nails and autologous bone grafts was an effective method for repair of nonunion of lower limb fractures combining with bone defects with minimal complications.


Asunto(s)
Clavos Ortopédicos , Trasplante Óseo/métodos , Fracturas del Fémur/cirugía , Fijación Intramedular de Fracturas/instrumentación , Fracturas no Consolidadas/cirugía , Fracturas de la Tibia/cirugía , Adolescente , Adulto , Estudios de Cohortes , Terapia Combinada , Diseño de Equipo , Femenino , Fracturas del Fémur/diagnóstico por imagen , Estudios de Seguimiento , Fijación Intramedular de Fracturas/métodos , Curación de Fractura/fisiología , Fracturas no Consolidadas/diagnóstico por imagen , Humanos , Ilion/cirugía , Puntaje de Gravedad del Traumatismo , Traumatismos de la Pierna/diagnóstico por imagen , Traumatismos de la Pierna/cirugía , Masculino , Persona de Mediana Edad , Cuidados Posoperatorios/métodos , Radiografía , Estudios Retrospectivos , Medición de Riesgo , Fracturas de la Tibia/diagnóstico por imagen , Resultado del Tratamiento , Adulto Joven
9.
Int Orthop ; 34(7): 1033-40, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20012433

RESUMEN

Displaced acetabular fractures should be treated surgically. Over the past decade, surgical approaches to the acetabulum and the surgical technique for repair of common fracture patterns have advanced. Excellent outcomes after repair of these injuries can be achieved. The aim of this study was to assess the medium-term results of reconstruction of acetabular fractures by using shape-memory alloy designed by the authors. This is a retrospective review conducted at a level 1 trauma centre. From October 1999 to July 2009, 19 patients with acetabular fractures were treated with our patented Ni-Ti shape-memory alloy acetabular tridimensional memory alloy-fixation system (ATMFS). The ATMFS device was cooled with ice before implantation and then warmed to 40-50°C after implantation to produce balanced axial and compression forces that would stabilise the fracture three dimensionally. Our results are as follows; according to the D'Aubigne-Postel scoring system: Fifteen cases out of 19 (79%) achieved excellent or good clinical results. In two patients, late complications included avascular necrosis of the femoral head (ANFH) associated with posterior dislocation of the hip joint two years after the operation. We also observed two cases of grade II or III ectopic ossification, with good hip function, and one case of traumatic arthritis. In conclusion, these results demonstrate the effectiveness of the ATMFS device for the management of acetabular fracture. The device provides continuous compression of the fracture with minimal disruption to the local blood supply.


Asunto(s)
Acetábulo/lesiones , Fijación Interna de Fracturas/instrumentación , Fracturas Óseas/cirugía , Fijadores Internos , Diseño de Prótesis , Acetábulo/fisiopatología , Adulto , Anciano , Aleaciones , China , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas/métodos , Curación de Fractura , Fracturas Óseas/fisiopatología , Fracturas Óseas/rehabilitación , Prótesis de Cadera , Humanos , Masculino , Persona de Mediana Edad , Níquel , Complicaciones Posoperatorias , Rango del Movimiento Articular , Estudios Retrospectivos , Titanio , Resultado del Tratamiento , Caminata , Adulto Joven
10.
Int Orthop ; 34(3): 369-75, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19198838

RESUMEN

From August 1990 to December 2007, 156 patients with humeral shaft nonunion were treated with our patented Ni-Ti shape memory alloy swan-like memory pressure connector (SMC). The SMC device cooled with ice before implantation was warmed to 40-50 degrees C after implantation to produce balanced axial and compression forces to stabilise the fracture three-dimensionally. This combined with autologous bone grafting achieved bone tissue regeneration in the fracture and promoted smooth recovery of joint function, with a nonunion healing rate of 98.7% after a single SMC implantation. Failure of nonunion healing occurred in only two cases but was successfully managed by a further operation. Complications were not found in any of these patients apart from four with pre-existing radial nerve injuries. These results demonstrate the effectiveness of the SMC device for the management of humeral shaft nonunion. The device provides continuous compression of the fracture with minimal trauma to the local blood supply.


Asunto(s)
Fijación Interna de Fracturas/instrumentación , Fracturas no Consolidadas/cirugía , Fracturas del Húmero/cirugía , Dispositivos de Fijación Ortopédica , Adulto , Anciano , Aleaciones , Femenino , Fijación Interna de Fracturas/métodos , Curación de Fractura , Humanos , Masculino , Persona de Mediana Edad , Níquel , Diseño de Prótesis , Titanio
11.
Int Orthop ; 33(4): 1127-33, 2009 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18704416

RESUMEN

The aim of this article is to discuss the clinical efficacy of high strength injectable calcium sulphate (MIIGX3) in the treatment of tibial plateau fractures. Thirty-one patients with tibial plateau fractures treated with MIIGX3 were included. Postoperative radiographic study was used to evaluate congruity of the articular surface, bone regrowth, and the absorption process of MIIGX3. Rasmussen's score system was adapted for the postoperative knee function recovery assessment. Twenty-eight of 31 patients were followed-up successfully with an average follow-up length of 14.6 months. Complete fracture healing was found in all patients. Complications included wound exudation and articular subsidence. Postoperative knee function was good according to Rasmussen's score system. Six months after surgery, radiographs demonstrated equivalent bone density in the previous area of MIIGX3 as that of surrounding cancellous bone. The use of MIIGX3 in the treatment of tibial plateau fractures provides adequate intraoperative stability and improves the safety of early knee motion.


Asunto(s)
Sulfato de Calcio/uso terapéutico , Fijación Interna de Fracturas/instrumentación , Fijación Interna de Fracturas/métodos , Fracturas de la Tibia/cirugía , Adulto , Anciano , Fenómenos Biomecánicos , Tornillos Óseos , Sulfato de Calcio/administración & dosificación , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intraarticulares , Inestabilidad de la Articulación/prevención & control , Masculino , Persona de Mediana Edad , Radiografía , Fracturas de la Tibia/diagnóstico por imagen , Fracturas de la Tibia/fisiopatología , Soporte de Peso/fisiología
12.
Chin J Traumatol ; 12(3): 153-6, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19486557

RESUMEN

OBJECTIVE: To explore the mechanical behavior of lumbar spine loaded by stress and provide the mechanical basis for clinical analysis and judgement of lumbar spine fracture classification, mechanical distribution and static stress. METHODS: By means of computer simulation method, the constructed lumbar spine three-dimensional model was introduced into three-dimensional finite element analysis by software Ansys 7.0. The lumbar spine mechanical behavior in different parts of the stress loading were calculated. Impact load is 0-8000 N. The peak value was 8000 N. The loading time is 0-40 minutes. The values of the main stress, stress distribution and the lumbar spine unit displacement in the direction of main stress were analyzed. RESULTS: The lumbar spine model was divided into a total of 121 239 nodes, 112 491 units. It could objectively reflect the true anatomy of lumbar spine and its biomechanical behavior and obtain the end-plate images under different stress. The stress distribution on the lumbar intervertebral disc (L(3)-L(4)) under the axial, lateral flexion and extension stress, and the displacement trace of the corresponding processus articularis were analyzed. CONCLUSION: It is helpful to analyze the stress distribution of lumbar spine and units displacement in static stress loading in the clinical research of lumbar spine injury and the distribution of internal stress.


Asunto(s)
Análisis de Elementos Finitos , Vértebras Lumbares/fisiología , Adulto , Fenómenos Biomecánicos , Femenino , Humanos , Sacro/fisiología , Estrés Mecánico
13.
Zhonghua Wai Ke Za Zhi ; 47(20): 1550-2, 2009 Oct 15.
Artículo en Zh | MEDLINE | ID: mdl-20092743

RESUMEN

OBJECTIVE: To explore the therapeutical effects through investigating the results of multiple traumas treated by means of damage control surgery (DCS) or early total care (ETC). METHODS: The clinical data of 90 patients with severe multiple traumas admitted from June 2001 to June 2007 were analyzed retrospectively. Forty-five patients were classified to the DCS group, 45 patients to the ETC group as a control. These severely injured patients were selected with an ISS > 25 points. RESULTS: Between the two groups, the recovery time of clearance of lactic acid, body temperature, prothrombin time (PT) and activated partial thromboplastin time (APTT) of DCS group was significantly shorter than that of ETC group (P < 0.05). Incidence of complications and mortality in DCS group was significant less than that in ETC group (P < 0.05). No significant differences existed in the volume of bleeding and duration of surgery (P > 0.05). CONCLUSIONS: The concept of DCS could reduce multiple traumas patients' mortality rate and incidence of complications. The indication of DCS should be the combination of physical feature, mechanism and severity of injuries.


Asunto(s)
Traumatismo Múltiple/terapia , Femenino , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Resultado del Tratamiento
14.
J Knee Surg ; 30(2): 166-173, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27206070

RESUMEN

Operative treatment is usually recommended in displaced patella fractures. Several techniques have been advocated for internal fixation of patella fractures. Despite the relatively good clinical outcomes that have been demonstrated in many studies, postoperative morbidities such as fixation failure, nonunion, infection, and knee stiffness are not uncommon. We present a new alternative treatment technique for displaced patellar fractures. Between April 1995 and May 2005, we used the Nitinol Patella Concentrator (NTPC) to treat 156 consecutive patients with displaced patellar fractures. Injuries arose from vehicular accidents in 56 (35.9%) cases, direct falls onto the knee in 85 (54.5%) cases, and sports injuries in 15 (9.6%) cases. The mean patient age was 46.3 years (range, 25-77 years). Clinical assessments were made using the Böstman knee score and the MOS SF-36 questionnaire (Medical Outcomes Study 36-item short-form health survey), which were both recorded at the final follow-up visit. The mean follow-up was 7.3 years (range, 6-17 years). At the final follow-up, the Böstman knee scores were excellent in 88 cases (28-30), good in 55 (20-27), and unsatisfactory in 13 (<20). According to the MOS SF-36 evaluation, the average score was 84.5 (range, 62-91). Treatment of patellar fracture with the NTPC not only may serve as an effective and rigid fixation method in multifragmented displaced and inferior pole fractures, but also may provide continuous concentrative compression during the osseous healing process. Thus, use of the NTPC may help restore the functional integrity of the extensor mechanism and permit early rehabilitation with a lower incidence of postoperative complications.


Asunto(s)
Fijación Interna de Fracturas/instrumentación , Fracturas Óseas/cirugía , Traumatismos de la Rodilla/cirugía , Rótula/cirugía , Adulto , Anciano , Aleaciones , Materiales Biocompatibles , Femenino , Fijación Interna de Fracturas/métodos , Humanos , Articulación de la Rodilla/cirugía , Masculino , Persona de Mediana Edad , Rótula/lesiones
16.
Artículo en Zh | MEDLINE | ID: mdl-26677610

RESUMEN

OBJECTIVE: To study the experimental biomechanics of acetabular posterior wall fractures so as to provide theoretical basis for its clinical treatment. METHODS: Six formalin-preserved cadaveric pelvises were divided into groups A and B (n=3). The fracture models of superior-posterior wall and inferior-posterior wall of the acetabulum were created on both hips in group A; fractures were fixed with two interfragmentary screws and a locking reconstruction plate. The fracture models of superior-posterior wall of acetabulum were created on both hips in group B; fractures were fixed with two interfragmentary screws and a locking reconstruction plate at one side, and with acetabular tridimensional memory fixation system (ATMFS) at the other side. The biomechanical testing machine was used to load to 1 500 N at 10 mm/min speed for 30 seconds. The displacement of superior and inferior fracture sites was analyzed with the digital image correlation technology. RESULTS: No fracture or internal fixation breakage occurred during loading and measuring; the displacement valuess of the upper and lower fracture lines were below 2 mm (the clinically tolerable maximum value) in 2 groups. In group A, the displacement values of the upper and lower fracture lines at superior-posterior wall fracture site were significantly higher than those at inferior-posterior wall fracture site (P < 0.01), and the displacement values of the upper fracture line were significantly higher than those of lower fracture line (P < 0.01) in two fracture types. In group B, the displacement values of the upper and lower fracture lines at the side fixed with screws and a locking reconstruction plate were similar to the values at the side fixed with ATMFS, all being close to 2 mm; the displacement values of the upper fracture line were significantly higher than those of lower fracture line (P < 0.05) in two fixation types. CONCLUSION: The actual biomechanical effect of the superior-posterior wall of acetabulum is much greater than that of the inferior-posterior wall of acetabulum and they should be discriminated, which might be the reasons of reduction loss, femoral head subluxation, and traumatic arthritis during follow-up.


Asunto(s)
Acetábulo/lesiones , Acetábulo/cirugía , Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Acetábulo/fisiopatología , Anciano , Artritis , Fenómenos Biomecánicos , Placas Óseas , Tornillos Óseos , Cadáver , Cabeza Femoral , Fijación Interna de Fracturas/instrumentación , Fracturas Óseas/fisiopatología , Humanos , Pelvis
17.
Di Yi Jun Yi Da Xue Xue Bao ; 23(7): 728-30, 2003 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12865234

RESUMEN

OBJECTIVE: To establish the animal model for treating humeral fracture with swan-shaped bone fixation device made of Ni-Ti shape memory alloy. METHODS: Models of humeral fractures was established in 30 rabbits and on one side the fracture was fixed with the Ni-Ti shape memory alloy device (SMC side) and on the other with 4-hole dynamic compression plate (DCP side). Anteroposterior radiograph of both humeri were taken at the time points of 2, 4, 8, and 12 weeks respectively after operation. RESULTS: All the rabbits survived the experiment and their forelimbs bore obviously less weight than hindlimb. In SMC side, the humeral fracture healed without either osteoporosis or external callus. The fracture healing in DCP side gave rise to obvious external callus formation, and the healing process took significantly longer time than in SMC group. CONCLUSION: The humerus of rabbit is similar to human humerus in view of their anatomic morphology and biomechanical properties, therefore rabbit humeral fracture models can be ideal for exploring the mechanism of fracture healing induced by the alloy device.


Asunto(s)
Fijación Interna de Fracturas/instrumentación , Fracturas del Húmero/cirugía , Dispositivos de Fijación Ortopédica , Animales , Femenino , Fijación Interna de Fracturas/efectos adversos , Masculino , Modelos Animales , Níquel , Conejos , Titanio
18.
Zhongguo Gu Shang ; 27(1): 71-3, 2014 Jan.
Artículo en Zh | MEDLINE | ID: mdl-24754153

RESUMEN

OBJECTIVE: To analyze causes of missed diagnosis of hiding post-malleolar fractures in treating ankle joint fractures of pronation-external rotation type according to Lauge-Hansen classification and assess its medium-term outcomes. METHODS: Among 103 patients with ankle joint fracture of pronation-external rotation type treated from March 2002 to June 2010,9 patients were missed diagnosis,including 6 males and 3 females,with a mean age of 35.2 years old (ranged, 18 to 55 years old) . Four patients were diagnosed during operation, 2 patients were diagnosed 2 or 3 days after first surgery and 3 patients came from other hospital. All the patients were treated remedially with lag screws and lock plates internal fixation. After operation,ankle joint function was evaluated according to American Orthopaedic Foot and Ankle Society (AOFAS). RESULTS: All the 9 patients were followed up, and the duration ranged from 14 to 30 months (averaged, 17 months). No incision infection was found, and all incision healed at the first stage. At the latest follow-up, AOFAS was 83.0 +/- 4.4, the score of 4 patients diagnosed during operation was 85.0 +/- 2.9, and the score of 5 patients treated by secondary operation was 81.0 +/- 5.3. All the patients got fracture union observed by X-ray at a mean time of 2.2 months after operation. There were no complications such as internal fixation loosing, broken and vascular or nerve injuries. CONCLUSION: Ankle joint fracture of pronation-external rotation type may be combined with hiding post-malleolar fractures. So to patients with ankle joint fracture of pronation-external rotation type, lateral X-ray should be read carefully, and if necessary, CT or MRI examination should be performed. If adding lateral X-ray examination after reduction of exterior and interior ankle joint fixation, the missed diagnosis may be avoided.


Asunto(s)
Fracturas de Tobillo , Fracturas Óseas/diagnóstico , Fracturas Óseas/cirugía , Pronación , Rotación , Adolescente , Adulto , Reacciones Falso Negativas , Femenino , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Adulto Joven
19.
Zhongguo Gu Shang ; 27(12): 1008-11, 2014 Dec.
Artículo en Zh | MEDLINE | ID: mdl-25638887

RESUMEN

OBJECTIVE: To explore methods of treating middle and distal tibia nonunion with the treatment of advanced bone graft combined with locking compression plate. METHODS: From January 2011 to December 2012, 12 patients with middle and distal tibia nonunion were treated with advanced bone graft combined with locking compression plate. Among patients, there were 8 males and 4 females aged from 20 to 69 with an average of 47 years old. The time from first injuries to bone nonunion was from 9 months to 5 years, avergaed 19 months. Four cases were treated with external fixation, 6 cases were treated with plate fixation, 2 cases of 12 patients occurred broken of plate and nail. Eleven patients were non-infective bone nonunion and 1 patient was infective bone nonunion. Preoperative X-ray and CT showed all patients had sequestration and formation of ossified bone with different degrees. Operative time, blood loss, wound healing were observed, fracture healing time was evaluated by postoperative X-ray. Johner-Wruhs scoring standards was used to evaluate ankle joint function after operation at 10 months. RESULTS: Operative time ranged from 90 to 185 min with an average of (125.00±20.15) min; blood loss ranged from 225 to 750 ml with an average of (415.00±120.00) ml. All patients were followed up from 10 months to 2.5 years with an average of 1.5 years. Postoperative X-ray showed bone union was formed around fracture after operation at 4 months in all patients, 3 cases obtained bone healing within 6 months after operation, 9 cases obtained from 8 to 12 months. No infection, injury of nerve and vessles, and broken of plate and nail were ocurred. According to Johner-Wruhs scoring at 10 months after operation, 10 cases obtained excellent results, 1 good and 1 moderate. CONCLUSION: Advanced bone graft combined with locking compression plate, which can build fracture multi-point supporting based on full compression of bone nonunion to get effective fixation, is an effective method in treating middle and distal tibia nonunion.


Asunto(s)
Placas Óseas , Trasplante Óseo , Fracturas no Consolidadas/cirugía , Fracturas de la Tibia/cirugía , Adulto , Anciano , Femenino , Curación de Fractura , Humanos , Masculino , Persona de Mediana Edad
20.
Cell Biochem Biophys ; 70(2): 1393-9, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25113643

RESUMEN

The aim of this study is to explore the method and clinical outcome of posterior trochanteric osteotomy in acetabular fractures. From January 2000 to January 2008, 32 cases of acetabular fractures involving the dome of acetabulum underwent posterior trochanteric osteotomy for a better exposure and internal fixation with acetabular tridimensional memory fixation system. 28 cases (16 men and 12 women, mean age 39.9 years, range 16-73 years) were followed up with an average of 48.9 months (range of 19-95 months) and four were lost during follow up. Of 28 cases, 19 were fresh fractures and 9 were old fractures. The reduction was evaluated with Matta criteria. Clinical evaluation was based on modified Merle d'Aubigne and Postel scoring. Motor strength of the abductors was evaluated according to the Medical Research Council grading system. Ectopic ossification was classified according to Brooker criteria. Anatomical reduction was achieved in 17 cases and satisfied reduction in 10 patients. Poor reduction happened in an old fracture. All acetabular fractures got a direct bone union and no displacement and deep infection occurred. All osteotomies healed within 3.5 months without any nonunion, proximal migration of the greater trochanter, loosing or broken of instrumentation, and deep infection. Two superficial infections were healed with a regular dressing. Two patients underwent removal of implants from greater trochanter because of irritation. The strength of the abductors was of Grade 3/5 in two patients, Grade 4/5 in five patients, and normal in the rest. Clinical scoring was excellent to good in 84 %. Ectopic ossification occurred in five patients, grade 1 in two patients, grade 2 in two, and grade 3 in one. But function of hip joint was not seriously affected. Posterior trochanteric osteotomy can provide an adequate exposure of the dome of acetabulum without the associated complications like nonunion, proximal replacement, and weak of the abductors which often occur with standard oblique osteotomy.


Asunto(s)
Acetábulo/lesiones , Fémur/cirugía , Fracturas Óseas/cirugía , Osteotomía/métodos , Acetábulo/diagnóstico por imagen , Acetábulo/cirugía , Adolescente , Adulto , Anciano , Femenino , Fracturas Óseas/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Osteotomía/efectos adversos , Complicaciones Posoperatorias/etiología , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Adulto Joven
SELECCIÓN DE REFERENCIAS
Detalles de la búsqueda