Objective To explore the clinical characteristics and treatment of “kissing fracture” of humeroradial joint. Methods A clinical data of 12 patients with “kissing fracture” of the humeroradial joint between January 2016 and June 2021 was retrospectively analyzed. There were 8 males and 4 females with an average age of 41.9 years (range, 15-75 years). The fractures caused by falling in 7 cases, by falling from height in 3 cases, and by sports in 2 cases. The time from injury to admission was 2-72 hours (median, 2 hours). According to Mason’s classification, the radial head fractures were rated as type Ⅰ in 2 cases, type Ⅱ in 8 cases, and type Ⅲ in 2 cases. According to Grantham’s classification, the humeral capitulum fractures were rated as type Ⅰ in 10 cases and type Ⅱ in 2 cases. Among them, 4 cases of Grantham type Ⅰ humeral capitulum fracture were missed by X-ray film and confirmed by CT and/or MRI. Four cases were complicated with other injuries of elbow joint. The radial head fractures were fixed with screws or mini plate in 11 cases and treated conservatively in 1 case; the humeral capitulum fractures were fixed with screw or plate in 9 cases, removed in 1 case, and treated conservatively in 2 cases. X-ray film was used to evaluate the fracture healing; Mayo Elbow Performance Score (MEPS) was used to evaluate the functional recovery of the affected limb, and the range of motion (ROM) of the elbow joint of the affected limb was detected. Results All the incisions healed by first intention without early complications. All patients were followed up 10-24 months, with an average of 15.2 months. X-ray films showed that all fractures healed, and the healing time was 2-3 months, with an average of 2.3 months. At last follow-up, the ROM of flexion-extension of the elbow joint was 65°-161°, with an average of 136.9°; the ROM of rotation was 70°-180°, with an average of 149.2°. MEPS ranged from 70 to 100, with an average of 87.4; 8 cases were excellent, 2 cases were good, and 2 cases were fair; the excellent and good rate was 83.3%. Conclusion The “kissing fracture” of the humeroradial joint is relatively rare, and the humeral capitulum fracture is milder than radial head fracture. X-ray examination alone can easily miss the diagnosis of Grantham type Ⅰ humeral capitulum fracture. The “kissing fracture” of the humeroradial joint is treated according to the principle of intra-articular fracture, and the good effectiveness can obtain.
ObjectiveTo investigate the effectiveness of percutaneous compression plate (PCCP) fixation for femoral neck fracture.MethodsA clinical data of 100 patients with femoral neck fractures who were treated with internal fixation were analyzed retrospectively. The fractures were fixed with the cannulated screws (CS) in 55 patients (CS group) and with the PCCP in 45 patients (PCCP group). There was no significant difference in gender, age, the cause of injury, the fracture type, complications, and disease duration between the two groups (P>0.05). The quality of fracture reduction, bone resorption, screw slipping, femoral neck shortening, complications (nonunion, failure of fixation, and osteonecrosis of femoral head), and functional recovery of hip (Harris score) were compared between the two groups.ResultsAll incisions healed by first intention. All patients were followed up 24-56 months, with an average of 30.7 months. The quality of fracture reduction was excellent in 26 cases, good in 18 cases, fair in 9 cases, and poor in 2 cases in CS group and excellent in 21 cases, good in 17 cases, fair in 4 cases, and poor in 3 cases in PCCP group, showing no significant difference between the two groups (Z=−0.283, P=0.773). The incidence of nonunion in PCCP group was significantly lower than that in CS group (P=0.046), and the fracture healing time in PCCP group was shorter than that in CS group (t=2.155, P=0.034). There was no significant difference in the incidences of bone resorption, screw slipping, femoral neck shortening, failure of fixation, and osteonecrosis of femoral head between the two groups (P>0.05). The overall complication rates were 27.27% (15/55) in CS group and 8.89% (4/45) in PCCP group, showing significant difference (χ2=5.435, P=0.020). The Harris score in PCCP group at 6 months after operation was significantly higher than that in CS group (t=−2.073, P=0.041). However, there was no significant difference in the Harris score at 12, 18, and 24 months after operation between the two groups (P>0.05).ConclusionStable sliding compression of PCCP is benefit for the femoral neck fracture healing, especially shortening union.