Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic ...Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic aspects of PSA of the diaphysis of long bones. Method: This retrospective work concerns 30 cases of non-union of the diaphysis of long bones treated in the orthopedic and trauma surgery department at Donka National Hospital, during a period of 18 months from January 1, 2019 to June 30, 2020. Results: We recruited 30 patients, 80% of whom were male, with an average age of 39.9 years. Public road accidents (AVP) represented the main cause of fractures of the diaphysis of long bones 87%, they were open in 25 cases or 83%. The fractures were located in the middle 1/3 of the diaphysis of the long bones in 50% of cases. Treatment of initial fractures was traditional in 21 cases, orthopedic in 2 cases and surgical in 7 cases. It was aseptic nonunion in 28 cases (93%) and septic nonunion in 2 cases. They were hypertrophic in 7 cases, slightly hypertrophic in 5 cases, oligotrophic in 11 cases, atrophic in 6 cases and with bone defect in 1 case. The treatment was based on osteosynthesis including 16 cases of screwed “PV” plate: 7 cases of centromedullary “ECM” nailing, 2 cases of external fixator, 1 case of broaching and 4 cases of Plastering. The results according to ASAMI criteria on an anatomical level were excellent in 19 cases, good in 3 cases and poor in 3 cases, with a union rate of 76%. And 5 patients undergoing consolidation. Conclusion: Based on the literature data and the experience of our department, the true treatment of PSA requires correct management of the initial fracture without forgetting the interest in preventing AVP which appears to be an element essential, making it possible to reduce the incidence of fractures of the diaphysis.展开更多
Objective: The aim of this work was to assess the epidemiological factors of the pseudoarthroses of diaphyseal humeral fractures in order to prevent them and also to assess the results of their treatment by screwed pl...Objective: The aim of this work was to assess the epidemiological factors of the pseudoarthroses of diaphyseal humeral fractures in order to prevent them and also to assess the results of their treatment by screwed plate associated with an auto-graft. Material and method: This was a retrospective series of 36 aseptic pseudoarthroses of the humeral diaphysis treated by screwed plate, associated or not with a bone autograft between January 1997 and December 2016 at the Treichville University Hospital. The criteria of inclusion refer to the existence of an aseptic pseudoarthrosis of the humeral diaphysis treated by screwed plate. The approach was antero-external. Two thirds of pseudoarthroses were between the middle 1/3. 23 atrophic pseudoarthroses (65%) and 13 hypertrophic pseudoarthroses. Functional results were assessed using the Steward and Hundley criteria. Results: Mortality was zero, and postoperative complications were dominated by 4 hematomas and 2 transient iatrogenic paresthesias of the radial nerve. The sequelae were minor and the consolidation was acquired in 97.25% of patients. Conclusion: The treatment of aseptic pseudoarthroses of the humerus by screwed plate associated with an auto-graft is a reliable technique, inexpensive with a satisfactory functional outcome.展开更多
Experimental investigation on the pull-out behaviour,including the withdrawal capacity,slip stiffness and inter-facial shear stress,of axially loaded screwed-in threaded rod embedded in cross laminated timber(CLT)was ...Experimental investigation on the pull-out behaviour,including the withdrawal capacity,slip stiffness and inter-facial shear stress,of axially loaded screwed-in threaded rod embedded in cross laminated timber(CLT)was con-ducted.Specimens with varying embedment length and different number of threaded rods were tested in this study.To prevent premature splitting failure of timber,some specimens were reinforced in the direction perpen-dicular to the timber grain with self-tapping screws.Test results showed that the screwed-in threaded rod con-nections exhibited good pull-out behaviour with high withdrawal capacity and slip stiffness.Within a certain range,the withdrawal capacity increases considerably with the increase of embedment length,while the average interfacial shear stress shows the opposite tendency.The self-tapping screws played an important role on reducing the splitting of the timber and improving the withdrawal capacity and slip stiffness of the screwed-in threaded rod.Additionally,for the specimens with self-tapping screw reinforcements,the improvement of withdrawal capacity and stiffness when increasing the number of threaded rods are much more obvious than that of the speci-mens without the self-tapping screws,due to the change of failure modes.展开更多
文摘Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic aspects of PSA of the diaphysis of long bones. Method: This retrospective work concerns 30 cases of non-union of the diaphysis of long bones treated in the orthopedic and trauma surgery department at Donka National Hospital, during a period of 18 months from January 1, 2019 to June 30, 2020. Results: We recruited 30 patients, 80% of whom were male, with an average age of 39.9 years. Public road accidents (AVP) represented the main cause of fractures of the diaphysis of long bones 87%, they were open in 25 cases or 83%. The fractures were located in the middle 1/3 of the diaphysis of the long bones in 50% of cases. Treatment of initial fractures was traditional in 21 cases, orthopedic in 2 cases and surgical in 7 cases. It was aseptic nonunion in 28 cases (93%) and septic nonunion in 2 cases. They were hypertrophic in 7 cases, slightly hypertrophic in 5 cases, oligotrophic in 11 cases, atrophic in 6 cases and with bone defect in 1 case. The treatment was based on osteosynthesis including 16 cases of screwed “PV” plate: 7 cases of centromedullary “ECM” nailing, 2 cases of external fixator, 1 case of broaching and 4 cases of Plastering. The results according to ASAMI criteria on an anatomical level were excellent in 19 cases, good in 3 cases and poor in 3 cases, with a union rate of 76%. And 5 patients undergoing consolidation. Conclusion: Based on the literature data and the experience of our department, the true treatment of PSA requires correct management of the initial fracture without forgetting the interest in preventing AVP which appears to be an element essential, making it possible to reduce the incidence of fractures of the diaphysis.
文摘Objective: The aim of this work was to assess the epidemiological factors of the pseudoarthroses of diaphyseal humeral fractures in order to prevent them and also to assess the results of their treatment by screwed plate associated with an auto-graft. Material and method: This was a retrospective series of 36 aseptic pseudoarthroses of the humeral diaphysis treated by screwed plate, associated or not with a bone autograft between January 1997 and December 2016 at the Treichville University Hospital. The criteria of inclusion refer to the existence of an aseptic pseudoarthrosis of the humeral diaphysis treated by screwed plate. The approach was antero-external. Two thirds of pseudoarthroses were between the middle 1/3. 23 atrophic pseudoarthroses (65%) and 13 hypertrophic pseudoarthroses. Functional results were assessed using the Steward and Hundley criteria. Results: Mortality was zero, and postoperative complications were dominated by 4 hematomas and 2 transient iatrogenic paresthesias of the radial nerve. The sequelae were minor and the consolidation was acquired in 97.25% of patients. Conclusion: The treatment of aseptic pseudoarthroses of the humerus by screwed plate associated with an auto-graft is a reliable technique, inexpensive with a satisfactory functional outcome.
基金This research was sponsored by the National Natural Science Foundation of China(Grant Nos.51878344 and 51578284).
文摘Experimental investigation on the pull-out behaviour,including the withdrawal capacity,slip stiffness and inter-facial shear stress,of axially loaded screwed-in threaded rod embedded in cross laminated timber(CLT)was con-ducted.Specimens with varying embedment length and different number of threaded rods were tested in this study.To prevent premature splitting failure of timber,some specimens were reinforced in the direction perpen-dicular to the timber grain with self-tapping screws.Test results showed that the screwed-in threaded rod con-nections exhibited good pull-out behaviour with high withdrawal capacity and slip stiffness.Within a certain range,the withdrawal capacity increases considerably with the increase of embedment length,while the average interfacial shear stress shows the opposite tendency.The self-tapping screws played an important role on reducing the splitting of the timber and improving the withdrawal capacity and slip stiffness of the screwed-in threaded rod.Additionally,for the specimens with self-tapping screw reinforcements,the improvement of withdrawal capacity and stiffness when increasing the number of threaded rods are much more obvious than that of the speci-mens without the self-tapping screws,due to the change of failure modes.
