Radial head dislocation associated with an ipsilateral radial shaft fracture is a rare lesion, even more so for open lesions. Few cases have been found in the literature. We report this case due to its exceptional nat...Radial head dislocation associated with an ipsilateral radial shaft fracture is a rare lesion, even more so for open lesions. Few cases have been found in the literature. We report this case due to its exceptional nature and discuss the mechanism of onset. A twenty-five-year-old patient presented with a dislocation of the radial head associated with a GUSTILO ANDERSON type II open fracture of the radial shaft following an occupational accident. He was managed twenty-four hours after the trauma. The mechanism was a direct blow. The dislocation was reduced by external manoeuvre following open reduction of the radial shaft. The fracture was stabilized by two Kirschner wires following reduction. The result at 12 months was satisfactory from a clinical and radiological standpoint.展开更多
Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children...Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.展开更多
Objective: To evaluate the feasibility of the pedicle screw pilot holes placement in thoracic spine using the spiral wires as the guide pin. Methods: The pedicle screw pilot holes were drilled within the center of the...Objective: To evaluate the feasibility of the pedicle screw pilot holes placement in thoracic spine using the spiral wires as the guide pin. Methods: The pedicle screw pilot holes were drilled within the center of the pedicle and the lateral and medial pedicle walls were violated in 9 human dried thoracic vertebrae. Kirschner wires or spiral wires were separately placed in the holes, and then the posteroanterior and lateral radiographs were taken. The radiographs were evaluated by 3 experienced spine surgeons and 3 young orthopedists. After radiographs were shown to these observers, they combined the posteroanterior and lateral radiographs in each place and determined whether the pedicle screw pilot hole violated the pedicle cortex or not. The results were analyzed by a statistical software. Results: Sensitivity, specificity and accuracy of the method using spiral wires to detect pedicle pilot hole placement were significantly higher than those of using Kirschner wires. With a true posteroanterior radiograph, the sensitivity, specificity and accuracy of the method using spiral wires approximated or attained 100%. Conclusions: The method of intrapedicular pilot hole placement verification using spiral wires is effective for guiding the accurate placement of pedicle screws.展开更多
目的研究分叉克氏针治疗髌骨骨折的临床效果。方法用分叉克氏针治疗髌骨骨折27例,用经典的克氏针钢丝张力带固定治疗髌骨骨折32例。比较术后两组手术所用时间、骨折愈合时间、术后并发症、术后3个月时膝关节屈曲角度。结果分叉克氏针组...目的研究分叉克氏针治疗髌骨骨折的临床效果。方法用分叉克氏针治疗髌骨骨折27例,用经典的克氏针钢丝张力带固定治疗髌骨骨折32例。比较术后两组手术所用时间、骨折愈合时间、术后并发症、术后3个月时膝关节屈曲角度。结果分叉克氏针组临床骨折愈合时间平均(10±1.8)周,术后3个月关节屈曲角度平均为(120.5±11)°,手术时间平均65 m in。并发症发生率3.7%;经典克氏针钢丝张力带组临床骨折愈合时间平均(12±1.8)周,术后3个月膝关节屈曲角度平均(110.0±15.5)°,手术时间平均61 m in,并发症发生率28.1%。结论分叉克氏针治疗髌骨骨折相比克氏针钢丝张力带治疗,并发症发生率低,骨折愈合时间相对较短,关节功能恢复好,是一种有效的治疗方法。展开更多
The femoral neck in children is much stronger than that in adults and can only be fractured by a severe force. It is therefore rare and often associated with severe injury once it takes place. Besides, as the blood su...The femoral neck in children is much stronger than that in adults and can only be fractured by a severe force. It is therefore rare and often associated with severe injury once it takes place. Besides, as the blood supply to the femoral head is precarious, the fracture can lead to a high incidence of post-traumatic avascular necrosis of the femoral head.^(1,2) So, much attention should be paid to the treatment of femoral fractures in children. The authors have successfully cured an old femoral neck fracture of a girl by open reduction and internal fixation with 3 Kirschner wires supplemented by an external fixator across the hip joint and cancellous allograft at the fracture site. The patient has gotten a satisfactory functional recovery of the hip.展开更多
Purpose： To evaluate the efficacy of intramedullary Kirschner wires for the treatment of unstable tibial shaft fractures in children. Methods： This prospective study was conducted at the Department of Orthopaedic Su...Purpose： To evaluate the efficacy of intramedullary Kirschner wires for the treatment of unstable tibial shaft fractures in children. Methods： This prospective study was conducted at the Department of Orthopaedic Surgery in Maharishi Markandeshwar Medical College from June 2005 to June 2010. Sixty-six children having closed fracture of the tibial shaft with a mean age of 7.7 years （range, 2-14 years） were recruited from emergency and outpatient department. They were treated with percutaneous intramedullary Kirschner wires. The clinical results of our study were rated on the basis of the criteria of union, nonunion, delayed union or malunion. All children were followed for one year. Results： Children achieved union in a mean time of 8 weeks （range, 6-10 weeks）. Postoperatively, three children （4.55%） had delayed union, one （1.52%） valgus deformity of lower leg, three （4.55%） post- operative knee pain and twelve （18.18%） skin irritation at pin site. Wires were removed after 8-22 weeks without any complications. No patient was lost to follow-up. The results were excellent in 95.45% and good in 4.55% children. Conclusion： This technique is cost-effective, simple, quick to perform, safe and reliable and avoids pro- longed hospitalization with good results.展开更多
文摘Radial head dislocation associated with an ipsilateral radial shaft fracture is a rare lesion, even more so for open lesions. Few cases have been found in the literature. We report this case due to its exceptional nature and discuss the mechanism of onset. A twenty-five-year-old patient presented with a dislocation of the radial head associated with a GUSTILO ANDERSON type II open fracture of the radial shaft following an occupational accident. He was managed twenty-four hours after the trauma. The mechanism was a direct blow. The dislocation was reduced by external manoeuvre following open reduction of the radial shaft. The fracture was stabilized by two Kirschner wires following reduction. The result at 12 months was satisfactory from a clinical and radiological standpoint.
基金supported by Program of the National Natural Science Foundation of China(No.82074233)Scientific Research Foundation for Advanced Talents,Xiang’an Hospital of Xiamen University(No.PM201809170009).
文摘Objective Supracondylar humerus fractures are the most frequent fractures of the paediatric elbow.The present study introduced a modified surgical procedure for treatment of supracondylar humerus fractures in children.Methods From February 2015 to August 2019,73 patients with Gartland’s type II and III supracondylar fractures were treated with this modified method.Totally,68 of all patients were followed up for 3–12 months(mean 8.25 months).The evaluation results included fracture nonunion,ulnar nerve injury,pin track infection,carrying angle and elbow joint Flynn score.Results The results showed that bone union was observed in all children,one case had an iatrogenic ulnar nerve injury,and the symptoms were completely relieved in 4 months after removing of the medial-side pin.All children had no cubitus varus deformity and no pin track infection,and the rate of satisfactory results according to Flynn’s criteria score was 100%.Conclusion The modified closed reduction and Kirschner wires internal fixation could effectively reduce the rate of open reduction,the risk of iatrogenic ulnar nerve injury,and the incidence of cubitus varus deformity in treatment of supracondylar humerus fractures in children.
文摘Objective: To evaluate the feasibility of the pedicle screw pilot holes placement in thoracic spine using the spiral wires as the guide pin. Methods: The pedicle screw pilot holes were drilled within the center of the pedicle and the lateral and medial pedicle walls were violated in 9 human dried thoracic vertebrae. Kirschner wires or spiral wires were separately placed in the holes, and then the posteroanterior and lateral radiographs were taken. The radiographs were evaluated by 3 experienced spine surgeons and 3 young orthopedists. After radiographs were shown to these observers, they combined the posteroanterior and lateral radiographs in each place and determined whether the pedicle screw pilot hole violated the pedicle cortex or not. The results were analyzed by a statistical software. Results: Sensitivity, specificity and accuracy of the method using spiral wires to detect pedicle pilot hole placement were significantly higher than those of using Kirschner wires. With a true posteroanterior radiograph, the sensitivity, specificity and accuracy of the method using spiral wires approximated or attained 100%. Conclusions: The method of intrapedicular pilot hole placement verification using spiral wires is effective for guiding the accurate placement of pedicle screws.
文摘目的研究分叉克氏针治疗髌骨骨折的临床效果。方法用分叉克氏针治疗髌骨骨折27例,用经典的克氏针钢丝张力带固定治疗髌骨骨折32例。比较术后两组手术所用时间、骨折愈合时间、术后并发症、术后3个月时膝关节屈曲角度。结果分叉克氏针组临床骨折愈合时间平均(10±1.8)周,术后3个月关节屈曲角度平均为(120.5±11)°,手术时间平均65 m in。并发症发生率3.7%;经典克氏针钢丝张力带组临床骨折愈合时间平均(12±1.8)周,术后3个月膝关节屈曲角度平均(110.0±15.5)°,手术时间平均61 m in,并发症发生率28.1%。结论分叉克氏针治疗髌骨骨折相比克氏针钢丝张力带治疗,并发症发生率低,骨折愈合时间相对较短,关节功能恢复好,是一种有效的治疗方法。
文摘The femoral neck in children is much stronger than that in adults and can only be fractured by a severe force. It is therefore rare and often associated with severe injury once it takes place. Besides, as the blood supply to the femoral head is precarious, the fracture can lead to a high incidence of post-traumatic avascular necrosis of the femoral head.^(1,2) So, much attention should be paid to the treatment of femoral fractures in children. The authors have successfully cured an old femoral neck fracture of a girl by open reduction and internal fixation with 3 Kirschner wires supplemented by an external fixator across the hip joint and cancellous allograft at the fracture site. The patient has gotten a satisfactory functional recovery of the hip.
文摘Purpose： To evaluate the efficacy of intramedullary Kirschner wires for the treatment of unstable tibial shaft fractures in children. Methods： This prospective study was conducted at the Department of Orthopaedic Surgery in Maharishi Markandeshwar Medical College from June 2005 to June 2010. Sixty-six children having closed fracture of the tibial shaft with a mean age of 7.7 years （range, 2-14 years） were recruited from emergency and outpatient department. They were treated with percutaneous intramedullary Kirschner wires. The clinical results of our study were rated on the basis of the criteria of union, nonunion, delayed union or malunion. All children were followed for one year. Results： Children achieved union in a mean time of 8 weeks （range, 6-10 weeks）. Postoperatively, three children （4.55%） had delayed union, one （1.52%） valgus deformity of lower leg, three （4.55%） post- operative knee pain and twelve （18.18%） skin irritation at pin site. Wires were removed after 8-22 weeks without any complications. No patient was lost to follow-up. The results were excellent in 95.45% and good in 4.55% children. Conclusion： This technique is cost-effective, simple, quick to perform, safe and reliable and avoids pro- longed hospitalization with good results.
