Objective To investigate the diagnose and treatment of intra-articular fracture of the 5th metacarpale base with carpometacarpal joint dislocation (reverse Bennett fracture). Methods Between January 2008 and March 2012, 26 cases of reverse Bennett fracture were treated. There were 20 males and 6 females, aged 19-48 years (mean, 26 years). The injury causes included boxing injury in 19 cases, falling injury in 3 cases, heavy pound injury in 3 cases, and crushing injury in 1 case. According to Lundeen classification, there were 8 cases of type A, 9 cases of type B, 3 cases of type C, and 6 cases of type D. The time from injury to operation ranged 1-8 days with an average of 4 days. All patients underwent open reduction and internal fixation with Kirschner wires, screws, or plates by L-shaped dorsal incision. Results Primary healing was obtained in all incisions; no infection, hematoma, and necrosis occurred after operation. All patients were followed up with an average time of 12.5 months (range, 8-24 months). X-ray films showed that all fractures healed after 6-8 weeks (mean, 6.5 weeks); no delayed union or nonunion and no the 5th carpometacarpal joint dislocation were observed. Two cases had mild osteoarthritis. According to the upper extremity functional evaluation standard by Hand Surgery Branch of Chinese Medical Association, the results were excellent in 22 cases, good in 3 cases, and fair in 1 case, with an excellent and good rate of 96.2%. Conclusion For patients with reverse Bennett fracture, good results can be obtained if early diagnose is done and appropriate internal fixation is selected.
To investigate the operative treatment of displaced intra-articular calcaneal fractures (DIACFs) using a combination of small lateral incision approach and internal fixation and allograft bone transplantation. Methods From January 2005 to December 2007, 28 patients with 34 DIACFs were treated with open reduction, allograft bone transplantationand internal fixation through a small lateral incision approach. Of them, there were 18 males and 10 females, aged 16-65 years. The disease course was 2 hours to 18 days. According to Sanders classification, there were 18 cases of type II fractures, 10 cases of type III fractures and 6 cases of type IV fractures. Results 22 patients with 28 DIACFs were followed up 18.5 months (13-28 months). The wound of 26 feet achieved primary heal ing, the acute rejection was found in 2 patients and developed wound compl ications. Both patients underwent further surgery prior wound heal ing. After the internal fixation were removed, factures was fixed with external fixator, closed continuous irrigation and drainage was employed. In the meantime, both patients received antibiotics and incisional dressing change. As a result, one achieved primary heal ing, the other developed delayed heal ing. Thepreoperative X-ray film showed that Bouml;hler angle was (6.19 ± 9.66)° and Gissane angle was (103.04 ± 15.03)°; the postoperative X-ray film demonstrated that Bouml;hler angle was (34.51 ± 5.89)° and Gissane angle was (112.18 ± 10.50)°; showing statistically significant differences (P lt; 0.05). The internal fixation of 12 patients (14 DIACFs) were removed at 6 -10 months after operation, Bouml;hler angle was (32.81 ± 5.10)° and Gissane angle was (110.81 ± 9.98)°. When compared with preoperative X-ray film, statistically significantdifferences (P lt; 0.05) was found, but there was no statistically significant differences (P gt; 0.05) when compared with normal X-ray film. According to the American Orthopedic Foot and Ankle Society evaluation system for ankle-hind foot, 3 feet scored 60-70 points, 10 feet 70-80 points, 12 feet 80-90 points and 3 feet 90-100 points. Conclusion Allograft bone transplantation is an option for management of DIACFs, because it enables satisfactory reconstruction of bone defects, allows met anatomic reduction and functional recovery, maintaining restoration of calcaneal height and anatomic reduction of the posterior facet.
Objective To assess the treatment effect of intra-articular fracture with absorbable screws and rods.Methods From June 1998 to August 2004， 35 patients with intra-articular fracture were treated by absorbable screws and rods made of self-reinforcedpolyglycolicacid (SR-PGA) and self-reinforcedpoly-L-Lacticacid (SR-PLLA). Of 35 patients, 30 were males and 5 were females (aged from 4 to 62 years). All cases had intra-articular or periarticular fracture. The interval between injury and operation was 3 hours to 29 days. Fracture were fixed with full thread screws of SR-PGA in 9 cases, with tensile screws of SR-PLLA in 26 cases, with rods of SR-PLLA in 15 cases. Bone traction orplaster external fixation were carried out postoperatively. Results The patients were followed from 3 months to 60 months with an average of 28 months．The wounds healed by first intention, and the healing time of bone was 1－3 months. No dislocation, infection and local effusion occurred. Functional recovery was satisfactory．According to AASO articular function standard, the results were excellentin 26 cases, good in 7 cases, fair in 1 case, and poor in 1 case; the total excellent and good rate was 94.3%. Conclusion Internal fixationof absorbable screws and rods are a perfect procedure in treating intraarticular and periarticularfracture, which can avoid the pain of taking out internal fixation materials because of second operation．
OBJECTIVE: To investigate the treatment results of fracture involved articular surface with absorbable screws and rods. METHODS: From October 1995 to May 2002, 32 patients with fracture involved articular surface were treated with absorbable screws and rods with the materials of SR-PGA and SR-PLLA. Bone traction or plaster external fixation were carried out postoperatively. RESULTS: The followed-up period varied from 3 months to 78 months, with an average of 18.5 months. According to the articular function evaluation criteria, the results were excellent in 24 patients, good in 6 patients and fair in 2 patients. The excellent and good rate was 93.7%. The fractures healed, without dislocation, infection and local effusion. CONCLUSION: Internal fixation of absorbable screws and rods is a perfect procedure for treating fracture involved articular surface, which avoided the pain of taking out internal fixation materials of the second operation.