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Four Pins Assisted reduction of Complex Segmental Femoral Fractures: a Technique for closed reduction

Journal of Huazhong University of Science and Technology(Medical Sciences) 2014年第6期34卷 912-916页

作者：郑占乐于贤许国强陈伟张英泽焦振清 Orthopedic Trauma Center and Key Biomechanical Laboratory of Orthopedics The Third Hospital of Hebei Medical University Department of Endocrinology The General Hospital of Hebei Province Hebei Medical University

Complex segmental femoral fractures are usually not amenable to closed reduction. The purpose of this study was to evaluate a series of patients who had undergone four pins assisted reduc- tion and intramedullary nail fixation to determine the therapeutic effect of this closed reduction tech- nique. Between December 2010 and January 2013, 15 consecutive patients with segmental femoral fractures were treated with four pins assisted reduction at our hospital. The patient was placed in a supine position on a radiolucent fracture table and a. gentle traction was attempted on the limb. Usu- ally, the proximal fracture segment exhibited the typical deformity of flexion, external rotation, and abduction, the middle segment exhibited adduction and distal fracture segment exhibited flexion. Four Schanz pins were placed percutaneously to fix one cortex and did not penetrate into the me- dullary cavity, and the ＂T＂ sharp handles were fixed on the Schanz pins. The fragments were then re- duced by reversing the deforming forces for segmental fractures by two assistants~ And then, the re- duction could be easily achieved and intramedullary nail fixation was performed. Radiographs were evaluated for the quality of the reduction and fracture union. closed reduction was achieved in all pa- tients using the four pins technology. All 15 fractures united uneventfully. No patient had a rotational malunion or limb length discrepancy at the time of the last follow-up. Thirteen of the fifteen （86.7%） patients had anatomic reduction and two of them （13.3%） had minor varus alignment of 3° and 5°. Knee stiffness was Observed in 2 patients and no implant failure was observed. Surgical treatment of complex segmental femoral fractures With four pins assisted reduction and intramedullary nail fixation techniques can result in excellent reductions and a high union rate.

关键词： fracture closed reduction segmental fracture femur

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Modified closed reduction and Percutaneous Kirschner Wires Internal Fixation for Treatment of Supracondylar Humerus Fractures in Children

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Current Medical Science 2021年第4期41卷 777-781页

作者： Shu-bin WANG Bin-hui LIN Wei LIU Guo-jun WEI Zong-guang LI Nai-chun YU Guang-rong JI Department of Orthopedic Surgery Xiang'an Hospital of Xiamen universityXiamen 361000China

Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric *** present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in *** From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified ***,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn *** The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side *** children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.

关键词： supracondylar humerus fractures closed reduction Kirschner wires internal fixation surgical method

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Lunate dislocation with avulsed triquetral fracture: A case report

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World Journal of Clinical Cases 2022年第1期10卷 331-337页

作者： Ling-Yi Li Cheng-Jyh Lin Chih-Yuan Ko Department of Orthopedic Surgery China Medical University HospitalTaichung City 40402Taiwan

BACKGROUND Lunate dislocation is an uncommon traumatic wrist injury that require prompt surgical *** or delayed treatment often leads to a poor *** reduction and surgical repair of disrupted ligaments are done in most cases to prevent long-term joint ***,this method has certain limitations that include partial functional improvement,which poses a high risk for degenerative arthritis and wrist *** SUMMARY A 37-year-old man presented to the Emergency Department of our hospital following a motorcycle *** examination revealed swelling and tenderness of the right hand and *** patient was initially misdiagnosed with a wrist contusion by an emergency physician,but was eventually diagnosed with lunate dislocation associated with a triquetral avulsed fracture,indicated for open reduction and ligament *** performed closed reduction and two Kirschner wire fixations following Tavernier’s *** injured hand was protected with a standard short-arm orthosis for one *** patient returned to normal daily work without discomfort at five months ***,there was no lunate necrosis or arthritis in the latest radiologic *** This case provides evidence that the closed reduction technique for addressing such cases can reduce soft tissue destruction.

关键词： Hand trauma Carpal injury Lunate dislocation Triquetral fracture closed reduction Case report

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Epidemiology of Maxillofacial Trauma in Pediatric and Adolescent Population: An Institutional Experience of 6 Years

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Open Journal of Orthopedics 2022年第6期12卷 277-287页

作者： Noaman Kazi Pallavi Ranadive Suday Rajurkar Ankit Sharma Mohan Deshpande Snehal Ingole Department of Oral and Maxillofacial Surgery M. A. Rangoonwala College of Dental Sciences & Research Centre Pune India Department of Oral and Maxillofacial Surgery Nair Hospital Dental College Mumbai India Consultant Oral and Maxillofacial Surgery Nagpur India Department of Oral and Maxillofacial Surgery Pacific Dental College Udaiur India

Introduction: Facial fractures are uncommon injuries in children. Pediatric maxillofacial fractures constitute 1% to 15% of all facial fractures, but show different clinical features when compared with adult patients. Worldwide, the major causes of fractures in children are accidents, falls, violence, and sports- related accidents. Facial trauma in children may result in injury to the facial growth centers, leading to subsequent developmental abnormalities in the injured area. Patients & Methods: Data of pediatric and adolescent patients (0 - 17 years), with a history of trauma, has been compiled over a period of 6 years. History, clinical and radiographic data records were analyzed. Compilation was done in the following categories;age and sex distribution, etiology, site of trauma and associated soft tissue injuries were recorded. The treatment rendered has also been mentioned. Results: A total of 340 patient records were assessed. Demographic data, etiology, type of fracture, associated injury and treatment rendered were recorded. It was found that males (54.7%) were more frequently affected than females (45.3%). Incidence of trauma was more in children belonging to the pre-school age group (38.5%) and the most common etiology was sports-related injuries (43.8%). Dentoalveolar fractures were the most common type (58.5%) of fractures seen in the patients. Most of the patients were managed by conservative treatment (35%) or closed reduction (48%), while a few required open reduction (7.9%). Conclusion: It is felt that this data will be useful in determining the pattern and etiology of maxillofacial trauma in pediatric patients in an Indian setting. Additionally, an outline of the treatment plan in different types of fractures is also summarized.

关键词： Maxillofacial Trauma Pediatric Trauma Open reduction closed reduction Mandibular Fractures

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Simple lateral elbow dislocation:A case report

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World Journal of Surgical Procedures 2023年第2期13卷 7-13页

作者： Mehmet Albayrak Department of Orthopaedics and Traumatology Ozel Tekirdag Yasam HospitalTekirdag 59020Turkey

BACKGROUND Simple lateral elbow dislocation(SLED)is a rare type of elbow dislocation;however,its treatment may be complicated by accompanying soft tissue or neurovascular ***,we report a rare case of SLED managed secondarily with open reduction and soft tissue repair following failure of closed *** SUMMARY A 67-year-old woman suffered SLED after falling on her outstretched left hand with her elbow *** developed pain,swelling,and movement restriction in the elbow;there were no neurovascular symptoms,except for numbness in the 4th and 5th *** investigation confirmed the SLED,and a closed reduction under anesthesia was *** follow-up radiographs at 1-wk revealed failure of reduction;accordingly,open reduction with lateral collateral ligament and common extensor origin repair were carried *** patient regained full elbow range of motion by six *** Adequate concentric reduction for SLED,conservatively or surgically,reduces complications and provides a more functional joint.

关键词： Common extensor origin Elbow joint capsule Lateral collateral ligament closed reduction Open reduction Fluoroscopy Case report

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Treatment of intertrochanteric fractures of the femur with L trapezoid compression plate and its mechanical principles

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Chinese Journal of Traumatology 2000年第2期3卷 67-71页

作者：徐莘香张晓南刘建国秦大明张琪 Department of Orthopaedics First Teaching Hospital Norman Bethune University o f Medical Sciences Changchun 130021 China.

Objective: To improve the results of the treatment of unstable types of intertrochanteric fractures of the femur (ITFF) by internal fixation. Methods: A L trapezoid compression plate system (L TCP) was designed and compared to the AO/ASIF angle plates of 95° and 130° (L AP) with mechanical tests. An Evans Type Ⅲ model was made, the simulation electrical test with loading on single and both legs were done. The results demonstrated that the stability of the L TCP fixation was significantly greater, and the stress concentration at the upper screw hole was relevantly smaller than that of L AP. From June 1986 to June 1998, 82 patients of ITFF were treated with L TCP fixation. The average age was 67.4 years old (26 91). Seventy four of those fractures were unstable. Fifty eight patients were treated with open reduction, and 24 cases were treated by closed reduction and limited open (only lateral aspect of upper femur was exposed) fixation with L TCP under X ray monitoring. Results: Sixty six patients were followed up for 6 69 months. Complications, including 3 wound infection, 1 non union, 3 coxa varus and 2 implant breakage (9 complications of 7 cases), all occurred in the open reduction group. No complication was found in the closed reduction group. Conclusions: In the treatment of ITFF, the results of closed reduction and limited open fixation with L TCP is significantly better than that of open reduction and fully exposed fixation.

关键词： Hip fractures Fixation plate closed reduction

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