目的观察微创经皮锁定加压钢板内固定术治疗老年四肢骨折患者的效果。方法回顾性分析88例老年四肢骨折患者的临床资料。根据接受内固定手术方案不同分为常规组和微创组。42例接受传统切开复位钢板内固定术治疗的患者设为常规组,46例接...目的观察微创经皮锁定加压钢板内固定术治疗老年四肢骨折患者的效果。方法回顾性分析88例老年四肢骨折患者的临床资料。根据接受内固定手术方案不同分为常规组和微创组。42例接受传统切开复位钢板内固定术治疗的患者设为常规组,46例接受微创经皮锁定加压钢板内固定术治疗的患者设为微创组。比较2组围术期基本指标、并发症发生率、视觉模拟疼痛评分法(VAS)评分、骨折愈合时间以及骨折恢复效果。结果微创组手术时间、住院时间均短于常规组,术中出血量和术后3、7 d VAS评分均优于常规组,差异均有统计学意义(P<0.05);微创组手术并发症发生率为4.35%,显著低于常规组的21.43%(P<0.05);术后6个月随访结果表明,2组钢板位置稳固,均未发生钢板断裂和内固定松动。微创组骨折愈合时间显著短于常规组(P<0.05),骨折恢复优良率显著高于常规组(P<0.05)。结论微创经皮锁定加压钢板内固定术治疗四肢骨折效果显著,能减轻手术创伤和降低并发症发生率,促进骨折骨性愈合。展开更多
目的：探讨静脉留置针保护套对四肢创伤患者留置针的保护和对焦虑情绪的影响。方法将152例创伤患者按入院顺序分为对照组和观察组各76例，对照组穿刺成功后采用3M透明敷贴、胶布固定；观察组在常规留置针护理的基础上加用尼龙弹力网套...目的：探讨静脉留置针保护套对四肢创伤患者留置针的保护和对焦虑情绪的影响。方法将152例创伤患者按入院顺序分为对照组和观察组各76例，对照组穿刺成功后采用3M透明敷贴、胶布固定；观察组在常规留置针护理的基础上加用尼龙弹力网套固定，静脉输液1周后，对患者采用William W. K. Zung编制的焦虑自评量表进行评定，并对住院期间患者满意度进行问卷调查；观察两组患者的焦虑评分情况及患者睡眠情况、留置针脱落、静脉炎、堵管情况以及住院期间患者的满意度。结果观察组11例患者发生焦虑，对照组23例，观察组较对照组低，差异有统计学意义（P〈0.05）；观察组患者留置针脱落次数少于对照组，对护理满意度高于对照组，差异有统计学意义（P〈0.05）；两组患者静脉炎、堵管情况比较差异无统计学意义（P〉0.05）。结论在常规留置针护理的基础上加用尼龙弹力网套固定可以有效防止留置针脱落，明显缓解创伤患者的焦虑情绪，提高患者夜间睡眠质量，让患者感到更安全、放心，同时提高护理满意度。展开更多
The most commonly accepted system of classification for tibia plateau fractures is that of Schatzker. Increasingly, both high energy injuries and atypical osteoporotic fragility failures have led to more complex, unus...The most commonly accepted system of classification for tibia plateau fractures is that of Schatzker. Increasingly, both high energy injuries and atypical osteoporotic fragility failures have led to more complex, unusual and previously undescribed fracture patterns being recognized. We present a case of a patient with a previously unreported pattern of tibia plateau fracture and knee dislocation. We highlight the challenges confronted and present the management and the outcomes of his injury. A 28-year old male motorcyclist was involved in a head on collision with a truck and was transferred by helicopter to our level I major trauma centre emergency department. His injuries were a circumferential degloving injury to his left leg and a right lateral tibial plateau fracture/knee dislocation. The pattern of the lateral tibial plateau fracture was unique and did not fit any recognised classification system. The patient received a spanning external fixator initially and after latency of 12 days for soft tissue resuscitation he underwent definite fixation through an antero-lateral approach to the proximal tibia with two cannulated 6.5 mm partially threaded screws and an additional lateral proximal tibia plate in buttress mode. A hinged knee brace was applied with unrestricted range of motion post-operatively and free weight bearing were permitted post operatively. At the 6 months follow up, the patient walks without aids and with no limp. Examination revealed a stable joint and full range of motion. Plain radiographs revealed that the fracture healed with good alignment and the fixation remained stable. High energy injuries can lead to more complicated fracture patterns, which challenge the orthopaedic surgeons in their management. It is crucial to understand the individual fracture pattern and the possible challenges that may occur. This study reports a lateral tibia plateau fracture/dislocation which perhaps is best described as a reverse Schatzker IV type fracture.展开更多
文摘目的观察微创经皮锁定加压钢板内固定术治疗老年四肢骨折患者的效果。方法回顾性分析88例老年四肢骨折患者的临床资料。根据接受内固定手术方案不同分为常规组和微创组。42例接受传统切开复位钢板内固定术治疗的患者设为常规组,46例接受微创经皮锁定加压钢板内固定术治疗的患者设为微创组。比较2组围术期基本指标、并发症发生率、视觉模拟疼痛评分法(VAS)评分、骨折愈合时间以及骨折恢复效果。结果微创组手术时间、住院时间均短于常规组,术中出血量和术后3、7 d VAS评分均优于常规组,差异均有统计学意义(P<0.05);微创组手术并发症发生率为4.35%,显著低于常规组的21.43%(P<0.05);术后6个月随访结果表明,2组钢板位置稳固,均未发生钢板断裂和内固定松动。微创组骨折愈合时间显著短于常规组(P<0.05),骨折恢复优良率显著高于常规组(P<0.05)。结论微创经皮锁定加压钢板内固定术治疗四肢骨折效果显著,能减轻手术创伤和降低并发症发生率,促进骨折骨性愈合。
文摘目的：探讨静脉留置针保护套对四肢创伤患者留置针的保护和对焦虑情绪的影响。方法将152例创伤患者按入院顺序分为对照组和观察组各76例，对照组穿刺成功后采用3M透明敷贴、胶布固定；观察组在常规留置针护理的基础上加用尼龙弹力网套固定，静脉输液1周后，对患者采用William W. K. Zung编制的焦虑自评量表进行评定，并对住院期间患者满意度进行问卷调查；观察两组患者的焦虑评分情况及患者睡眠情况、留置针脱落、静脉炎、堵管情况以及住院期间患者的满意度。结果观察组11例患者发生焦虑，对照组23例，观察组较对照组低，差异有统计学意义（P〈0.05）；观察组患者留置针脱落次数少于对照组，对护理满意度高于对照组，差异有统计学意义（P〈0.05）；两组患者静脉炎、堵管情况比较差异无统计学意义（P〉0.05）。结论在常规留置针护理的基础上加用尼龙弹力网套固定可以有效防止留置针脱落，明显缓解创伤患者的焦虑情绪，提高患者夜间睡眠质量，让患者感到更安全、放心，同时提高护理满意度。
文摘The most commonly accepted system of classification for tibia plateau fractures is that of Schatzker. Increasingly, both high energy injuries and atypical osteoporotic fragility failures have led to more complex, unusual and previously undescribed fracture patterns being recognized. We present a case of a patient with a previously unreported pattern of tibia plateau fracture and knee dislocation. We highlight the challenges confronted and present the management and the outcomes of his injury. A 28-year old male motorcyclist was involved in a head on collision with a truck and was transferred by helicopter to our level I major trauma centre emergency department. His injuries were a circumferential degloving injury to his left leg and a right lateral tibial plateau fracture/knee dislocation. The pattern of the lateral tibial plateau fracture was unique and did not fit any recognised classification system. The patient received a spanning external fixator initially and after latency of 12 days for soft tissue resuscitation he underwent definite fixation through an antero-lateral approach to the proximal tibia with two cannulated 6.5 mm partially threaded screws and an additional lateral proximal tibia plate in buttress mode. A hinged knee brace was applied with unrestricted range of motion post-operatively and free weight bearing were permitted post operatively. At the 6 months follow up, the patient walks without aids and with no limp. Examination revealed a stable joint and full range of motion. Plain radiographs revealed that the fracture healed with good alignment and the fixation remained stable. High energy injuries can lead to more complicated fracture patterns, which challenge the orthopaedic surgeons in their management. It is crucial to understand the individual fracture pattern and the possible challenges that may occur. This study reports a lateral tibia plateau fracture/dislocation which perhaps is best described as a reverse Schatzker IV type fracture.
