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find Keyword "空心钉" 17 results
  • COMPARISON OF EFFECTIVENESS BETWEEN MINIMALLY INVASIVE CANNULATED SCREW AND OPEN REDUCTION AND PLATE FIXATION IN TREATMENT OF HUMERAL GREATER TUBEROSITY FRACTURE

    Objective To compare the effectiveness between minimally invasive cannulated screw and open reduction and plate fixation in treatment of humeral greater tuberosity fracture by a prospective case-control study. Methods Between January 2008 and January 2011, 49 cases of humeral greater tuberosity fractures were treated with minimally invasive cannulated screw in 25 cases (trial group), and with open reduction and plate fixation in 24 cases (control group). There was no significant difference in gender, age, injury cause, disease duration, fracture displacement, injury side, and complications between 2 groups (P gt; 0.05). The length of incision, operation time, intraoperative blood loss, and hospitalization days were recorded. According to Neer grading system, the effectiveness was evaluated; fracture healing was observed by X-ray films. Results The trial group had smaller incision, shorter operation time, less blood loss, and shorter hospitalization days than the control group, showing significant differences (P lt; 0.01). Superficial infection occurred in 2 cases of the control group, and were cured after symptomatic treatment; primary healing of incision was obtained in the others of 2 groups. All patients were followed up 1-4 years (mean, 2.3 years). The fracture healing time was (7.0 ± 2.3) weeks in the trial group, and was (7.8 ± 2.1) weeks in the control group, showing no significant difference (t=1.24, P=0.22). No heterotopic ossification or loosening and breakage of internal fixation occurred during follow-up. The shoulder function Neer score of the trial group (86.3 ± 2.8) was significantly higher than that of the control group (80.1 ± 2.1) (t=6.37, P=0.00). The results were excellent in 14 cases, good in 8 cases, fair in 2 cases, and poor in 1 case with an excellent and good rate of 88.0% in the trial group; the results were excellent in 12 cases, good in 7 cases, fair in 2 cases, and poor in 3 cases with an excellent and good rate of 79.2% in the control group; and difference had no statistical significance (Z=0.83, P=0.41). Conclusion Compared with open reduction and plate fixation, minimally invasive cannulated screw for greater tuberosity fracture has the advantages of simple operation, less trauma, less intraoperative blood loss, and good shoulder function recovery.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • PERCUTANEOUS RETROGRADE CANNULATED SCREW FIXATION OF ACUTE STABLE SCAPHOID WAIST FRACTURE BY A TRANSTRAPEZIAL APPROACH

    Objective To explore the technique and effectiveness of percutaneous retrograde cannulated screw fixation for acute stable scaphoid waist fracture by a transtrapezial approach. Methods Between May 2010 and April 2012, 23 patients with acute stable scaphoid waist fracture were treated with percutaneous retrograde cannulated screw fixation by a transtrapezial approach. There were 18 males and 5 females, aged 21-54 years with an average of 32 years. All fractures were caused by supporting with hands after falling. The locations were the left side in 10 cases and the right side in 13 cases. The major symptoms included the wrist swelling, tenderness at the anatomic snuff box, and grip weakness. Two cases were accompanied by distal radius fractures. The time between injury and operation ranged from 1 to 5 days with an average of 3 days. Results All incisions healed by first intention. All the cases were followed up 4-26 months with an average of 10 months. All fractures healed 6-12 weeks postoperatively with an average of 8.2 weeks. The patients resumed normal life and work at 4-6 weeks and at 2-4 months after operation, respectively. At last follow-up, all the wrists were free from the pain and the tenderness. The postoperative grip power ranged from 30 to 51 kg (mean, 37 kg). The active flexion-extension range of motion was 140-165° with an average of 153.7°. All patients were satisfied with the results of treatment. Conclusion Percutaneous retrograde cannulated screw fixation by a transtrapezial approach is a simple, safe, and reliable method to treat acute stable scaphoid waist fracture. By this approach, it is easier to place the screws into the center of the long axis of scaphoid.

    Release date:2016-08-31 04:12 Export PDF Favorites Scan
  • 空心钉锁定钢板治疗青壮年股骨颈骨折近期疗效

    目的 总结空心钉锁定钢板治疗青壮年股骨颈骨折的近期疗效。 方法2009年2月-2011年5月采用牵引复位、空心钉锁定钢板内固定术治疗23例青壮年股骨颈骨折患者。男15例,女8例;年龄17~54岁,平均32.2岁。骨折分型:股骨颈头下型8例,经颈型10例,基底型5例;GardenⅠ型2例,Ⅱ型4例,Ⅲ型9例,Ⅳ型8例。 结果术后患者切口均Ⅰ期愈合。23例均获随访,随访时间12~32个月,平均18.3个月。1例于术后6个月复查见骨折不愈合并股骨头缺血性坏死关节面塌陷,行人工全髋关节置换术;其余患者均获骨性愈合,愈合时间6~11个月,平均9.1个月。未出现内固定物松动、断裂等并发症。术后6个月Harris评分为(89.39 ± 6.29)分,与术前(40.83 ± 9.07)分比较差异有统计学意义(t=17.38,P=0.00)。 结论空心钉锁定钢板具有固定可靠、退钉率低、骨折愈合率较高等优势,是治疗青壮年股骨颈骨折的一种有效方法。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • 三枚空心钉与动力髋螺钉结合空心钉治疗青壮年股骨颈骨折的比较研究

    目的 比较3 枚空心钉及动力髋螺钉(dynamic hip screw,DHS)结合空心钉治疗青壮年股骨颈骨折的临床疗效。 方法 2007 年10 月- 2009 年1 月,收治72 例青壮年股骨颈骨折患者。其中40 例采用3 枚空心钉固定(空心钉组):男21 例,女19 例;年龄20 ~ 50 岁,平均35.2 岁。车祸伤8 例,摔伤32 例。受伤至手术时间1 ~ 4 d,平均 2.7 d。32 例采用DHS 结合空心钉固定(结合组):男18 例,女14 例;年龄20 ~ 46 岁,平均37.4 岁。车祸伤6 例,摔伤26 例。受伤至手术时间1 ~ 4 d,平均2.5 d。两组患者一般资料比较,差异无统计学意义(P gt; 0.05),具有可比性。 结果 术后两组切口均Ⅰ期愈合。患者均获随访,随访时间12 ~ 26 个月,平均18.6 个月。空心钉组骨折愈合率为90%(36/40),结合组为100%(32/32);空心钉组股骨头坏死率为10.0%(4/40),结合组为9.4%(3/32)。末次随访髋关节功能按Harris 评分标准进行评价,空心钉组(85.2 ± 4.3)分,结合组(87.4 ± 3.9)分。以上指标两组比较差异均无统计学意义(P gt; 0.05)。 结论 采用3 枚空心钉或DHS 结合空心钉固定治疗青壮年股骨颈骨折均可获得较好疗效。

    Release date:2016-08-31 05:49 Export PDF Favorites Scan
  • ARTHROSCOPIC PERCUTANEOUS OSTEOSYNTHESIS OF LOW-ENERGY TIBIAL PLATEAU FRACTURES

    Objective To explore the treatment of low-energy tibial plateau fractures with arthroscopic percutaneous osteosynthesis. Methods From May 2004 to April 2008, 27 cases of tibial plateau fractures were treated with arthroscopic management. There were 19 males and 8 females, aged 18-61 years old (mean 41.5 years old). Fracture was caused by trafficaccident in 18 cases, by fall ing from height in 6 cases, by bruise in 2 cases, and by other in 1 case. There were 8 cases of type I, 12 cases of type II, 2 cases of type III and 5 cases of type IV according to Schatzker classification. The time from injury to operation was 3-15 days (mean 5.2 days). After symptomatic managements were performed arthroscopically in 11 cases of meniscus tear, 4 cases of medial collateral l igament rupture of knee joint, 3 cases of anterior cruciate l igament rupture of knee joint and 2 cases of cartilage fracture resulting in joint bodies, fracture was reduced and fixed with 2 or 4 cannulated screws (7 mm in diameter). Autograft of il ium was given 6 cases of bone defect. Early functional exercise was done. Results The operation time was 55-150 minutes (mean 93 minutes); the hospital ization days were 7-22 days (mean 16 days). All incision healed primarily. Edema of the affected leg occurred in all patients and subsided after 3 days of symptomatic management. In one patient who did not cooperate in functional exercise, adhesion occurred and normal function was recovered after by manual dissolution under conditions of anesthesia after 3 months of operation. All patients were followed up 6-36 months (mean 16.6 months). The range of motion of knee joint was 105-140° (mean 121°). According to Lysholm scale of knee joint, the score was 72-100 points (mean 93.6 points) 6 months after operation. The X-ray film showed no signs of osteoarthritis. Conclusion Arthroscopic percutaneous osteosynthesis yields satisfactory results and can be accepted as an alternative and effective method for the treatment of low-energy tibial plateau fractures.

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • 空心钉内固定加股直肌骨瓣移植治疗青壮年股骨颈骨折23 例

    探讨一种治疗青壮年股骨颈骨折的方法。 方法 2000 年5 月- 2005 年10 月,采用空心钉内固定加股直肌骨瓣治疗青壮年股骨颈骨折23 例。男16 例,女7 例;年龄21 ~ 45 岁,平均31.3 岁。车祸伤18 例,高处坠落伤5 例。左侧10 例,右侧13 例。骨折部位:头下型10 例,头下经颈型13 例。Garden 分型:Ⅲ型15 例,Ⅳ型8 例。 结 果 23 例患者术后获随访16 ~ 52 个月,平均26 个月。术后无感染、退钉、骨瓣松动等发生。22 例术后4 ~ 6 个月X 线片示骨折愈合;1 例术后8 个月X 线片示骨折未愈合,术后16 个月CT 及ECT 示股骨头坏死。髋关节功能按Harris 评分标准:优13 例,良8 例,差2 例,优良率91%。 结论 空心钉内固定加股直肌骨瓣移植能有效减少青壮年股骨颈骨折的骨折不愈合和股骨头坏死的几率。

    Release date:2016-09-01 09:12 Export PDF Favorites Scan
  • Femoral Neck Fracture Treated with Close Reduction plus Cannulated Screw Fixation with Quadratus Femoris Muscle Pedicle Bone Grafting

    目的 目前对青壮年有移位新鲜股骨颈骨折患者的治疗仍存在许多争议,被认为尚未完全解决难题之一,股骨颈骨折内固定术后常导致骨折不愈合股骨头缺血性坏死。 方法 2003年1月-2008年6月,收治青壮年新鲜移位股骨颈骨折患者12例,年龄17~55岁,平均36.3 岁。所有患者在受伤后1周内采用牵引下闭合复位空心钉内固定加股方肌骨瓣移植术治疗。术后随访1~5年,平均3.5年。 结果 12例患者均达骨性愈合,随访期内未出现股骨头缺血性坏死;术后采用Harris 髋关节评分标准进行评估,获优良10例,一般1例,差1例。 结论 青壮年新鲜有移位股骨颈骨折患者,采用牵引下闭合复位空心钉内固定加股方肌骨瓣转移术治疗效果良好,均能达到骨折愈合,且无股骨头缺血性坏死发生。

    Release date:2016-09-08 09:49 Export PDF Favorites Scan
  • 股骨颈骨折合并Ⅲ期以上压疮患者的整体治疗

    目的探讨老年患者股骨颈骨折合并严重压疮的有效治疗方案。 方法对2011年4月-2014年12月收治的37例老年股骨颈骨折早期未能进行人工关节置换术又合并Ⅲ期以上压疮患者的整体治疗进行总结分析。整体治疗的方法是根据股骨颈骨折不同阶段采用闭合复位经皮空心钉内固定术固定骨折部位,结合波浪床、骑跨椅进行康复锻炼,创面使用封闭式负压引流治疗。 结果37例患者中,34例患者压疮完全愈合且能坐骑跨椅离床外出活动,其中9例康复后行髋关节置换术,最终能站立并能扶拐杖行走;2例因家庭支持力度不够仍然卧床,压疮行负压引流治疗;1例因心肺功能衰竭骨折后2年死亡。 结论采用闭合复位经皮空心钉内固定股骨颈骨折联合波浪床、骑跨椅以及封闭式负压引流对股骨颈骨折合并Ⅲ期以上压疮患者进行整体治疗效果良好,可在基层医疗单位推广。

    Release date:2016-10-02 04:54 Export PDF Favorites Scan
  • ARTHROSCOPOIC FIXATION WITH PERCUTANEOUS CANNULATED SCREWS FOR ACUTE DISPLACED ISOLATED GREATER TUBEROSITY FRACTURES OF THE PROXIMAL HUMERUS

    ObjectiveTo evaluate the technique and the effectiveness of arthroscopic fixation with percutaneous cannulated screws for acute displaced isolated greater tuberosity fractures of the proximal humerus. MethodsA retrospective analysis was made on the clinical data of 15 patients with acute displaced isolated greater tuberosity fractures of the proximal humerus, who accepted arthroscopic percutaneous cannulated screw fixation treatment between January 2010 and February 2013. There were 8 males and 7 females with an average age of 44.9 years (range, 31-66 years). Eight left shoulders and 7 right shoulders were affected. The mean interval of injury and operation was 9.9 days (range, 4-19 days). Before operation, the average range of motion (ROM) values of the affected shoulder were (74.13±17.19)° in forward flexion, (121.67±17.50)° in abduction, (T11±2)° in internal rotation, and (39.27±8.08)° in external rotation; the visual analogue scale (VAS) score was 6.46±1.30; and Costant score was 62.27±11.90. ResultsOperations were all successfully completed and incision healed by first intention in all cases. All cases were followed up 12-27 months (mean, 15 months). Postoperative X-ray films showed good reduction, alignment, and union of fracture. The average fracture healing time was 8 weeks (range, 6-13 weeks). At last follow-up, the ROM of the affected shoulder were significantly improved to (169.33±7.99)° in forward flexion, (156.67±10.47)° in abduction, (T6±2)° in internal rotation, and (71.67±7.94)° in external rotation (P<0.05); the VAS score was significantly reduced to 1.73±1.02 (t=-8.51, P=0.00); and the Costant score was significantly increased to 96.20±2.34 (t=11.50, P=0.00). No complication was found, such as neural or vascular injury, infection, shoulder joint adhesion, fixation failure, or fracture displacement. ConclusionArthroscopic fixation with percutaneous cannulated screws is a safe method to treat acute displaced isolated greater tuberosity fractures of the proximal humerus, and it has good short-term effectiveness with the advantages of little trauma and satisfactory functional recovery.

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  • Strategies of closed reduction in treatment of femoral neck fracture using cannulated screw fixation

    ObjectiveTo study intraoperative reduction strategy in treatment of femoral neck fracture using cannulated screw fixation and the relationship between excellent and good rate of reduction and postoperative effectiveness. MethodsA retrospective analysis was made on the clinical data of 174 cases of femoral neck fracture treated between August 2005 and March 2015. There were 78 males and 96 females with an average age of 53.8 years (range, 23-75 years). The injury causes were falling in 85 cases, traffic accident in 61 cases, and falling from height in 28 cases. According to Garden typing, there were 35 cases of type I, 56 cases of typeⅡ, 47 cases of typeⅢ, and 36 cases of typeⅣ. The time from injury to operation was 1-7 days (mean, 2.74 days). Based on reduction strategy, closed 3 hollow compression screws were used; evaluating standards for fracture reduction effect were also established. Harris score was used for effectiveness evaluation. ResultsAll the cases received follow-up of 12-42 months (mean, 36.5 months). Bone healing was obtained in 152 cases at 6-12 months (mean, 9 months). Non-union and internal fixation failure occurred in 9 and 3 patients respectively, who underwent hemiarthroplasty; femoral head necrosis occurred in 6 patients after removing internal fixator at 15-26 months (mean, 18.5 months) after operation, who underwent total hip arthroplasty; 4 patients with non-union received vascular pedicle iliac flap transplantation. No other serious complications were observed. At last follow-up, the excellent and good rate of reduction was 94.29% for Garden type I, 91.07% for typeⅡ, 87.23% for typeⅢ, and 75.00% for typeⅣ, with a total excellent and good rate of 87.36%; the excellent and good rate of Harris score was 97.14% for Garden type I, 78.57% for typeⅡ, 68.09% for typeⅢ, and 50.00% for typeⅣ, with a total excellent and good rate of 73.56%. ConclusionTo obtain high Harris score in fixation of femoral neck fractures by using hollow screws, surgeons not only need reasonable technology, but also follow correct and good reduction strategy and assessment, fracture complexity is inversely proportional to excellent and good rate of reduction. Higher excellent and good reduction rate of complexity fracture should be obtained as much as possible in order to achieve good prognosis.

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