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find Author "刘宏智" 3 results
  • Clinical application of lower extremity axial distractor in closed reduction and retrograde intramedullary nail fixation of distal femoral fractures

    ObjectiveTo explore the efficacy and advantages of the lower extremity axial distractor assisted closed reduction and retrograde intramedullary nail internal fixation in the treatment of distal femoral fractures.MethodsThe clinical data of 49 patients with distal femoral fractures treated with retrograde intramedullary nail internal fixation between April 2016 and December 2018 were retrospectively analyzed. According to the different methods of intraoperative reduction, the patients were divided into trial group (29 cases, using lower extremity axial distractor to assist closed reduction) and control group (20 cases, using free-hand retraction reduction). There was no significant difference in general information between the two groups (P>0.05), such as gender, age, side of injury, cause of injury, and fracture classification. The operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, and callus formation time were recorded and compared between the two groups. The function of the affected limb was evaluated according to the Schatzker-Lambert standard at 1 year after operation.ResultsAll patients successfully completed the operation. In the control group, there was 1 case with open reduction and internal fixation, and the rest of the two groups were closed reduction. There was no significant difference in operation time, intraoperative blood loss, and intraoperative fluoroscopy frequency between the two groups (P>0.05). There was no complication such as vascular or nerve injury and iatrogenic fracture, etc. during and after operation, and the incisions healed by first intention. Except for 2 patients in the trial group who were lost to follow-up at 3 months after operation, the rest of the patients were followed up 12-36 months, with an average of 16.0 months. There was no significant difference in the callus formation time between the two groups (t=2.195, P=0.145). During the follow-up, postoperative knee joint stiffness occurred in 1 case in the control group, which improved by strengthening the knee joint function exercise and removing the internal fixator; the rest were not found to be associated with delayed or nonunion fractures, knee stiffness, and internal fixation complication. The function of the affected limb was evaluated according to the Schatzker-Lambert standard at 1 year after operation, the trial group achieved excellent results in 22 cases, good in 4 cases, and fair in 1 case, with an excellent and good rate of 96.3%; in the control group, the results were excellent in 16 cases, good in 3 cases, and fair in 1 case, with an excellent and good rate was 95.0%; showing no significant difference in the excellent and good rate between the two groups (χ2=0.451, P=0.502).ConclusionThe lower extremity axial distractor assisted closed reduction and retrograde intramedullary nailing for the treatment of distal femoral fractures is convenient, which has satisfactory efficacy.

    Release date:2021-06-30 03:55 Export PDF Favorites Scan
  • 应用解剖锁定钢板治疗O'DriscollⅡ型及Ⅲ型尺骨冠突骨折近期疗效

    目的总结解剖锁定钢板治疗O'DriscollⅡ、Ⅲ型尺骨冠突骨折的近期疗效。 方法2012年12月-2013年12月,采用解剖锁定钢板治疗11例尺骨冠突骨折患者。男7例,女4例;年龄23~68岁,平均41.2岁。致伤原因:摔伤6例,交通事故伤3例,高处坠落伤2例。根据O'Driscoll分型标准,Ⅱ型4例,Ⅲ型7例。合并尺侧副韧带损伤5例,尺神经损伤2例。受伤至手术时间2~8 d,平均4.2 d。 结果术后切口均Ⅰ期愈合。11例均获随访,随访时间6~18个月,平均12个月。X线片复查示,骨折均解剖复位并达骨性愈合,愈合时间6~10周,平均8周。末次随访时,肘关节屈伸活动度为112~145°,平均130°;前臂旋转116~148°,平均135°。Mayo肘关节功能评分为74~100分,平均87.8分;其中优6例,良4例,可1例,优良率90.9%。 结论采用切开复位解剖锁定钢板内固定治疗O'DriscollⅡ、Ⅲ型尺骨冠突骨折,固定强度佳,允许术后早期功能锻炼,肘关节功能恢复良好,并发症少。

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  • CLINICAL CHARACTERISTICS AND SURGICAL MANAGEMENT OF Eyres TYPE V CORACOID FRACTURE COMBINED WITH SUPERIOR SHOULDER SUSPENSORY COMPLEX INJURY

    ObjectiveTo investigate the cl inical characteristics of Eyres type V coracoid fracture combined with superior shoulder suspensory complex (SSSC) injuries, and the effectiveness of open reduction and fixation. MethodsBetween March 2004 and July 2012, 13 patients with Eyres type V coracoid fracture and SSSC injuries were treated. There were 10 males and 3 females with an average age of 41 years (range, 23-59 years). Injury was caused by fall ing from height in 4 cases, by traffic accident in 6 cases, and by impact of the heavy weight in 3 cases. The interval from injury to operation was 3-10 days (mean, 5.2 days). SSSC injuries included 9 cases of acromioclavicular joint dislocation, 5 cases of clavicular fractures, and 4 cases of acromion fractures. The coracoid fractures were fixed with cannulated screws; the acromioclavicular joint dislocations were fixed with hook plate (6 cases) or Kirschner wires (2 case) except 1 untreated case; the clavicular fractures were fixed with anatomical locking plate (3 cases) and hook plate (2 cases); the acromion fractures were fixed with cannulated screws (1 case), Kirschner wires (2 cases), or both of them (1 case). ResultsThe mean operation time was 158.0 minutes (range, 100-270 minutes), and the mean intraoperative blood loss was 207.7 mL (range, 150-300 mL). The other patients obtained primary healing of incision except 1 patient who had inflammation around incision, which was cured after change dressing. All patients were followed up for 22.6 months on average (range, 17-35 months). All fractures achieved union at a mean time of 3.6 months (range, 2-6 months). No nerve injury and implant fixation failure complications were observed. At last follow-up, the Constant score and the disabil ity of the arm, shoulder, and hand (DASH) score had a significant improvement when compared with scores at pre-operation (P<0.05). The shoulder range of motion in flexion, abduction, and external rotation at last follow-up were significantly higher than those at pre-operation (P<0.05). ConclusionEyres type V coracoid fracture associated with SSSC injuries usually results in the instabil ity of the shoulder. With individual surgical treatment, the satisfactory function and good effectiveness can be obtained.

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