检索结果-南通市图书馆

A comparative study of variable angle volar plate and bridging external fixator with K-wire augmentation in comminuted distal radius fractures

引用

Chinese Journal of Traumatology 2021年第5期24卷 301-305页

作者： Ratish Kumar Mishra Bhagwati Prasad Sharma Amit Kumar Rohit Sherawat Orthopedic Department Sir Gangaram HospitalNew Delhi 11006India Central Institute of Orthopedics Vardhman Mahavir Medical College and Safdarjung HospitalNew Delhi 110029India Orthopedic Department All India Institute of Medical SciencesRae Bareli 229405India Central Institute of Orthopaedics Vardhman Mahavir Medical College and Safdarjung HospitalNew Delhi 110029India

Purpose:comminuted intraarticular distal radial fractures are difficult to treat conservatively and require operative treatment.This study compared the functional outcomes between variable angle volar plating and external fixator with K-wire augmentation in open reduction and internal fixation.Methods:A total of 62 adult patients with comminuted intraarticular distal radius fracture were randomized into 2 groups:volar plate group and external fixator group.These patients aged between 18 and 60 years had unilateral fractures,and agreed to be included in the study.Patients with a history of fracture,bilateral fracture,associated other injuries,delayed injury for more than 2 weeks,open fracture,pre-existing arthrosis or disability,psychiatric illness and pathological fracture were excluded.Patients were followed up at 6 weeks,3 months,6 months and 1 year.The assessment of pain,functional activity,range of motion and grip strength was done at each stage of follow-up.The pain and functional activities were assessed by patient rated wrist evaluation(PRWE)score and disabilities of the arm,shoulder and hand(DASH)score.Results:Patients in volar plate group had superior PRWE score and DASH score at each stage of followup.At 1 year follow-up,the mean PRWE score were 7.48 for volar plate group and 7.35 for external fixator group;while the mean DASH score was 4.65 for volar plate group and 5.61 for external fixator group.They had better flexion and extension range of movement.They also had better pronation and supination range of motion at initial follow-up,however the difference get attenuated by 1 year.Volar plate group had significantly better grip strength than external fixator group.Complication rates were higher in external fixation group.Conclusion:Fixation with variable angle volar plate results in early wrist mobilization,better range of movement,less pain and disability and early return of function.

关键词： comminuted Distal radius fracture Intraarticular Volar plate External fixator

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Bench-to-bedside strategies for osteoporotic fracture: from osteoimmunology to mechanosensation

引用

Bone Research 2019年第3期7卷 259-271页

作者： Yong Xie Licheng Zhang Qi Xiong Yanpan Gao Wei Ge Peifu Tang Department of Orthopedics Chinese PLA General Hospital Beijing China Department of Oncology Chinese PLA General Hospital Beijing China State Key Laboratory of Medical Molecular Biology and Department of Immunology Institute of Basic Medical Sciences Chinese Academy of Medical Sciences Beijing China

Osteoporosis is characterized by a decrease in bone mass and strength, rendering people prone to osteoporotic fractures caused by low-energy forces. The primary treatment strategy for osteoporotic fractures is surgery;however, the compromised and comminuted bones in osteoporotic fracture sites are not conducive to optimum reduction and rigid fixation. In addition, these patients always exhibit accompanying aging-related disorders, including high inflammatory status, decreased mechanical loading and abnormal skeletal metabolism, which are disadvantages for fracture healing around sites that have undergone orthopedic procedures. Since the incidence of osteoporosis is expected to increase worldwide, orthopedic surgeons should pay more attention to comprehensive strategies for improving the poor prognosis of osteoporotic fractures. Herein, we highlight the molecular basis of osteoimmunology and bone mechanosensation in different healing phases of elderly osteoporotic fractures, guiding perioperative management to alleviate the unfavorable effects of insufficient mechanical loading, high inflammatory levels and pathogen infection. The well-informed pharmacologic and surgical intervention, including treatment with anti-inflammatory drugs and sufficient application of antibiotics, as well as bench-to-bedside strategies for bone augmentation and hardware selection, should be made according to a comprehensive understanding of bone biomechanical properties in addition to the remodeling status of osteoporotic bones, which is necessary for creating proper biological and mechanical environments for bone union and remodeling. Multidisciplinary collaboration will facilitate the improvement of overall osteoporotic care and reduction of secondary fracture incidence.

关键词： comminuted skeletal prone to

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

An Innovative Cerclage Wire Passer

引用

Surgical Science 2018年第6期9卷 197-202页

作者： Hrishikesh Saodekar Salphale Yogesh Suyash Hospital Rukmini Nagar Amravati India

The cerclage wire is an important adjuvant in the management of Orthopaedic and trauma cases and is particularly useful in long bone fractures. It is especially useful for addressing the fractures, especially the comminuted ones with a butterfly fragment. Orthopaedic cerclage Wiring is used as an adjunct to maintain fracture reduction (either temporarily or permanently), while the bone is primarily stabilised by either a plate intramedullary nail or external fixation frame. Multiple cerclage wires provide adjunctive fixation against compressive shear, bending & rotational forces and have been used in traumatology since many years. The aim of this article is to introduce a new year simple low cost instrument named as “Suyash cerclage wire passer”, with excellent outcomes without any major complications to the Orthopaedic community.

关键词： Diaphyseal Femur Fracture Diaphyseal Tibia Fracture Cerclage Wire Butterfly Fragment comminuted Fractures Wire Passer Malleable Metal

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

I-stage cranial reconstruction in severe frontal comminuted depressed skull fractures

I-stage cranial reconstruction in severe frontal comminuted ...

引用

2014浙江省神经外科学学术年会

作者：李新伟万应锋宋正飞亓旭晨马力钱聪孙伟军杨树旭王义荣浙江大学医学院附属邵逸夫医院神经外科

Objective:Severe frontal comminuted depressed skull fractures needs special attention due to complications and esthetics.The optimal method of reconstruction and fixation of frontal bone fragments remains a matter of discussion.We explored the advantages of reconstruction of frontal bone with titanium clamps as soon as possible after trauma.Patients and methods:From May 2006 to September 2011 we performed 18craniotomies with titanium clamps to fix the cranial fragments.On the beginning of craniotomy,single window craniotomy(n=11)and two windows craniotomy(n=9)were designed.After dural closure and frontobasal reconstruction,these fragments were fixed with titanium clamps.A helical CT-scan was obtained after operation and a three dimensional technique was performed to evaluate the postoperative results.Results:The craniofix titanium clamp system was applied in 18 patients.No intraoperative and postoperative complications related to clamps were observed.The number of bone fragments ranged from 2 to 5(average 3.3 pieces)while the number of clamps ranged from 3 to 8(average 5.8).The time of refixation ranged from 5 to 17minutes with average 9.4 minutes.Obvious statistical significance(p=0.015)was found in postoperative CT-scan results between single window group and two windows group,although it is no statistical difference in intraoperative subjective valuation(p>0.05).In all 18 cases,the alignment of fragments was precise,the fixation rigid,and the esthetic result satisfying.Conclusions:Reconstruction forehead by refixation of bone fragments with titanium clamps in frontal depressed skull fractures is safe and suitable.This technique promises to be a good alternative in the repair of frontal comminuted depressed skull fractures.The simplicity,reliable fixation and fast handling are its prominent features.

关键词： titanium clamp reconstruction frontal refixation comminuted depressed skull fracture I stage

来源： cnki会议评论