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find Author "沈光银" 3 results
  • EFFECTIVENESS COMPARISON OF PROXIMAL FEMORAL NAIL ANTIROTATION AND DYNAMIC HIP SCREW FOR INTERTROCHANTERIC FRACTURES IN THE ELDERLY PATIENTS

    Objective To compare the effectiveness of the proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in the treatment of elderly patients with intertrochanteric fractures. Methods Between May 2007 and May 2010, 63 elderly patients with intertrochanteric fractures were treated, and fractures were fixed with PFNA in 31 patients (PFNA group) and with DHS in 32 patients (DHS group). There was no significant difference in gender, age, injury cause, disease duration, and fracture type between 2 groups (P gt; 0.05). Results All incisions healed by first intention. The incision length, operation time, and blood loss in PFNA group were significantly less than those in DHS group (P lt; 0.05). The averagefollow-up time was 13.6 months in PFNA group and was 13.8 months in DHS group. The fracture heal ing time was (11.80 ± 1.32) weeks in PFNA group and was (12.21 ± 1.26) weeks in DHS group, showing no significant difference (t=1.23, P=0.29). The complication rate was 0 in PFNA group and was 12.5% (4/32) in DHS group, showing no significant difference (P=0.06). After 1 year, Harris hip score of PFNA group (86.55 ± 10.32) was higher than that of DHS group (80.36 ±11.18) (t=2.28, P=0.03). Conclusion There are two surgical methods to treat intertrochanteric fractures in the elderly patient: PFNA and DHS, and each has advantages; for unstable intertrochanteric fractures, PFNA treatment is the first choice.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • COMPARISON STUDY ON EFFECTIVENESS BETWEEN ARTHROSCOPY ASSISTED PERCUTANEOUS INTERNAL FIXATION AND OPEN REDUCTION AND INTERNAL FIXATION FOR Schatzker TYPES II AND III TIBIAL PLATEAU FRACTURES

    Objective To compare the effectiveness of arthroscopy assisted percutaneous internal fixation and open reduction and internal fixation for Schatzker types II and III tibial plateau fractures. Methods Between August 2006 and April 2010, 58 patients with tibial plateau fractures of Schatzker types II and III were treated with arthroscopy assisted percutaneous internal fixation (arthroscopy group, n=38), and with open reduction and internal fixation (control group, n=20). There was no significant difference in gender, age, disease duration, fracture type, and compl ication between 2 groups (P gt; 0.05). The operation time, incision length, fracture heal ing time, and compl ications were compared between 2 groups. Knee function score and the range of motion were measured according to American Hospital for Special Surgery (HSS) scorestandard. Results All patients achieved primary incision heal ing. The arthroscopy group had smaller incision length andlonger operation time than the control group, showing significant differences (P lt; 0.05). The patients of 2 groups were followed up 12 to 14 months. At 6 months, the HSS score and the range of motion of the arthroscopy group were significantly greater than those of the control group (P lt; 0.05). The X-ray films showed bony union in 2 groups. The fracture heal ing time of the arthroscopy group was shorter than that of the control group, but no significant difference was found (t=2.14, P=0.41). Morning stiffness occurred in 2 cases (5.3%) of the arthroscopy group, joint pain in 6 cases (30.0%) of the control group (3 cases had joint stiffness) at 1 week, which were cured after symptomatic treatment. There was significant difference in the incidence of compl ications between 2 groups (χ2=6.743, P=0.016). Conclusion The arthroscopy assisted percutaneous internal fixation is better than open reduction and internal fixation in the treatment of tibial plateau fractures of Schatzker types II and III, because it has smaller incision length and shorter fracture heal ing time.

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • 改良关节镜下缝线内固定治疗前交叉韧带胫骨止点骨折

    目的 总结改良关节镜下缝线内固定治疗前交叉韧带(anterior cruciate ligament,ACL)胫骨止点骨折的疗效。 方法 2011 年 4 月—2015 年 4 月,收治 28 例 ACL 胫骨止点骨折患者。男 21 例,女 7 例;年龄 11~47 岁,平均 28.6 岁。致伤原因:运动伤 19 例,交通事故伤 9 例。受伤至手术时间 1~5 d,平均 2.1 d。膝关节Lysholm 评分为(42.7±7.6)分。按照 Meyers-Mckeever-Zaircznyj 分型标准:Ⅱ 型 3 例,Ⅲ 型 17 例,Ⅳ 型 8 例。合并半月板损伤 3 例。采用改良关节镜下缝线内固定治疗,术后正规康复锻炼。 结果 术后 X 线片示骨折均达解剖复位;切口均 Ⅰ 期愈合。患者均获随访,随访时间 12~18 个月,平均 14.2 个月。X 线片复查示,术后 6 个月骨折均达骨性愈合。术后 12 个月,膝关节 Lysholm 评分为(93.2 ±6.5)分,与术前比较差异有统计学意义(t=26.721,P=0.000)。Lachman 试验及前抽屉试验均为阴性。胫骨结节内侧内固定缝线经皮处无瘢痕或仅遗留点状瘢痕。 结论 改良关节镜下缝线内固定治疗ACL胫骨止点骨折,更微创,操作简便,疗效良好。

    Release date:2017-03-13 01:37 Export PDF Favorites Scan
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