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find Keyword "重建钢板" 15 results
  • A BIOMECHANICAL STUDY ON INTERNAL FIXATION OF PROXIMAL ULNA COMBINED WITH OLECRANON FRACTURE

    Objective To compare the biomechanical stability of Kirschner wire and tension band wiring, reconstruction plate combined with tension band wiring, and olecranon anatomical plate in fixing proximal ulna combined with olecranon fracture, so as to provide the theoretical evidence for clinical selection of internal fixation. Methods Eight specimens of elbow joints and ligaments were taken from eight fresh male adult cadaveric elbows (aged 26-43 years, mean 34.8 years) donated voluntarily. The model of proximal ulna combined with olecranon fracture was made by an osteotomy in each specimen. Fracture end was fixed successively by Kirschner wire and tension band wiring (group A), reconstruction plate combined with tension band wiring (group B), and olecranon anatomical plate (group C), respectively. The biomechanical test was performed for monopodium compression experiments, and load-displacement curves were obtained. The stability of the fixation was evaluated according to the load value when the compression displacement of fracture segment was 2 mm. Results No Kirschner wire withdrawal, broken plate and screw, loosening and specimens destruction were observed. The load-displacement curves of 3 groups showed that the displacement increased gradually with increasing load, while the curve slope of groups B and C was significantly higher than that of group A. When the compression displacement was 2 mm, the load values of groups A, B, and C were (218.6 ± 66.9), (560.3 ± 116.1), and (577.2 ± 137.6) N, respectively; the load values of groups B and C were significantly higher than that of group A (P lt; 0.05), but no significant difference was observed between groups B and C (t=0.305, P=0.763). Conclusion The proximal ulna combined with olecranon fracture is unstable. Reconstruction plate combined with tension band wiring and olecranon anatomical plate can meet the requirement of fracture fixation, so they are favorable options for proximal ulna combined with olecranon fracture. Kirschner wire and tension band wiring is not a stable fixation, therefore, it should not be only used for proximal ulna combined with olecranon fracture.

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • DOUBLE VOLUME INTERNAL FIXATION FOR CORRECTION OF ADULT POST-TRAUMATIC CUBITUS VARUS

    Objective Supracondylar closing wedge osteotomy is a standard operation for the management of post-traumatic cubitus varus deformity. There are many fixation methods for the broken ends of bone. However, most of these fixation methods are fraught with various complications. To evaluate the methods and functional results of double volume internal fixation for correction of adult post-traumatic cubitus varus deformity. Methods The cl inical data were retrospectively reviewed, from 22 cases of adults post-traumatic cubitus varus deformity between June 2007 and December 2010.There were 16 males and 6 females, aged 18-29 years (mean, 21 years) and they all had a history of supracondylar fracture. The deformities of cubitus varus appeared at 6 months (range, 3 months to 1 year) after fracture, and the operations were carried out at 4-17 years (mean, 8 years) after deformity occurrence. The valgus angle were 16-25° (mean, 20.6°) and the Flynn functional scores were all poor before operation. Supracondylar closing wedge osteotomies were performed. Two reconstruction plates were moulded and placed to the media and lateral volumes of the humerus to fix the broken ends of the osteotomy surfaces. External fixation was not needed and early rehabil itation was performed postoperatively in all cases. Results Incisions healed by first intention. All cases were followed up 6 to 24 months (mean, 13 months). At last follow-up, the valgus angle was 0-10° (mean, 7.5°). All cases got bone union at 8-13 weeks (mean, 10 weeks) after operation. No related complications occurred, such as infection, nervous or vein injury, and loosening or breakage of internal fixator; and no cubitus varus recurred. The Flynn scores were excellent in 17 cases, good in 3 cases, and fair in 2 cases; the excellent and good rate was 91%. Conclusion The operation of supracondylar osteotomy with double plates internal fixation for the correction of adult post-traumatic cubitus varus deformity can rigidly stabil ize distal humerus, which is helpful to functional training just after operation and satisfactory restoration of the elbow function.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • TREATMENT OF PROXIMAL ULNA AND OLECRANON FRACTURES BY RECONSTRUCTION PLATE COMBINED WITH TENSION BAND WIRING

    Objective To review the efficacy of reconstruction plate combined with tension band wiring for treating proximal ulna and olecranon fractures. Methods Between November 2004 and September 2009, 10 patients with proximal ulna and olecranon fractures were treated by reconstruction plate combined with tension band wiring. There were 6 males and4 females with an average age of 45.3 years (range, 21-75 years). Five fractures were caused by traffic accident, 2 by fall ing from height, 2 by tumbl ing, and 1 by a machine strangulation. The locations were the left side and the right side in 5 cases respectively. One case was open fracture (Gustilo II) and the other 9 were closed fractures. Olecranon fractures included 4 cases of traverse fractures and 6 cases of comminuted fractures, and proximal ulna fractures included 6 cases of comminuted fractures and 4 cases of obl ique fractures. The combined fractures included 6 radial head fractures, 4 coronoid process fractures, 2 proximal humerus fractures, and 3 scapula fractures; other injury included 1 elbow dislocation and 1 shoulder dislocation. Two patients had secondary operation; the other 8 patients received the primary operations and the time from injury to operation varied from 7 days to 20 days, with an average of 11 days. Results One case had infection at the incision 1 week after operation, and recovered after 2 months of antibiotics and debridement; incisions healed by first intention in other 9 patients. All patients were followed up 12-64 months (mean, 40.5 months). The X-ray films showed that fracture heal ing was achieved at 10-24 weeks (mean, 12 weeks). There was no ulnar nerve symptom in all cases. Heterotopic ossification occurred in 1 case at 2 months and stiffness of the elbow in 1 case at 3 months after operation; they were both cured after symptomatic treatment. Proximal migration of Kirschner wires was found in 1 case at 6 months after operation, whose implants were taken out at 9 months after the first operation because fracture had healed. At last follow-up, the flexion and extension arc of the elbow averaged 92.8°(range, 23-130°), and the arc of forearm rotation averaged 124.4° (range, 42-175°). According to the American Hospital for Special Surgery (HSS) evaluation method, the results were classified as excellent in 6 cases, good in 2, fair in 1, and poor in 1. Conclusion Treating proximal ulna and olecranon fractures by reconstruction plate combined with tension band wiring allows patients to do postoperative exercise early and could effectively avoid compl ications.

    Release date:2016-08-31 05:41 Export PDF Favorites Scan
  • 32 例髋臼骨折手术疗效

    【摘 要】 目的 总结髋臼骨折的手术治疗适应证、手术入路、术后处理及并发症防治。 方法 1998 年5 月-2006 年7 月,收治32 例髋臼骨折患者。男21 例,女11 例;年龄18 ~ 67 岁,平均42 岁。车祸伤20 例,砸压伤4 例,坠落伤8 例。按Letournel 分类:后壁骨折6 例,后壁及后柱骨折3 例,前壁骨折、前壁及前柱骨折各2 例,双柱骨折7 例,双柱伴横行骨折、髋关节脱位伴髋臼骨折各4 例,股骨颈骨折伴内壁粉碎性骨折、伴髋臼后壁骨折、伴后柱骨折、伴前壁骨折各1 例。术前常规牵引1 ~ 2 周后行手术复位内固定30 例,全髋关节置换2 例。 结果 患者术后切口均Ⅰ期愈合。全部获随访6 个月~ 7 年,平均28 个月。X线片示骨折于术后12 ~ 16 周愈合。3 例发生异位骨化;1 例发生髋关节骨性关节炎,股骨头坏死,二期行全髋关节置换;1 例坐骨神经损伤8 个月后基本恢复。参照美国矫形外科研究院评价髋关节功能的方法:优25 例,良2 例,可2 例,差3 例,优良率84.4%。 结论 术前明确骨折分类、手术时机适当、合适入路、可靠内固定及满意复位是提高髋臼骨折治疗效果的关键,重建钢板技术是一种较好的治疗方法,螺钉的植入方向是技术关键。

    Release date:2016-09-01 09:09 Export PDF Favorites Scan
  • BIOMECHANICAL RESEARCH ON INTERNAL FIXATION METHODS OF POSTERIOR PELVIC RING FRACTURE DISLOCATION

    Objective To investigate the biomechanical differences of three internal fixation approaches, namely improved Galveston (IG), reconstruction plate (RP), and il iosacral screw (LS) to the posterior pelvic ring fracture dislocation and provide experimental evidence for the cl inical appl ication of proper internal fixation method. Methods Six donatedfresh adult cadaver pelvic specimens (age averaged 45 years old) were numbered randomly and their normal biomechanics were tested by the measure instrument (MTS855 Mini-Blonix). The displacement values of normal pelvis were measured under the vertical compression (800 N) and reverse direction compression (8 N·m). Then they were made into left Denis I pelvic fracture and fixed with the IG, RP, and LS, respectively, in different orders. Biomechanics test was conducted on the fixed pelvis from both the vertical and the reversed directions. Results Concerning the direction of vertical ity and torsion, the order of fracture displacement from small to large was the normal pelvis, LS, IG and RP. There was no significant difference between LS and the normal pelvis (P gt; 0.05), and the differences between other tow groups were significant (P lt; 0.05). Conclusion The LS fixation can provide better stabil ity for posterior pelvic ring fracture dislocation when compared with IG and RP.

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • 髋臼横形骨折的治疗

    目的 总结切开复位重建钢板内固定治疗髋臼横形骨折临床效果。 方法 1999 年8 月- 2007 年3 月,采用切开复位重建钢板内固定治疗20 例髋臼横形骨折患者。男12 例,女8 例;年龄32 ~ 68 岁,平均48.5 岁。交通事故伤12 例,高处坠落伤5 例,重物砸伤3 例。左髋9 例,右髋11 例。伤后3 周内手术18 例,超过3 周手术2 例。按Letournel 髋臼骨折分类标准均为髋臼横形骨折。术中采用Kocher-Langenbeck 入路9 例,髂腹股沟切口3 例,联合入路8 例。 结果 术后切口均Ⅰ期愈合,无深部感染发生,无坐骨神经损伤患者。术后X 线片示骨折复位良好,骨折于12 ~ 16 周愈合。20 例均获随访,随访时间1 ~ 6 年,平均28 个月。按照美国矫形外科学会制定的标准,获优14 例,良6 例,优良率100%。2 例术后发生异位骨化,1 例发生骨性关节炎。1 例术后发生股骨头缺血性坏死,经全髋关节置换术后功能恢复。 结论 髋臼横形骨折采用重建钢板内固定治疗具有良好的效果。

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • TREATMENT OF OLD TILE B1 PELVIC FRACTURE BY STAGED PELVIC CLOSURE USING EXTERNAL FIXATORCOMBINED WITH RECONSTRUCTION PLATE

    【Abstract】 Objective To summary the effects of staged pelvic closure using external fixator combined withreconstruction plate for old Tile B1 pelvic fracture. Methods From August 2000 to August 2006, 14 patients (9 males and 5 females, age ranging from 21 to 65 years with old Tile B1 pelvic fracture with pubic symphysis separation were treated. The injuries were caused by the traffic accident in 10 patients, high crash in 3, and crush in 1. The duration ranged from 4 weeks to 3 months. The 14 patients were compl icated with other injuries in some degrees. The X-ray and CT showed pubic symphysis separation. In 13 patients, pubic symphysis separation distance was more than 2.5 cm, who also had fracture or dislocation in the posterior structure of pelvis. The X-ray films showed the mean pubic symphysis separation distance was (6.67 ± 2.11) cm preoperatively. The 14 patients underwent pelvic external fixation at first and staged pelvic closure gradually for the pubic symphysis separation. After 2 to 3 weeks, when the pubic symphysis separation distance was less than 1 cm, the patients underwent open reduction and internal fixation with reconstruction plate. Pubic symphysis separation distance was measuredin the preoperative and postoperative pelvic anterioposterior X-ray films. The condition of the posterior structure of pelvis was observed in CT films. The functions of patients were assessed according to Majeed grading system. Results All incisions healed by first intention. The 14 patients were followed up for 6 months to 2 years (15 months on average). The X-ray films showed the mean pubic symphysis separation distance of post-operation was (0.85 ± 0.23) cm, showing statistically significant difference when compared with that of pre-operation (P lt; 0.05). The CT films showed fracture and dislocation of the posterior structure of pelvis had bony heal ing after 6 to 12 months. According to the Majeed grading system, the results were excellent in 5 cases, good in 4 cases, fair in 4 cases and poor in 1 case; the excellent and good rate was 64.29%. Conclusion Staged pelvic closure using external fixation combined with reconstruction plate for old pelvic fracture with pubic symphysis separation can reduce the pubic symphysis separation distance significantly. Satisfactory effects can be expected in treating the patients with TileB1 fracture.

    Release date:2016-09-01 09:10 Export PDF Favorites Scan
  • COMPARISON OF PLATE AND KIRSCHNER WIRE FIXATION IN TREATMENT OF CLAVICULAR NONUNION

    Objective To compare the results of plate and Kirschner wire fixation in treatment of nonunion of clavicular fracture. Methods From September 1991 to January 2002, 19 patients (9 with plate and 10 with Kirschner wire) were treated. The results were evaluated by reduction, bone union time, recovery of joint function, pain, and correction of deformation. Results The follow-up time was 6-23 months with an average of 11 months. Bone union -occurred after a mean time of 11 weeks. In plate group, 7 patients gained excellent results, 1 good and1 fair. In Kirschner wire group, 3 patients gained excellent results, 3 good, 3 fair and 1 poor. The result of plate is significantly better than that of Kirschner wire fixation(Plt;0.05). Conclusion Plate fixation is a good simple method for treatment of nonunion of clavicular fracture.

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  • 钢丝联合重建钢板治疗分离性肩锁关节脱位的近期疗效观察

    【摘要】 目的 总结采用钢丝联合重建钢板治疗分离性肩锁关节脱位的临床近期疗效。 方法 2008年2月-2010年11月,采用钢丝联合重建钢板治疗分离性肩锁关节脱位4例。男2例,女2例;年龄24~45岁,平均年龄33.5岁。肩锁关节均呈分离性脱位,分离距离4.0~6.5 cm,平均5.2 cm。受伤至手术时间2~4 d。治疗后参照Karlsson评价标准,根据疼痛程度、上肢肌力、肩部活动度及X线片检查中肩锁关节间隙进行疗效评定。 结果 3例获随诊,随访时间2~12个月,平均5.6个月。X线片示肩锁关节位置正常,无钢板螺钉断裂、松动。术后2个月,按Karlsson标准评价疗效,获优1例,良2例。 结论 钢丝联合重建钢板治疗分离性肩锁关节脱位固定牢固,符合生物力学要求,可早期进行功能锻炼,获得良好的临床效果。

    Release date:2016-09-08 09:27 Export PDF Favorites Scan
  • EFFICACY COMPARISON OF RECONSTRUCTION BELT AND RECONSTRUCTION PLATE FOR COMPLICATED ACETABULAR FRACTURE BY COMBINED ANTERIOR AND POSTERIOR APPROACHES

    Objective To explore the advantage of reconstruction belt for treating complicated acetabular fracture by combined anterior and posterior approaches through the comparison with reconstruction plate. Methods A retrospective analysis was made on the clinical data of 39 patients with acetabular fractures who met the selection criteria. After open reduction by combined anterior and posterior approaches was performed, fracture was fixed by reconstruction belt in 20 cases (trial group), and by reconstruction plate in 19 cases (control group). There was no significant difference in gender, age, cause of injury, time from injury to hospital, type of fracture, and preoperative visual analogue scale (VAS) score between 2 groups (P > 0.05). The number of plate shaping, plate shaping time, operation time, bleeding amount, perspective times, VAS score, modified Merled’Aubigne-Postel hip score, and related complications were recorded and compared. According to Matta standard, the fracture displacement was measured to evaluate the fracture reduction and fracture healing. Results The number of plate shaping, plate shaping time, operation time, bleeding amount, and perspective times in the trial group were significantly less than those in the control group (P < 0.05). The patients were followed up 12-29 months (mean, 21.1 months) in the trial group, and 12-27 months (mean, 20.5 months) in the control group. The VAS score was significantly lower at 7 days and 6 months after operation than at pre-operation, and at 6 months than at 7 days in 2 groups (P < 0.05), but difference was not significant between 2 groups (P > 0.05). At 6 months after operation, the Merled’Aubigne-Postel score of hip function in the trial group was 15.950±1.504, showing no significant difference when compared with the control group (15.895±1.629) (t= -0.110, P=0.913). The fracture displacement was (0.750±1.070) mm in the trial group and was (0.842±1.068) mm in the control group, showing no significant difference (t= -0.269, P=0.789). The X-ray films showed that all fractures healed in 2 groups. The healing time was (16.10±2.07) weeks in the trial group and was (15.84±2.14) weeks in the control group, showing no significant difference (t =0.382, P=0.075). Conclusion Reconstruction belt for complicated acetabular fracture by combined anterior and posterior approaches has similar effectiveness to reconstruction plate, but the number of plate shaping, plate shaping time, and perspective times are fewer.

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