Objective To compare the effectiveness of suspension fixation plus hinged external fixator with double plate internal fixation in the treatment of type C humeral intercondylar fractures. Methods Between January 2014 and April 2016, 30 patients with type C (Association for the Study of Internal Fixation, AO/ASIF) humeral intercondylar fractures were treated. Kirschner wire suspension fixation plus hinged external fixator was used in 14 cases (group A), and double plate internal fixation in 16 cases (group B). There was no significant difference in gender, age, injury cause, disease duration, injury side, and type of fracture between 2 groups (P>0.05). Results There was no significant difference in operation time and hospitalization stay between 2 groups (P>0.05). But the intraoperative blood loss in group A was significantly less than that in group B (P<0.05); the visual analogue scale (VAS) score at 1 day and 3 days after operation in group A were significantly less than those in group B (P<0.05). Primary healing of incision was obtained in all patients of 2 groups, and no surgery-related complications occurred. The patients were followed up 6-24 months (mean, 12.3 months) in group A and 6-24 months (mean, 12.8 months) in group B. The self-evaluation satisfaction rate was 85.7% (12/14) in group A and was 81.2% (13/16) in group B at 3 months after operation, showing no significant difference (χ2=0.055, P=0.990). Based on the improved Gassebaum elbow performance score at 6 months after operation, excellent and good rate of the elbow function was 78.6% (excellent in 5 cases, good in 6 cases, fair in 2 cases, and poor in 1 case) in group A and was 81.2% (excellent in 6 cases, good in 7 cases, fair in 2 cases, and poor in 1 case) in group B, showing no significant difference between 2 groups (χ2=0.056, P=0.990). Heterotopic ossification occurred at 3 months after operation in 1 case of each group respectively. The X-ray films showed bony union in all cases; no loosening or breakage of screw was observed. The bone union time showed no significant difference between 2 groups (t=–0.028, P=0.978). The time of internal fixation removal, the intraoperative blood loss, and VAS score at 1 day and 3 days after operation in group A were significant better than those in group B (P<0.05). Conclusion The suspension fixation plus hinged external fixator and double plate internal fixation for the treatment of type C humeral intercondylar fractures have ideal outcome in elbow function. But the suspension fixation plus hinged external fixator is better than double plate internal fixation in intraoperative blood loss, postoperative VAS score, and time of internal fixation removal.
Objective To investigate clinical effects of modified Xiaozhiling injection with anal cushion suspensory fixation in treatment of prolapsed hemorrhoids. Methods From January 2012 to June 2013, 150 hospitalized patients with Ⅱ and Ⅲ degrees internal hemorrhoids and mixed hemorrhoid, with prolapsing as the main clinical manifestations, were included prospectively, then subsequently randomly divided into a modified Xiaozhiling injection with anal cushion suspensory fixation group (observation group), a procedure for prolapse and hemorrhoids (PPH) group, and a classic Milligan-Morgan surgery (M-M) group. The Xiaozhiling injection with saline by 1:1 mixture was injected into the rectum submucosa and perirectal gap and the anal cushion suspensory fixation were performed for the treatment of prolapsed hemorrhoids in the observation group. The operations of the PPH group and M-M group were same as the convention. The treatment effect, hospitalization time, hospital expenses, postoperative complications, and recurrence were compared among these 3 groups. Results ① Fourty-nine cases were cured and 1 case was improved in the observation group, 48 cases were cured and 2 cases were improved in the PPH group, 48 cases were cured and 2 cases were improved in the M-M group, the treatment effects had no significant differences among these 3 groups (χ2=0.411, P=0.814). ② The hospitalization time and hospitalization expenses of the observation group were significantly less than those of the PPH group (P<0.001) and the M-M group (P<0.001). ③ No prolapse of hemorrhoids and infection happened on day 1, 2, 3, 7, and 14 among these 3 groups. The pains of the observation group were slighter on day 1, 2, 3, 7, and 14 as compared with the PPH group (except on day 14,P<0.05) and the M-M group (P<0.05). The anus bulges had no significant difference between the observation group and the PPH group (except on day 1,P>0.05), which of the observation group were significantly slighter than those of the M-M group (P<0.05). The bleeding on day 2 and 3 and the perianal edema on day 3 had no significant difference between the observation group and the PPH group (P>0.05), which of the observation group were significantly slighter than those of the M-M group (P<0.05). The urinary retention had no significant difference on day 1–3 among these 3 groups (P>0.05). ④ The anal stenosis, anal continence, and hemorrhoids recurrence on month 1, 6, and 12 had no significant differences among these 3 groups (P>0.05). Conclusions Modified Xiaozhiling injection with anal cushion suspensory fixation in treatment of prolapsed hemorrhoids could effectively make anal cushion fixation, eliminate main symptoms of bleeding and prolapse, preserve anal function well. It’s clinical efficacy is same as PPH and M-M methods, with a shorter hospitalization time, less hospitalization expenses, milder postoperative complications, and lower recurrence rate.
ObjectiveTo explore the feasibility and effectiveness of using auricular cartilage multi-point suspension fixed on deep craniofacial fascia in correcting mild to moderate cupped ear malformation.MethodsBetween January 2014 and March 2016, 22 patients (12 males and 10 females) with mild to moderate cupped ear malformation were admitted, aged from 6 to 28 years, with an average age of 15 years. Sixteen cases were unilateral and 6 cases were bilateral. According to Tanzer classification, there were 18 sides of type Ⅰ and 10 sides of type Ⅱ. The otocranial groove incision was selected to expose and release the posterior auricular muscles and ligaments. The abnormal structure of auricle subunits was remolded. The auricle cartilage was suspended and fixed on the deep craniofacial fascia with non absorbable line to remodel the shape and position of auricle.ResultsThe incision healed by first intention, without hematoma, infection, and skin necrosis. All the patients were followed up 3-48 months, with an average of 12 months. In addition to 1 case of slippage of the fixed line knot, the effect was good after being suspended and fixed again, the auricles of the other patients were not drooping and tilted forward, the shape of the outer ear was good, the ear boat was obvious, the shape of the upper and lower feet of the ear wheel and the pair of ears was natural, the bilateral symmetry was good, and the patients and their families were satisfied.ConclusionAuricular cartilage multi-point suspension fixed on deep craniofacial fascia is effective in the treatment of mild to moderate cupped ear malformation.
Objective To investigate the effectiveness of arthroscopic suspension fixation with Endobutton in the treatment of tibial insertion avulsion fractures of posterior cruciate ligament (PCL). Methods A retrospective analysis was conducted on the clinical data of 52 patients (52 knees) with tibial insertion avulsion fractures of PCL, who were treated by arthroscopic suspension fixation with Endobutton between June 2017 and October 2022. There were 29 males and 23 females, with an average age of 40.6 years (range, 19-66 years). There were 24 cases of traffic accident injuries, 17 cases of sports injuries, and 11 cases of fall injuries. The time from injury to operation ranged from 6 to 19 days (mean, 13.3 days). According to the Meyers-McKeever classification, there were 30 cases of type Ⅱ and 22 cases of type Ⅲ fractures. All patients exhibited positive posterior drawer test results. Preoperative knee joint function was assessed with Lysholm score (21.3±6.7), International Knee Documentation Committee (IKDC) score (20.7±5.8), and visual analogue scale (VAS) score (5.3±0.7); and knee joint range of motion was (41.73±3.17)°. Based on preoperative CT three-dimensional reconstruction measurements, the longitudinal diameter of the avulsed bone fragment ranged from 13 to 25 mm (mean, 18.1 mm). Operation time and occurrence of complications were recorded, and postoperative imaging was used to assess fracture healing. Knee joint function and pain severity were evaluated using knee joint range of motion, Lysholm score, IKDC score, and VAS score. Results The operation time ranged from 46 to 81 minutes (mean, 56.2 minutes). All patients were followed up 12-28 months (mean, 20.1 months). The iatrogenic fractures of bone fragments occurred during operation in 4 cases; and knee effusion occurred in 2 cases and anterior knee pain in 1 case after operation. All incisions healed by first intention. Imaging evaluations at 3 months after operation showed the fracture healing and no internal fixation failure. All patients demonstrated good knee function and had returned to normal activities at 12 months after operation. At last follow-up, the knee joint range of motion was (133.44±4.17)°, Lysholm score 93.6±3.1, IKDC score 93.4±2.5, and VAS score 1.0±0.6, with significant differences compared to preoperative scores (P<0.05). Conclusion Arthroscopic suspension fixation with Endobutton in the treatment of tibial insertion avulsion fractures of PCL is simple to operate, and the knee joint function recovers well.