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Chu X.,The 101st Hospital of Chinese PLA
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery | Year: 2013

To observe the effectiveness of the superior fibular head approach for the treatment of posterolateral fracture of the tibial plateau. Between June 2010 and February 2012, 20 cases of posterolateral fracture of the tibial plateau were treated through superior fibular head approach, including 1 case of simple posterolateral fracture of the tibial plateau and 19 cases of posterolateral fracture of the tibial plateau with other fractures. There were 12 males and 8 females with an average age of 42.2 years (range, 28-58 years). All patients had closed fractures. Fracture was caused by traffic accident in 14 cases, by falling from height in 4 cases, and by twist injury in 2 cases. Associated injuries included lateral meniscus injury in 5 cases, medial meniscus injury in 2 cases, and anterior cruciate ligament injury in 1 case. The time from injury to admission ranged from 90 minutes to 32 hours (mean, 4.5 hours), and the time from admission to operation was 5-12 days (mean, 7.8 days). All cases underwent fracture reduction and fixation with Pilon plates through the superior fibular head approach, and associated fracture and meniscal injury were treated. All incisions healed by first intention, and no numbness or articular instability occurred. All patients were followed up 6-26 months (mean, 19.1 months). The average fracture healing time was 10.2 weeks (range, 8-12 weeks). During following-up, no related complication of fixation loosening or articular surface loss occurred. According to Rasmussen knee score criteria at last follow-up, the score was 18-30 (mean, 27.9); 16 cases were graded as excellent, 3 cases as good, and 1 case as fair, with an excellent and good rate of 95%. The superior fibular head approach for the treatment of posterolateral fracture of the tibial plateau is simple, safe, and effective, and can achieve a good surgical outcome. Source


Liu W.,Nanjing Medical University | Xiao J.,The 101st Hospital of Chinese PLA | Ji F.,Nanjing Medical University | Xie Y.,Nanjing Medical University | Hao Y.,Nanjing Medical University
Orthopaedics and Traumatology: Surgery and Research | Year: 2015

Background: The optimal treatment of midshaft clavicle fractures remains controversial. Nonunion is usually considered to be an uncommon complication following a nonoperatively treated clavicle fracture. Hypothesis: Not every midshaft clavicular fractures shares the same risk of developing nonunion after nonoperative treatment. The present study was performed to identify the intrinsic and extrinsic independent factors that are independently predictive of nonunion in patients with midshaft clavicular fractures after nonoperative treatment. Materials and methods: We performed a retrospective study of a series of 804 patients (391 men and 413 women with a median age of 51.3 years) with a radiographically confirmed midshaft clavicle fracture, which was treated nonoperatively. There were 96 patients who underwent nonunion. Putative intrinsic (patient-related) and extrinsic (injured-related) risk factors associated with nonunion were determined with the use of bivariate and multivariate statistical analyses. Results: By bivariate analysis, the risk of nonunion was significantly increased by several intrinsic risk factors including age, sex, and smoking and extrinsic risk factors including displacement of the fracture and the presence of comminution (P < 0.05 for all). On multivariate analysis, smoking (OR = 4.16, 95% CI: 1.01-14.16), fracture displacement (OR = 7.81, 95% CI: 2.27-25.38) and comminution of fracture (OR = 3.86, 95% CI: 1.16-13.46) were identified as independent predictive factors. Conclusion: The risk factors for nonunion after nonoperative treatment of midshaft clavicle fractures are multifactorial. Smoking, fracture displacement and comminution of fracture are independent predictors for an individual likelihood of nonunion. Further studies are still required to evaluate these factors in the future. Level of evidence: Level III, case-control study. © 2015 Elsevier Masson SAS. Source


Liu W.,Nanjing Medical University | Xiao J.,The 101st Hospital of Chinese PLA | Ji F.,Nanjing Medical University | Xie Y.,Nanjing Medical University | Hao Y.,Nanjing Medical University
Revue de Chirurgie Orthopedique et Traumatologique | Year: 2015

Background: The optimal treatment of midshaft clavicle fractures remains controversial. Nonunion is usually considered to be an uncommon complication following a non-operatively treated clavicle fracture. Hypothesis: Not every midshaft clavicular fracture shares the same risk of developing nonunion after non-operative treatment. The present study was performed to identify the intrinsic and extrinsic independent factors that are independently predictive of nonunion in patients with midshaft clavicular fractures after non-operative treatment. Materials and methods: We performed a retrospective study of a series of 804 patients (391 men and 413 women with a median age of 51.3. years) with a radiographically confirmed midshaft clavicle fracture, which was treated non-operatively. There were 96 patients who underwent nonunion. Putative intrinsic (patient-related) and extrinsic (injured-related) risk factors associated with nonunion were determined with use of bivariate and multivariate statistical analyses. Results: By bivariate analysis, the risk of nonunion was significantly increased by several intrinsic risk factors including age, sex, and smoking and extrinsic risk factors including displacement of the fracture and the presence of comminution (. P<. 0.05 for all). On multivariate analysis, smoking (OR. =. 4.16, 95% CI: 1.01, 14.16), fracture displacement (OR. =. 7.81, 95% CI: 2.27, 25.38) and comminution of fracture (OR. =. 3.86, 95% CI: 1.16, 13.46) were identified as independent predictive factors. Conclusion: The risk factors for nonunion after non-operative treatment of midshaft clavicle fractures are multifactorial. Smoking, fracture displacement and comminution of fracture are independent predictors for an individual likelihood of nonunion. Further studies are still required to evaluate these factors in the future. Level of evidence: Level III, case-control study. © 2015 Elsevier Masson SAS. Source


Cai F.-j.,The 101st Hospital of Chinese PLA | Zhu J.-p.,The 101st Hospital of Chinese PLA | Luo Y.-c.,The 101st Hospital of Chinese PLA | Yu X.-h.,The 101st Hospital of Chinese PLA | And 4 more authors.
Chinese Journal of Tissue Engineering Research | Year: 2012

BACKGROUND: Paraspinal muscle approach for the treatment of thoracolumbar burst fracture makes it possible for pedicle screw-rod implantation and fixation through paraspinal muscle approach. OBJECTIVE: To compare the clinical effect of paraspinal muscle approach and conventional approach for the treatment of thoracolumbar burst fracture. METHODS: Fifty-three patients who suffered from thoracolumbar burst fractures without obvious nerve injury were included; all the patients were injured with kyphosis greater than 20° and/or anterior vertebral height collapse larger than 50%. The patients were treated with paraspinal muscle approach (n=28) and conventional approach (n=25) respectively. RESULTS AND CONCLUSION: The visual analog scale of the patients treated with paraspinal muscle approach was significantly decreased when compared with the patients treated with conventional approach (P < 0.05). There was no significant difference in the radiographic results (Cobb angle, height of anterior edge of the fractured vertebrae and midsagital diameter of the fractured spinal canal) between two groups (P > 0.05). Paraspinal muscle space approach fixation can reach the same effect with conventional approach for the treatment of thoracolumbar burst fractures, and can promote functional recovery. Source

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