ObjectiveTo evaluate the short-term effectiveness of transarticular fixation of humeroradial joint by Kirschner wire (or combined with proximal ulnar osteotomy) for old radial head dislocation after open reduction of the radial head in children. MethodsA retrospective analysis was made on the clinical data of 25 children with old radial head dislocation between January 2008 and December 2010.There were 18 boys and 7 girls,aged 2 years and 5 months to 9 years and 5 months (mean,5 years and 11 months).The left side was involved in 13 cases,and the right side in 12 cases.The interval of injury and operation was 3 weeks to 30 months (median,14 months).The main presentations were abnormal mass in the anterior elbow,motion limitation of forearm pronation,and dorsiflexion inability of wrist and thumb.Three patients had radial nerve lesion.In 23 patients with simple radial head dislocation,transarticular fixation of humeroradial joint by Kirschner wire was used after open reduction of the radial head; in 2 patients with Monteggia fracture,transarticular fixation by Kirschner wire and additional proximal ulnar osteostomy were used. ResultsA primary healing of incision was obtained,without complication of infection,joint stiffness,or radial head necrosis.Twenty-four patients were followed up 29-58 months (mean,44.3 months); one case had re-dislocation,failed to be followed up at 2.5 months postoperatively.In 3 patients with radial nerve injury,neural function recovery was obtained in 2 cases,and no improvement was observed in 1 case.Twenty-three had no pain,no deformity,and no motion limitation of elbow and forearm except 1 patient with no improvement of neural function.The mean range of montion (ROM) of elbow flexion was 134° (range,125-140°),and the mean ROM of extension was -4° (range,-8-0°); the mean ROM of forearm pronation was 74° (range,65-80°),and the ROM of supination was 90°.According to Mackay's criteria,the results were excellent in 22 cases,good in 1 case,and poor in 1 case at 2 years after operation. ConclusionThe transarticular fixation of humeroradial joint by Kirschner wire (or combined with proximal ulnar osteotomy) is a feasible and effective method to treat old radial head dislocation in children based on a short-term follow-up.
ObjectiveTo investigate the value of chest high-resolution computed tomography (HRCT) score in evaluating the severity of hip fracture-induced early acute lung injury (ALI) in the elderly patients.MethodsThe clinical data of 289 elderly hip fracture patients in Chongqing Traditional Chinese Medicine Hospital from July 2014 to April 2020 were retrospectively analyzed. All patients were divided into two groups, including an ALI group (n=114, 36 males and 78 females at age of 82.94±6.85 years) and a non-ALI group (n=175, 51 males and 124 females at age of 84.42±6.31 years). General information, chest HRCT scores and PaO2/FiO2 were compared between the two groups. Correlation analysis was used to compare the relationship between chest HRCT scores and PaO2/FiO2. Multiple linear stepwise regression analysis was applied to evaluate the effective extent of the diffuse ground glass opacity (DGGO), intense parenchymal opacification (IPO), and reticulation HRCT scores to the overall HRCT scores.ResultsThe DGGO scores, IPO scores, reticulation scores, overall HRCT scores and PaO2/FiO2 were higher in the ALI group than those in the non-ALI group (P<0.001). In the ALI group, correlation analysis showed that DGGO, overall HRCT scores were in significantly negative correlation with PaO2/FiO2 (P<0.001). In addition, the correlation among PaO2/FiO2 and overall HRCT scores was more significant than that of DGGO scores. Multiple stepwise regression analysis indicated that DGGO, IPO, and reticulation scores were independent influencing factors for overall HRCT scores. Among the influencing factors, DGGO scores had the greatest impact, then IPO scores and reticulation scores. The HRCT signs of DGGO, IPO, and reticulation appeared simultaneously had the greatest effects on the overall HRCT scores.ConclusionThe chest HRCT score, which is associated with PaO2/FiO2, also can be used in the severity assessment of elderly patients with early ALI caused by hip fracture.