ObjectiveTo explore the clinical effects of wet dressing in treating non-healing wound caused by gout stone curettage. MethodsFifteen patients with non-healing wound after hand and foot gout curettage between April 2010 and January 2014 were included in our study. Medication, diet management, lifestyle changes, and health guidance were carried out before and after surgery to control patients' uric acid concentration. Through evidence-based method and considering the characteristics of gout stone curettage wound, we selectively used wet dressing to deal with the wound during the three processes of wound healing:debridement, hyperplasia, and maturing. The curative effect and patients' recovery were observed. ResultsAll the 15 cases of wound were cured, and the average treatment time was (40±5) days No recurrence occurred. ConclusionWet dressing can promote healing of gout stone curettage wound. With comprehensive treatment method, it can restore patients' health as soon as possible.
ObjectiveTo analyze the outcome and prognostic factors of using locking plate for treating proximal humerus fracture. MethodsBetween January 2005 and January 2012, 45 aged patients with a displaced 3-part or 4-part fracture of the proximal humerus were treated by locking plate. Range of motion and Constant-Mudey score were observed during the follow-up. ResultsForty-three patients were followed up from 12 to 48 months with an average of 18 months. The mean final Constant-Mudey score was 72.3±9.5 and 6 of them needed a second surgery. In addition to fracture type, other prognostic factors included redisplacement (4 cases, 9.3%), nonunion (3 cases, 7.0%), crashing (3 cases, 7.0%), necrosis of the humeral head (6 cases, 14.0%) and screw cut-out (5 cases, 11.6%). Among the patients with disrupted medial calcar, 4 needed a second surgery at the final follow-up, 3 had redisplacement, 2 had nonunion, and 2 had screw cut-out. ConclusionLocked screw-plates provide more secure fixation of fracture in aged patients, but the complication rate remains high. We suggest anatomic reduction, and plate and screws position, length of the screws, the medial cortical contact and stability may be the chief prognostic factors affecting the shoulder function following a proximal humeral fracture.