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Uncontacted tire explosion causing trauma to bilateral lower extremities： A case report

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Chinese Journal of Traumatology 2017年第3期20卷 177-179页

作者： Ming-Yang Yu Yun Su Xiang-Jun Meng Bo-Wu Luan Gui-Shan Gu Qiang Sun De-Wei Zhao Department of Traumatic Orthopedics Affiliated Zhongshan Hospital of Dalian University Dalian 116001 China Department of Ophthalmology Affiliated Zhongshan Hospital of Dalian University Dalian 116001 China Department of Discovery Biology GenScript USA Inc. Piscataway 08854 USA Department of Orthopedics First Hospital of Jilin University Changchun 130021 China Department of Orthopeclics Affiliated Zhongshan Hospital of Dalian University Dalian 118001 China

It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with partial bone loss in the right calcaneus （a comminuted fracture in the right ankle joint） and a closed comminuted fracture in the left tibia and fibula. This damage was caused by uncontacted tire explosion, thanks to a thick floor between the exploded tire and the patient＇s feet. This type of injury on lower extremity caused by uncontacted tire explosion was uncommon.

关键词： Lower extremity fractures, bone Tire explosion

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White blood cells and hemoglobin assay for the evaluation of multiple traumas

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Chinese Journal of Traumatology 2004年第3期7卷 191-192页

作者：陈扬罗新乐马灿泽 White blood cells and hemoglobin assay for the evaluation of multiple traumas Fuyong Hospital of Shenzhen

It is commonly seen that patients with bone fracture often complicate other parts of injuries that present a more urgent situation than fractures and often need timely recognition and management. Since December 1998, we have detected and analyzed the ratio of white blood cells (WBC) and hemoglobin (Hb) in diagnosis of complicated injuries in patients with bone fracture and try to raise rescue rate and reduce missed diagnosis rate.

关键词： Adolescent Adult Aged Aged, 80 and over Child Child, Preschool Female fractures, bone Hemoglobins Humans Leukocyte Count Male Middle Aged Multiple Trauma

Clinical study of a new approach to thoracolumbar surgery

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Chinese Journal of Traumatology 2008年第3期11卷 148-151页

作者：刘刚赵建宁 Akira Dezawa Department of Orthopaedic Surgery Nanjing GeneralHospital of Nanjing Military Command Nanjing 210001China Department of Orthopaedic Surgery Teikyo University Mizonokuchi Hospital Kanagawa 213-8507 Japan

Objective： The conventional approaches for treatment of thoracolumbar diseases require extensive surgical exposure, often leading to postoperative pain and morbidity. Thoracoscopic-assisted surgery in these regions usually requires an extended recovery period due to the placement of drainage. We developed an innovative retroperitoneal-extrapleural approach to thoracolumbar involvement by an extra-diaphragmatic technique using dedicated instruments. Neither incision nor reconstruction of the diaphragm was necessary. Exposure to the lateral part of the thoracolumbar vertebrae could be achieved without crus resection. This study is aimed to evaluate the clinical outcomes of this new surgical procedure. Methods： A total of 9 cases （5 cases of thoracolumbar fracture-dislocation, 1 each of spinal infection, tumor, thoracolumbar scoliosis and ossification of posterior longitudinal ligament） were subjected to the study. The average age of the patients was 52.3 years. The results were compared with the control group consisting of thoracoscopic surgery subgroup （5 patients, mean age 52.1 years） and conventional surgery subgroup （12 patients, mean age 61.3 years）. Results： Compared with the control group, the average period of bed confinement and mean intra- and postoperative blood loss decreased significantly. Pulmonary complications were avoided in all cases. The surgical time was shortened, postoperative pain was reduced, and early postoperative ambulation became possible. Conclusion： The diaphragm-preserving retroperitoneal-extrapleural approach that we developed is a valid minimally invasive alternative for the treatment of thoracolumbar diseases.

关键词： Thoracic vertebrae Lumbar vertebrae fractures, bone Surgical procedures, minimally invasive

Percutaneous estrogen in prevention of early postmenopausal bone loss in Chinese women

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Chinese Medical Journal 2002年第12期115卷 1790-1795页

作者：孙爱军林守清余卫秦明伟陈凤领张颖魏扬 Bruno de Lignieres 北京协和医院妇产科北京100730 北京铁路医院北京100038 NeckerHospital

OBJECTIVE: To identify the optimal dosage of 17beta-estradiol gel + oral progestin for preventing bone loss in postmenopausal Chinese women. METHODS: A 3-year open label, randomized, prospective clinical trial was conducted. Sixty healthy women who had been postmenopausal for 1 to 5 years were recruited and divided into following 4 groups: group 1, percutaneous gel 17beta-estradiol (E(2)) 1.5 mg/d plus micronized progesterone (MP) 100 mg/d; group 2, percutaneous gel 17beta-estradiol (E(2)) 1.5 mg/d plus medroxyprogesterone acetate (MPA) 2 mg/d; group 3, percutaneous gel 17beta-estradiol (E(2)) 0.75 mg/d plus micronized progesterone (MP) 100 mg/d; and group 4, percutaneous gel 17beta-estradiol (E(2)) 0.75 mg/d plus medroxyprogesterone acetate (MPA) 2 mg/d. Estrogen and progestin were given continuously for 25 days per month. bone mineral density (BMD) was measured using quantitative computed tomography (QCT) for trabecular bone of L2-5 and dual energy X-ray absorptiometry (DEXA) for L2-4 and hip 5 times during the trial at baseline and at the 6-, 12-, 18-, 24- and 36-month visits. RESULTS: Fifty-nine patients (98.3%, 59/60) stayed in the study for 1 year, 56 patients (93.3%, 56/60) for 2 years, and 51 (85%, 51/50) for 3 years. On average, menopausal symptoms were relieved by 80% after 6 months of treatment. By the 24th month, the mean increase in BMD ranged from 4.3% to 7.5% in trabecular bone; and by the 36th month, it ranged from 4.2% to 6.2% in L2-4 and 1.61% to 3.77% in the neck. There were significant difference after treatment (P 0.05) was found in improvement of symptoms, levels of bone markers or BMD. CONCLUSION: A daily dose of estradiol gel, either 0.75 mg or 1.5 mg, is effective in preventing early postmenopausal bone loss and relieving menopausal symptoms. After 3-year treatment, spinal BMD could increase steadily, so does hip BMD, especially in the first 2 years.

关键词： Administration, Cutaneous Adult bone Density Estradiol Estrogen Replacement Therapy Female fractures, bone Humans Medroxyprogesterone 17-Acetate Middle Aged Osteoporosis, Postmenopausal

Management of limb fractures in a teaching hospital： comparison between Wenchuan and Yushu earthquakes

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Chinese Journal of Traumatology 2013年第1期16卷 16-21页

作者： MIN Li TU Chong-qi LIU Lei ZHANG Wen-li YI Min SONG Yue-ming HUANG Fu-guo YANG Tian-fu PEI Fu-xing Department of Orthopaedics West China HospitalSichuan University Chengdu 610041 China

Objective： To comparatively analyze the medical records of patients with limb fractures as well as rescue strategy in Wenchuan and Yushu earthquakes so as to provide references for post-earthquake rescue. Methods： We retrospectively investigated 944 patients sustaining limb fractures, including 891 in Wenchuan earthquake and 53 in Yushu earthquake, who were admitted to West China Hospital （WCH） of Sichuan University. Results： In Wenchuan earthquake, WCH met its three peaks of limb fracture patients influx, on post-earthquake day （PED） 2, 8 and 14 respectively. Between PED 3-14, 585 patients were transferred from WCH to other hospitals out- side the Sichuan Province. In Yushu earthquake, the maxi- mum influx of limb fracture patients happened on PED 3, and no one was shifted to other hospitals. Both in Wenchuan and Yushu earthquakes, most limb fractures were caused by blunt strike and crush/burying. In Wenchuan earthquake, there were 396 （396/942, 42.0%） open limb fractures, includ- ing 28 Gustilo I, 201 Gustilo II and 167 Gustilo III injuries. But in Yushu earthquake, the incidence of open limb fracture was much lower （6/61, 9.8%）. The percent of patients with acute complications in Wenchuan earthquake （167/891,18.7%） was much higher than that in Yushu earthquake （5/53, 3.8%）. In Wenchuan earthquake rescue, 1 018 surgeries were done, composed of debridement in 376, internal fixation in 283, external fixation in 119, and vacuum sealing drainage in 117, etc. While among the 64 surgeries in Yushu earthquake rescue, the internal fixation for limb fracture was mostly adopted. All patients received proper treatment and sur- vived except one who died due to multiple organs failure in Wenchuan earthquake. Conclusion： Provision of suitable and sufficient medi- cal care in a catastrophe can only be achieved by construc- tion of sophisticated national disaster medical system, pre- diction of the injury types and number of injuries, and con- flrmation of participating hospit

关键词： Earthquakes Extremities fractures, bone Disaster medicine

Research and application of absorbable screw in orthopedics： a clinical review comparing PDLLA screw with metal screw in patients with simple medial malleolus fracture

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Chinese Journal of Traumatology 2013年第1期16卷 27-30页

作者： TANG Jin HU Jin-feng GUO Wei-chun YU Ling ZHAO Sheng-hao Foxconn Clinic Renmin Hospital of Wuhan UniversityWuhan 430060 China

Objective： To observe the therapeutic effect of absorbable screw in medial malleolus fracture and discuss its clinical application in orthopedics. Methods： A total of 129 patients with simple medial malleolus fracture were studied. Among them, 64 patients were treated with poly-D, L-lactic acid （PDLLA） absorbable screws, while the others were treated with metal screws. All the patients were followed up for 12-20 months （averaged 18.4 months） and the therapeutic effect was evaluated according to the American Orthopaedic Foot and Ankle Society clinical rating systems. Results： In absorbable screw group, we obtained excel- lent and good results in 62 cases （96.88%）; in steel screw group, 61 cases （93.85%） achieved excellent and good results. There was no significant difference between the two groups. Conclusion： In the treatment of malleolus fracture, absorbable screw can achieve the same result compared with metal screw fixation. Absorbable screw is preferred due to its advantages of safety, cleanliness and avoiding the removal procedure associated with metallic implants.

关键词： Ankle bone screws fractures, bone

Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking cal- caneal plate

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Chinese Journal of Traumatology 2013年第6期16卷 355-360页

作者： Saurabh Jain Anti Kumar Jain Ish Kumar Department of Orthopaedics Mahaveer HospitalIndore India Department of Orthopaedics UCMS and GTB HospitalDelhi India

Objective：Debate continues regarding the management of calcaneal fractures,between open reduction and internal fixation and closed *** we aim at evaluating the radiological and functional outcomes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with locking calcaneal ***：In this series,28 patients （26 unilateral and 2 bilateral） with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of *** were evaluated in terms of associated injuries and X-rays of anteroposterior,lateral and axial views of the *** scan was done to assess the amount ofcomminution and articular *** were followed up clinically and radiologically at least for 1 *** assessment was done by Bohler＇s angle and Gissane＇s angle along with measurement ofcalcaneal height and *** outcome was assessed using the American Orthopaedics Foot and Ankle Society （AOFAS） ***：At average follow-up of 14.5 months,average AOFAS score was 86.3 （range 66 to 97）,with 86% having excellent to good results and 2 （7.7%） and 1 （3.7%） having fair and poor results *** patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30°.Average subtalar range of motion was 17°.The mean Bohler＇s angle,mean Gissane＇s angle,calcaneal height and width were 25.47°,121.3°,4.32 cm and 3.81cm respectively at final *** patients had flap necrosis at incision site and one had superficial and deep *** arthritis was seen in 5 patients,whereas sural nerve hypoaesthesia in 1 *** of the patients had compartment syndrome,heel pad problems,peroneal tendinitis,reflex sympathetic dystropy or implant ***：Open reduction and internal fixation with locking calcaneal plate gives sound functional outcome,*** anato

关键词： Calcaneus fractures, bone boneplates Fracture f'ocation, internal

Internal fixation with headless compression screws and back buttress plate for treatment of old Hoffa fracture

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Chinese Journal of Traumatology 2014年第2期17卷 79-83页

作者： Min Li Tu Chongqi Wang Guanglin Fang Yue Duan Hong Liu Lei Zhang Hui Department of Orthopedics West China HospitalChengdu 610041 China

Objective： To analyze the early clinical and radiographic outcomes of Hoffa fractures treated by a standard protocol of open reduction and internal fixation using headless compression screws combined with back buttress plate in a consecutive series of 8 Chinese patients. Methods： Open reduction and internal fixation was performed on all patients. The fractures were anatomical- ly reduced and held temporarily by K-wire. If the ends of fractures were atrophic, autologous bone graft from the ipsilateral iliac crest was packed between the ends. Then the fracture fragments were fixed with AO 6.5 mm headless compression cannulated screws. At least two screws were used to provide rotational stability. One pre-contoured reconstruction plate was placed on the nonarticular surface posteromedially or posterolaterally as back buttress plate. Results： All the patients were followed up for at least 12 months （range 12-25 months）. All fractures achieved anatomical reduction and healed clinically and radiographically. At recent follow-up, the mean flexion degree was 120.6° （range 110°-135°） and the mean extension degree was 2.5° （range 0°-5°）. The average visual analogue scale score was 1.6 points （range 0-3）. Six patients were assessed as excellent and 2 as good according to the hospital for special surgery knee score system. There were no superficial or deep infections, or hardware breakages. No patient had giving way or locking of the knee, though some had intermittent pain and swelling after strenuous exercise. Injury mechanism had significant influence on the functional outcome （P=0.046）. Conclusion： Headless compression screws combined with back buttress plate and/or autologous bone grafting to treat old Hoffa fracture is one of effective measures. It would be conducive to not only fracture healing but also early exercise and functional recovery.

关键词： fractures, bone Fracture foration, internal Intra-articular fractures

Comparison of three different surgical approaches for treatment of thoracolumbar burst fracture

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Chinese Journal of Traumatology 2013年第1期16卷 31-35页

作者： WU Han WANG Chun-xin GU Chang-yue ZHANG Zi-yan TONG Shen YAN Hua-dong WANG Jin-cheng Department of Orthopedic Surgery China-Japan UnionHospital of Jilin University Changchun 130033 China

Objective： The main treatment method used for thoracolumbar fractures is open reduction and in- ternal fixation. Commonly there are three surgical approaches： anterior, posterior and paraspinal. We attempt to compare the three approaches based on our clinical data analysis. Methods： A group of 94 patients with Denis type A or B thoracolumbar burst fracture between March 2008 and September 2010 were recruited in this study. These patients were treated by anterior-, posterioror paraspinal-approach reduction with or without decompression. The fracture was fixed with titanium mesh and Z-plate via anterior approach （24 patients）, screw and rod system via posterior approach （38 patients） or paraspinal approach （32 patients）. Clinical evaluations included operation duration, blood loss, inci- sion length, preoperative and postoperative Oswestry disability index （ODI）. Results： The average operation duration （94.1 min±13.7 rain）, blood loss （86.7 ml-20.0 ml）, length of incision （9.3 mm± 0.7 mm） and postoperative ODI （6±0.5） were significantly lower （P〈0.05） in paraspinal approach group than in traditional posterior approach group （operation duration 94.1 min±13.7 min, blood loss 143.3 ml±28.3 ml, length of incision 15.4 cm±2.1 cm and ODI 12±0.7） and anterior approach group （operation duration 176.3 min±20.7 min, blood loss 255.1 ml±38.4 mt, length of incision 18.6 cm±2.4 cm and ODI 13±2.4）. There was not statistical difference in terms of Cobb angle on radiographs among the three approaches. Conclusion： The anterior approach surgery is conve- nient for resection of the vertebrae and reconstruction of vertebral height, but it is more complicated and traumatic. Hence it is mostly used for severe Denis type B fracture. The posterior approach is commonly applied to most thoracolumbar fractures and has fewer complications compared with the anterior approach, but it has some shortcomings as well. The paraspinal approach has great advantages compared with the other two approach

关键词： Thoracic vertebrae Lumbar vertebrae fractures, bone Surgical procedures, operative Spine