Average Fracture Union Time Research Articles

견갑골 관절와 골절의 수술적 치료

Purpose: To determine the causes of the surgical treatment results in glenoid fracture by a retrospective analysis. Materials and methods: From March 1999 to February 2004, 9 patients who underwent an open reduction due to a glenoid fracture were reviewed. The modified Ideberg classification was used. There were 1, 3, 2, 1 and 2 cases of modified Ideberg type I, II, III, V, and VI, respectively. The internal fixators were a reconstruction plate, a small plate, a one-third tubular plate, a small screw, and a cannulated screw in 6, 1, 3, 3 and 1 case, respectively. The constant score and Adam`s functional assessment method were used to evaluate the postoperative shoulder function. Results: The average time for fracture union was 7 weeks. The functional assessment was excellent in 4 cases, good in 3 cases, and fair in 2 cases. There were two complications related to surgery; articular screw encroachment, and inferior glenoid bone resorption without instability. Conclusion: A glenoid fracture with glenohumeral instability or displaced that was treated by open surgery showed good clinical results. Moreover, the more comminuted fracture had a lower functional score.

Comparative study of the clinical results of metacarpal and phalangeal fractures fixed by AO miniplates and cross K-wires

目的 评价AO微型钢板和克氏针治疗掌、指骨骨折的疗效.方法共评价68例88处掌、指骨骨折病例,分为AO微型钢板组(26例37处)及交叉克氏针组(42例51处),随访3～12个月(平均5.3个月).以TAFS评分为评价标准.结果所有病例均达骨性愈合.AO微型钢板组TAFS评分中,优良率为78.4%;而交叉克氏针组为54.9%.两者的TAFS功能评分结果差异有统计学意义(x2=5.179,P<0.05),前者明显优于后者.AO微型钢板组延迟愈合率为2.70%;交叉克氏针组为7.84%,前者优于后者.AO微型钢板组平均骨折愈合时间为4.5周,交叉克氏针组为7.6周,两者结果差异有统计学意义(t=2.964,P<0.05),前者病例骨折愈合时间明显短于后者.两者术后感染率相似.结论 AO微型钢板治疗掌、指骨骨折在术后关节功能恢复情况、骨折延迟愈合率及骨折愈合时间、并发症发生等指标上明显优于交叉克氏针固定,但在术后感染率上无明显差异。

External fixation in fractured patients aged more than 60 years

Fractures account for significant morbidity and mortality among the elderly. Commonly, surgical procedures like internal fixation are not exempt of complications (infection, soft-tissue problems). In this study, we examined the use of external fixation (EF) in 28 patients aged more than 60 years with a total of 30 fractures. There were 16 men and 12 women with a mean age of 72 (61–85) years. The upper limb was involved in four cases and the lower limb in 26. In half of the cases, open fractures were present, which were classified according to Gustilo: eight type I, six type II, and one type III. Fracture healing, angular deviation and bone aspect in the pin site were accessed radiologically. Clinical criteria included fracture healing, pain and articular function. The average time for fracture union was 7 (2–18) months. The overall rate of complications was high (66.6%). The most common complications were malunion (20%), non-union or delayed union (20%) and superficial pin-tract infection (10%). However, severe complications were rare. No deep infection or soft-tissue problems occurred. We consider that EF can be used not only for open and comminuted fractures but also in closed and minimally comminuted fractures with a high risk of soft-tissue problem where no other fixation is suitable.