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find Author "曹立海" 7 results
  • SURGICAL TREATMENT OF CALCANEAL FRACTURE INVOLVING TALOCALCANEAL AND CALCANEOCUBOID JOINTS

    Objective To explore the method and effectiveness of lateral calcaneal U-shaped incision approach to treat calcaneal fractures involving the talocalcaneal and calcaneocuboid joints. Methods Between January 2009 and March 2011, 36 cases of calcaneal fractures involving the talocalcaneal and calcaneocuboid joints were treated by the lateral calcaneal U-shaped incision approach and calcaneal anatomical plate fixation. There were 27 males and 9 females with an average age of 38.7 years (range, 19-58 years). According to the Sanders classification criteria, there were 12 cases of type II, 20 cases of type III, and 4 cases of type IV. The Bouml;hler and Gissane angles were (6.21 ± 10.48)° and (89.85 ± 12.34)°, respectively. The average time from injury to surgery was 4.2 days (range, 2-14 days). Results Superficial skin flap necrosis and wound exudate occurred in 1 case respectively, which were cured after dressing change; primary healing was obtained in the other cases. All the cases were followed up 12-26 months (mean, 15.2 months). The X-ray films showed that all fractures healed with an average healing time of 10.6 weeks (range, 8-12 weeks). The reduction of articular surface was satisfactory, and the heel height returned to normal. No complication of breakage of internal fixation or traumatic arthritis occurred. The Bouml;hler and Gissane angles were (29.64 ± 5.33)° and (121.75 ± 6.65)°, respectively at 3 months after operation, showing significant differences when compared with the preoperative values (t=43.800, P=0.000; t=33.200, P=0.000). The average time of plate removal was 11.2 months (range, 9-20 months). According to Maryland foot score, the results were excellent in 17 cases, good in 15 cases, and fair in 4 cases; the excellent and good rate was 88.9%. Conclusion The lateral calcaneal U-shaped incision approach is an effective method to treat calcaneal fractures involving the talocalcaneal and calcaneocuboid joints, which can expose the fracture fully, restore the anatomy of the calcaneal bone, and do early exercise under the condition of rigid internal fixation.

    Release date:2016-08-31 04:06 Export PDF Favorites Scan
  • 微型钢板螺钉治疗 足母 趾近节趾骨骨折

    目的 总结应用微型钢板螺钉治疗 足母 趾近节趾骨骨折的手术方法和近期疗效。 方法 2003 年3 月-2007 年5 月,采用开放复位、微型钢板螺钉内固定治疗36 例 足母 趾近节趾骨骨折。男27 例,女9 例;年龄17 ~ 55 岁,平均31.5 岁。压砸伤22 例,交通伤10 例,其他伤4 例。均为闭合骨折。骨折类型:横形16 例,斜形6 例,粉碎性14 例。合并肌腱损伤3 例。受伤至手术时间3 h ~ 15 d,平均3 d。 结果 术后3 例切口部分皮缘坏死,经换药后愈合;其余切口均Ⅰ期愈合。36 例均获随访,随访时间12 ~ 18 个月,平均15 个月。X 线片示骨折均于术后2.5 ~ 3.0 个月愈合,无骨不连、骨折畸形愈合发生。关节活动良好,根据美国足与踝关节协会 足母 趾、趾间关节功能评定标准,获优25 例,良9 例,可2 例,优良率94.4%。 结论 微型钢板螺钉内固定是治疗 足母 趾近节趾骨骨折的一种有效方法。

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
  • 微型接骨板桥式支撑固定治疗骰骨压缩骨折

    目的 总结应用微型接骨板桥式支撑固定治疗骰骨压缩骨折的临床疗效。 方法 2007 年7 月-2009 年11 月,采用指掌骨微型接骨板桥式支撑固定治疗骰骨压缩骨折15 例15 足。男13 例,女2 例;年龄22 ~ 48 岁,平均35 岁。致伤原因:扭伤3 例,交通事故伤2 例,高处坠落伤3 例,重物压伤7 例。合并第4、5 跗跖关节脱位6 例。于伤后2 ~ 10 d,平均3.7 d 行手术切开复位内固定治疗。 结果 术后切口均Ⅰ期愈合。X 线片检查示骨折于术后8 ~ 12周愈合。15 例均获随访,随访时间6 ~ 34 个月,平均19.2 个月。3 例术后8 ~ 12 周开始负重功能锻炼,4 ~ 6 周后X 线片复查示螺钉于钉帽与钉体连接处断裂,未作处理,于术后4.5 ~ 6.0 个月取出内固定。术后4 例持续步行后出现足背外侧胀痛。术后4.5 ~ 6.0 个月取出内固定,内固定取出后4 ~ 6 周根据美国骨科协会足踝外科分会标准评价足功能,获优11 例,良4 例,优良率100%。 结论 指掌骨微型接骨板桥式支撑固定在不进一步损伤关节面的同时既可恢复足外侧柱长度,又可固定骨折及跗跖关节脱位,是治疗骰骨压缩骨折的良好方法之一。

    Release date:2016-09-01 09:03 Export PDF Favorites Scan
  • 单纯第一跖骨基底部闭合性粉碎骨折脱位的治疗

    目的总结手术治疗单纯第1跖骨基底部闭合性粉碎骨折脱位的方法及疗效。 方法2009年2月-2013年10月,采用切开复位微型接骨板跨关节桥式支撑内固定治疗9例(9足)单纯第1跖骨基底部闭合性粉碎骨折脱位。男7例,女2例;年龄22~65岁,平均38.5岁。致伤原因:高处坠落伤6例,扭伤3例。根据Myerson跗跖关节骨折脱位分型,均为B1型。其中3例骨折端骨质压缩。受伤至手术时间2~4 d,平均2.7 d。 结果术后切口均Ⅰ期愈合。患者均获随访,随访时间1年1个月~3年,平均1年8个月。骨折均愈合,愈合时间10~12周,平均10.8周。术后5例固定接骨板靠近关节侧的螺钉断裂,未作特殊处理;9例均于术后6个月~2年取出内固定物。末次随访时,按照美国矫形足踝协会(AOFAS)标准评分为80~95分,平均88.4分。 结论微型接骨板跨关节桥式支撑内固定具有手术操作简便、固定牢固、减少关节面损伤、断钉易取出等优点,是治疗第1跖骨基底部闭合性粉碎骨折脱位理想方法之一。

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  • Effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture

    ObjectiveTo summarize the effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture.MethodsBetween January 2011 and October 2016, 25 cases with comminuted Jones fracture were treated with mini locking plate combined with Kirschner wire. There were 9 males and 16 females with an average age of 31.4 years (range, 16-66 years). The fractures located on the left side in 11 cases and on the right side in 14 cases. The causes of injury included spraining in 21 cases, falling down in 3 cases, and bruise in 1 case. The bone fragment of all cases was more than 3 pieces. The fracture line was mostly Y-shape or T-shape. Twelve of them were combined with other fractures. The time from injury to operation was 1-9 days (mean, 5 days). The mini locking plate and Kirschner wire were removed at 9-12 months postoperatively. At 12 months postoperatively, the pain was evaluated by the visual analogue scale (VAS) score, and the function by the American Orthopaedic Foot & Ankle Society (AOFAS) score.ResultsAll incisions healed by first intention. All cases were followed up 12-36 months with an average of 21.7 months. Fracture union was observed in all patients without complications such as nonunion, delayed union, and malunion. The fracture union time was 8-12 weeks (mean, 9.4 weeks). At 12 months postoperatively, the VAS score was 1.15±0.87; the AOFAS score was 89.45±6.24, and the results were excellent in 14 cases, good in 9 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 92%.ConclusionThe procedure of mini locking plate combined with Kirschner wire for comminuted Jones fracture has such advantages as convenient operation, more rigid fixation, high rate of fracture healing, and good functional recovery in foot.

    Release date:2018-05-02 02:41 Export PDF Favorites Scan
  • TREATMENT OF FRESH CLOSED FRACTURE-DISLOCATION OF MIDTARSAL JOINT

    Objective To investigate the treatment method and effectiveness of fresh closed fracture-dislocation of the midtarsal joint. Methods Between April 2004 and April 2011, 73 patients (75 feet) with fresh closed fracture-dislocation of the midtarsal joint were treated with closed reduction combined with open reduction and internal fixation. There were 56 males (58 feet) and 17 females (17 feet), aged from 19 to 62 years (mean, 35.8 years). Injuries were caused by falling from height in 35 cases, by sprain in 4 cases, by machine twist in 5 cases, by heavy pound in 9 cases, and by traffic accident in 20 cases. The time from injury to admission ranged from 1 hour and 30 minutes to 48 hours (mean, 4.5 hours). According to Main’s classification standard, 6 feet were rated as vertical compression injury, 33 feet as medial displacement injury, 17 feet as lateral displacement injury, 9 feet as flexion injury, and 10 feet as crush injury. Concomitant injuries included midfoot fracture-dislocation (34 feet), scaphoid fracture (6 feet), cuboid bone fracture (18 feet), calcaneal fracture (8 feet), talus fracture (7 feet), tibiotalar joint dislocation (2 feet), subtalar joint dislocation (2 feet), medial malleolus fracture (1 foot), and acute compartment syndrome (3 feet). Results Healing of incision by first intention was achieved in 65 cases (67 feet), by second intention in 8 cases (8 feet). Sixty-two cases (62 feet) were followed up from 11 months to 7 years and 11 months (mean, 3 years and 6 months). After operation, feet pain occurred in 26 cases, and stiffness or discomfort of the affected foot in 36 feet when walking. The X-ray examination showed good reduction of fracture-dislocation of the midtarsal joint and concomitant injuries with no re-dislocation or bone nonunion in 59 feet; 3 feet had flatfoot secondary to navicular necrosis, and underwent arthrodesis. The American Orthopaedic Foot and Ankle Society (AOFAS) score was 77-90 (mean, 88.6) at last follow-up. Conclusion According to the preoperative evaluation of the damage, using the manual reduction combined with internal fixation (mini-plate or hollow screw with Kirschner wire) methods can obtain good effectiveness in the treatment of fracture-dislocation of the midtarsal joint.

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • ANALYSIS OF DIAGNOSIS AND TREATMENT OF TALUS LATERAL PROCESS FRACTURE

    Objective To analyse and summarize the diagnosis, treatment, and cl inical effects of talus lateral process fracture. Methods Between February 2001 and March 2009, 21 male patients with an average age of 33.6 years (range, 18-46years) with talus lateral process fractures were treated. Fracture was caused by fall ing from height in 18 cases, by tumbl ing in 2 cases, and by sprain in 1 case. According to Hawkins classification, there were 4 cases of type I, 15 cases of type II, and 2 cases of type III, all being closed fractures. The disease course was from 2 hours to 26 days. In 17 patients whose fracture fragments were more than 1 cm × 1 cm × 1 cm or whose fracture fragments shifting was more than 1 mm, open reduction and internal fixation with AO hollow titanium nails were performed in 14 patients, open reduction and internal fixation with door-shape self-made nail in 1 patient, and open reduction and internal fixation with absorbable screws in 2 patients. In 4 patients whose fracture fragments were less than 0.6 cm × 0.5 cm × 0.5 cm or whose fracture fragments shifting was less than 1 mm, fragments removel was performed in 2 patients, Kirschner pins in 1 patient, and plaster conservative therapy in 1 patient. In patients with l igaments injury, the l igaments was reconstructed during the operation. Results All the incisions achieved primary heal ing. Twenty-one patients were followed up 9.5 months to 8 years. No ankle pain occurred and the range of joint motion was normal after operation. The X-ray films showed that all cases achieved fracture union. And the healing time was from 8 weeks to 14 weeks (10 weeks on average). According toAmerican Orthopeadic Foot amp; Ankle Society (AOFAS) for foot, the results were excellent in 17 cases, good in 3 cases, and moderate in 1 case; the excellent and good rate was 95.24%. Conclusion The size and displacement of fracture fragment should be considered first in the treatment of lateral process fracture of talus; in patients who are compl icated by lateral malleolus l igament injury, the l igament should be reconstructed to avoid the chronic non-stabil ity of lateral ankle.

    Release date:2016-08-31 05:48 Export PDF Favorites Scan
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