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find Keyword "外固定支架" 25 results
  • BIOMECHANICS STUDY ON THREE-DIMENSIONAL EXTERNAL FIXATOR FOR OSTEOPOROTIC FRACTURE

    ObjectiveTo explore the mechanical stability of the three-dimensional (3-D) external fixator for osteoporotic fracture so as to provide the biomechanical basis for clinical application. MethodsForty-five fresh frozen adult tibial specimens were selected to rapidly prepare the extracorporal tibia osteoporotic fracture models, and were randomly divided into 3 groups (n=15). Fractures were fixed with 3-D external fixators (3-D external fixators group), intramedullary nails (intramedullary nail group), and plate (plate group) respectively. Five specimens randomly from each group were used to do axial compression test, three-point bending test, and torsion test with microcomputer control electronic universal testing machine, then the mechanical parameters were calculated. ResultsIn the axial compression test, the displacement of 3-D external fixator group and intramedullary nail group were shorter than plate group, showing significant differences (P<0.05); but no significant difference was found between 3-D external fixator group and intramedullary nail group (P>0.05). In the three-point bending test and torsion test, the deflection and the torsional angle of 3-D external fixator group and intramedullary nail group were smaller than plate group, showing significant differences (P<0.05); but no significant difference was found between 3-D external fixator group and intramedullary nail group (P>0.05). ConclusionThe 3-D external fixator can fix fracture three-dimensionally from multiple plane and it can offer strong fixing. It is biomechanically demonstrated to be suitable for osteoporotic fracture.

    Release date:2016-08-25 10:18 Export PDF Favorites Scan
  • Treating Distal Radius Fracture Using External Fixator

    目的:评价外固定支架治疗桡骨远端骨折的疗效。方法:2004年3月至2008年8月以外固定支架或辅以克氏针、可吸收螺钉内固定治疗桡骨远端骨折37例。结果:31例获得4~28 个月(平均14 个月)的随访,所有骨折均临床愈合,平均愈合时间8周。腕关节功能按Sarmiento标准进行评定,优17例,良9例,可4例,差1例,优良率839%。结论:外固定支架治疗桡骨远端骨折疗效可靠,值得推广。

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • COMPARISON STUDY ON LOCKING COMPRESS PLATE EXTERNAL FIXATOR AND STANDARD EXTERNAL FIXATOR FOR TREATMENT OF TIBIAL OPEN FRACTURES

    Objective To compare the clinical results of locking compress plate (LCP) as an external fixator and standard external fixator for treatment of tibial open fractures. Methods Between May 2009 and June 2012, 59 patients with tibial open fractures were treated with LCP as an external fixator in 36 patients (group A), and with standard external fixator in 23 patients (group B). There was no significant difference in gender, age, cause of injury, affected side, type of fracture, location, and interval between injury and surgery between 2 groups (P gt; 0.05). The time of fracture healing and incision healing, the time of partial weight-bearing, the range of motion (ROM) of knee and ankle, and complications were compared between 2 groups. Results The incidence of pin-track infection in group A (0) was significantly lower than that in group B (21.7%) (P=0.007). No significant difference was found in the incidence of superficial infection and deep infection of incision, and the time of incision healing between 2 groups (P gt; 0.05). Deep vein thrombosis occurred in 5 cases of group A and 2 cases of group B, showing no significant difference (χ2=0.036, P=0.085). All patients were followed up 15.2 months on average (range, 9-28 months) in group A, and 18.6 months on average (range, 9-47 months) in group B. The malunion rate and nonunion rate showed no significant difference between groups A and B (0 vs. 13.0% and 0 vs. 8.7%, P gt; 0.05); the delayed union rate of group A (2.8%) was significantly lower than that of group B (21.7%) (χ2=5.573, P=0.018). Group A had shorter time of fracture healing, quicker partial weight-bearing, greater ROM of the knee and ankle than group B (P lt; 0.05). Conclusion The LCP external fixator can obtain reliable fixation in treating tibial open fracture, and has good patients’ compliance, so it is helpful to do functional exercise, improve fracture healing and function recovery, and reduce the complication incidence.

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 微型外固定支架在虎口外伤急诊治疗中的应用及疗效

    目的探讨微型外固定支架在急诊治疗虎口外伤中的应用及临床疗效。 方法2009年2月-2011年6月,收治虎口外伤患者34例。男21例,女13例;年龄18~65岁,平均31.4岁。致伤原因:机器冲压伤15例,重物压砸伤12例,切割伤5例,爆炸伤2例。受伤至入院时间20 min~6 h 30 min。按创伤程度及范围,26例为简单损伤,8例为复合性损伤。急诊清创后一期微型外固定支架开大虎口或联合虎口“Z”字成形治疗,复合性损伤者二期行皮瓣修复。 结果术后1例发生针道感染,经对症处理后愈合;其余患者切口均Ⅰ期愈合,复合性损伤患者皮瓣及供区植皮均顺利成活。31例获随访,随访时间5~14个月,平均7.5个月。末次随访时虎口开大角度为65~95°,平均80°。拇指指间关节纹尺侧点与示指掌指关节桡侧点距离为4.0~5.5 cm,平均4.8 cm;按顾玉东等的评价方法评价,获优19例,良10例,差2例,优良率达93.5%。 结论在虎口外伤急诊治疗中,采用微型外固定支架开大虎口,手术操作简便,损伤小,避免了虎口挛缩的发生。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • IN VIVO EXPERIMENTAL STUDY ON ANTIBACTERIAL AND OSTEOGENIC CAPABILITIES OF HYDROXYAPATITE ANTIMICROBIAL COATING WITH SILVER

    Objective To investigate the antibacterial and osteogenic capabil ities in vivo of hydroxyapatite (HA)/silver (Ag) coating. Methods HA/Ag coating (Ag qual ity percentage was 3%) and HA coating were deposited to external fixator Schanz screws. The tibial fracture model was establ ished in right hindl imb of 18 adult male Beagle dogs (weighing 15-20 kg). Thetibia was stabil ized with an external fixator and 2 Schanz screws of HA coating at proximal tibia (control group, n=18) and HA/Ag coating at distal tibia (experimental group, n=18), and every screw incision was infected with Staphylococcus aureus. Infection in screw holes and the changes of bone-screw interface were observed by wound grading and X-ray films. Results In control group, wounds infection became worse with time (χ2=13.492, P=0.001), while in experimental group, no obvious change was observed (χ2=0.208, P=0.901). The wound grading of experimental group was significantly better than that of the control group at 1, 2, and 3 weeks (P lt; 0.05). Laser scanning confocal microscope showed that there was bacterial adhesion on the surface of screws in 2 groups, viable becteria mainly in control group and non-viable becteria mainly in experimental group. The scanning electron microscope (SEM) observation results of the fractured sclerous tissue section showed that an obvious transparent boundary between screw and bone in control group, but no obvious boundary in experimental group. The osseointegration ratios were 76.23% ± 15.54% in control group and 93.42% ± 5.53% in experimental group, showing significant difference (t=8.843, P=0.000). The SEM observation showed that HA/Ag coating integrated with new bone and the surface of implant was filled with new bone in experimental group; obvious interspace was seen between the HA coating and new bone in control group. Conclusion HA/Ag coating has good antibacterial and osteogenic capabil ities, so it can take effects in preventing infection in screw holes and loosening of implants.

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • 外固定支架在老年股骨转子间骨折的应用

    【摘 要】 目的 评价外固定支架对老年股骨转子间骨折的治疗作用。 方法 2003 年1 月- 2005 年12 月,用外固定支架治疗高龄股骨转子间骨折60 例。其中男37 例,女23 例;年龄73 ~ 95 岁,平均83 岁。骨折至治疗时间2 ~ 15 d,平均5 d,平均12 周;按AO 分型,A1 型22 例,A2 型30 例,A3 型8 例。均合并多种内科疾病而不能耐受内固定手术。 结果 外固定架操作手术时间20 ~ 40 min,平均30 min,术中无明显出血,术中及术后未输血。所有患者均获随访8 ~ 24 个月,平均18 个月。无外固定失败者。全部骨折愈合,愈合时间10 ~ 16 周,平均12 周。无死亡者。有髋内翻畸形4 例;钉道感染8 例,经口服抗生素及局部换药等处理好转,拔除外固定钉后钉道感染痊愈。髋关节功能情况按Harris 评分系统进行评分:优35 例,良22 例,差3 例,优良率95%。 结论 外固定支架治疗股骨转子间骨折具有手术安全、创伤小、失血量少等优点,是治疗老年转子间骨折的良好选择。

    Release date:2016-09-01 09:09 Export PDF Favorites Scan
  • 双重固定加植骨治疗肱骨干陈旧性骨折术后骨不连

    目的 总结双重固定加自体松质骨或原骨痂植骨治疗肱骨干陈旧性骨折术后骨不连的疗效。 方 法 2004 年5 月- 2008 年11 月,采用双重固定加自体松质骨或原骨痂植骨治疗肱骨干陈旧性骨折骨不连21 例。其中男13 例,女8 例;年龄18 ~ 61 岁,平均35 岁。骨折位于肱骨干远1/3 5 例,中1/3 15 例,近1/3 1 例。均曾行2 ~ 4 次手术治疗。骨不连类型:肥大型14 例,萎缩型7 例。该次手术距受伤时间7 ~ 43 个月,平均11 个月。术中采用髓内针结合外固定支架固定14 例,髓内钉结合接骨板固定4 例,接骨板结合外固定支架固定3 例。术中植骨量3 ~ 6 cm3,平均4 cm3。 结果 术后切口均Ⅰ期愈合。21 例均获随访,随访时间10 ~ 34 个月,平均15 个月。X 线片示患者骨折均愈合,愈合时间3 ~ 8 个月,平均4.5 个月。无感染、腋神经及桡神经损伤症状发生。末次随访时肩关节和肘关节功能恢复满意。 结论 采用双重固定加自体松质骨或原骨痂植骨治疗肱骨干陈旧性骨折术后骨不连是一种较理想的方法。

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • A BIOMECHANICAL STUDY ON INTERNAL AND EXTERNAL FIXATION DEVICES FOR TREATMENT OFHUMERAL SHAFT FRACTURE

    To provide the scientific theoretical basis for cl inical practice by comparing biomechanicalcharacteristics of single compressed plate with intramedullary pin, locking intramedullary nail and simple arm externalfixator with simple internal fixation devices. Methods Eighteen wet humeral bone specimens of adult cadaver were madecompl icated fracture models of humeral shaft and divided into 3 groups according to fixation methods. Fracture was fixed by single compressed plate with intramedullary pin in plate group, by locking intramedullary nail in intramedullary nail group and by external fixator with simple internal fixation devices in external fixator group. The intensity and rigidity of compl icated fracture models of humeral shaft was measured in compress test and torsion test. Results In compress test, the maximum load in plate group (6 162.09 ± 521.06) N and in intramedullary nail group (6 738.32 ± 525.89) N was significantly larger than that in external fixator group (2 753.57 ± 185.59) N (P lt; 0.05); but there was no significant difference between plate group and intramedullary nail group (P gt; 0.05). Under 600 N physiological compress load, the rigidity was (171.69 ± 6.49) N/mm in plate group, (333.04 ± 36.85) N/mm in intramedullary nail group and (132.59 ± 2.93) N/mm in external fixator group; showing no significant difference between plate group and external fixator group (P gt; 0.05), and showing significant difference between intramedullary nail group and plate, external fixator groups (P lt; 0.05). In torsion test, the maximum torque in plate group (38.24 ± 7.08) Nm was significantly larger than those in intramedullary nail group (17.12 ± 5.73) Nm and external fixator group (20.26 ± 6.42) Nm (P lt; 0.05), but there was no significant difference between intramedullary nail group and external fixator group (P gt; 0.05). Under 0.80 Nm physiological torque, the rigidity was (16.36 ± 2.07) Ncm/° in plate group and (18.79 ± 2.62) Ncm/° in external fixator group, which was significantly larger than that in intramedullary nail group (11.45 ± 0.22) Ncm/° (P lt; 0.05); but there was no significant difference between plate group and external fixator group (P gt; 0.05). Conclusion Those fracture models fixed by single compressed plate with intramedullary pin have better compress and torsion intensity, they also have better torsion rigidity but less compress rigidity. Those fracture models fixed by locking intramedullary nail have better compress intensity but less torsion intensity, they also have better compress rigidity but less torsion rigidity. Those fracture models fixed by external fixator with simple internal fixation device have less compress and torsion intensity, they also have less compress rigidity but better torsion rigidity.

    Release date:2016-09-01 09:12 Export PDF Favorites Scan
  • BIOMECHANICAL EVALUATION OF STABILITY OF THE VOLAR CAPSULAR LIGAMENT COMPLEX

    【Abstract】 Objective To investigate the effect of the volar capsular l igament complex on stabil ity of the wrist jointand to provide basic biomechanical theoretical criteria for cl inic appl ication of the external fixator. Methods Nine upperl imbs specimens (left 6, right 3) were taken from fresh adult cadavers to make wrist joint-bone capsular l igament complex specimens. Firstly, soft tissues of forearms and hands were resected and capsular membranes and l igaments were reserved to make the bone-articular l igament complex (normal specimen). Secondly, the volar capsular l igament complex was cut off from radial malleolus to ulnar malleolus (impaired specimen). Thirdly, the impaired volar capsular l igament complex was interruptedly sutured by the use of 4# suture silk (repaired specimen). To simulate cl inical operation with external fixator, the biomechanical test was done according to the sequence (normal, impaired, repaired, repaired and fixed, impaired and fixed). Statistical significance was analyzed through selected loads at the three different shifts (1.5, 2.0, 2.5 cm). Results According to the sequence (normal, impaired, repaired, repaired and fixed, impaired and fixed), when the shift was 1.5 cm, the different respective loads were (60.74 ± 20.60), (35.23 ± 13.88), (44.36 ± 20.78), (168.40 ± 29.21) and (139.00 ± 33.18) N, respectively. When the shift was 2.0 cm, the different loads were (138.46 ± 12.93), (87.17 ± 24.22), (97.52 ± 23.29), (289.00 ± 54.29) and (257.98 ± 55.74) N, respectively. When the shift was 2.5 cm, the different loads were (312.87 ± 37.15), (198.16 ± 37.14), (225.66 ± 30.96), (543.15 ± 74.33) and (450.35 ± 29.38) N, respectively. There was no statistically significant difference between the impaired and repaired specimens (P gt; 0.05). Similarly, there was statistically significant difference among the rest specimens (P lt; 0.05). The same statistical results were obtained when the two different shifts were compared. There was statistically significant difference at the three different shifts for the same specimen (P lt; 0.05). Conclusion Volar capsular l igament complex is an important anatomic structure to keep stabil ity of the wrist joint. The carpal instabil ity arises out of the injured complex. Repairing the injured complex only can not immediately restore stabil ity of the wrist joint. The external fixator can effectively help to diminish the relative shift of the impaired capsular l igament complex, to reduce the load of the repaired complex and to protect the complex accordingly. The device plays an important role in maintaining stabil ity of the wrist joint.

    Release date:2016-09-01 09:12 Export PDF Favorites Scan
  • COMPARATIVE STUDY ON INTERNAL FIXATION AND EXTERNAL FIXATION FOR THE TREATMENT OFCOMPLEX TIBIAL PLATEAU FRACTURE

    Objective To compare effects, advantages and disadvantages of simple internal fixation to that of l imited internal fixation with external supporting frame fixation in the treatment of complex fractures of tibial plateau. Methods From July 2002 to August 2006, 66 cases of complex fractures of the tibial plateau were divided into the internal fixation group (n=39) and the external fixator group (n=27). The interal fixation group had 18 cases of IV, 7 cases V and 14 cases VI according to Schatzker, including 25 males and 14 females aged 18-79 years with an average of 45.4 years. The external fixator group had 13 cases of IV, 6 cases V and 8 cases VI according to Schatzker, including 18 males and 9 femles aged 18-64 years with an average of 44.2 years. No significant difference was evident between the two groups (P gt; 0.05). Patients were treated by using screws, steel plates or external supporting frame fixation strictly based on the princi ple of internalfixation. Results All patients were followed up for 1-5 years. Fracture healed with no occurrence of nonunion. Two cases inthe internal fixation group presented partial skin infection and necrosis, and were cured through the dressing change and flap displacement. Fracture heal ing time was 6-14 months with an average of 7.3 months. The time of internal fixator removal was 6-15 months with an average of 8.3 months. In the external fixation group, 11 cases had nail treated fluid 7 days to 3 months after operation, combining with red local skin; 3 cases had skin necrosis; and 3 cases had loose bolts during follow-up. Through debridement, dressing change and flap displacement, the skin wounds healed. Fracture heal ing time was 3-11 months with an average of 5.1 months. The time of external fixator removal was 5-11 months with an average of 6.4 months. At 8-14 months after operation, the knee function was assessed according to Merchant criteria. In the internal fixation group, 29 cases were excellent, 4 good, 5 fair and 1 poor, while in the external fixation group, 20 cases were excellent, 3 good, 2 fair and 2 poor. There was no significant difference between the two groups (P gt; 0.05). Conclusion The therapeutic effects of simple internal fixation and l imited internal fixation with external supporting frame fixation were similar in the treatment of complex fractures of tibial plateau. Fixation materials should be selected according to the state of injury and bone conditions for the treatment of tibial plateau fracture of type IV, V and VI based on Sehatzker classification.

    Release date:2016-09-01 09:16 Export PDF Favorites Scan
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