Plaster Fixation Research Articles

Evaluation of the Treatment Efficacy of Bone Traction Combined with Small Splint External Fixation for Tibiofibular Fractures

Objective: To evaluate the clinical efficacy of bone traction combined with small splint external fixation in treating tibiofibular fractures. Methods: 378 patients with tibiofibular fractures who were treated in the Department of Orthopedics of our hospital from January 2019 to January 2023 were selected as study subjects. According to the specific conditions of the patients and the indications for surgery, they were divided into the observation group (bone traction combined with small splint external fixation) and the control group (conventional plaster fixation), with 189 cases in each group. Both groups of patients immobilized the affected limb as instructed by their doctors and were treated with oral anti-inflammatory and pain-relieving medications. The healing of the fractures was monitored using imaging techniques such as X-rays, computed tomography scans, and magnetic resonance imaging, while postoperative complications were also recorded. Results: The incidence rate of non-healing in the control group (7.41%) was significantly higher than that in the observation group (1.06%) (P < 0.05); the complications in the observation group were mainly three cases of limb deformity, three cases of pressure sores, and four cases of skin necrosis, with a total of 10 cases and an incidence rate of 5.29%; while in the control group, there were three cases of fracture nonunion, nine cases of skin necrosis, seven cases of pressure sores, and three cases of limb deformity, with a total of 22 cases and an incidence rate of 5.29%, the difference between the two groups was statistically significant (χ2 = 4.916, P = 0.027). Conclusion: Bone traction combined with small splint external fixation has shown remarkable efficacy in the treatment of tibiofibular fractures, which can not only quickly stabilize the fracture end, reduce pain, and promote fracture healing, but also reduce the occurrence of complications and shorten the treatment period.

Influence and risk factors of lateral hinge fracture on early effectiveness of supramalleolar osteotomy

To evaluate the influence of lateral hinge fracture (LHF) on the early effectiveness of supramalleolar osteotomy (SMO) and to explore the related risk factors for LHF. A total of 39 patients (39 feet) with varus-type ankle osteoarthritis treated with SMO between January 2016 and December 2022 were analyzed retrospectively. There were 10 males and 29 females, aged from 41 to 71 years (mean, 57.7 years). According to Takakura stage, there were 6 feet in stage Ⅱ, 19 feet in stage Ⅲa, and 14 feet in stage Ⅲb. The LHF was recognized by the immediate postoperative X-ray film. The osteotomy healing time and the changes of pain visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, tibial anterior surface angle (TAS), tibial lateral surface angle (TLS), and tibiotalar angle (TT) before and after operation were compared between patients with and without LHF. The age, gender, affected side, body mass index, Takakura stage, preoperative VAS score, preoperative AOFAS score, preoperative TAS, preoperative TLS, preoperative TT, SMO correction angle, osteotomy distraction, distance from medial osteotomy to ankle joint line (MD), and distance from lateral osteotomy to ankle joint line (LD) were compared between with and without LHF patients, and further logistic regression analysis was used to screen the risk factors of LHF during SMO. All patients were followed up 12-54 months (mean, 27.1 months). During operation, 13 feet developed LHF (group A) and 26 feet did not develop LHF (group B). X-ray film reexamination showed that 1 patient in group A complicated with tibial articular surface cleft fracture had delayed osteotomy and healed successfully after plaster fixation; the osteotomy of other patients healed, and there was no significant difference in healing time between the two groups ( P>0.05). At last follow-up, there were significant differences in VAS score, AOFAS score, TAS, TLS, and TT of the two groups when compared with preoperative ones ( P<0.05), but there was no significant difference in the changes of above indicators before and after operation between the two groups ( P>0.05). The differences in SMO correction angle, osteotomy distraction, and LD between with and without LHF patients were significant ( P<0.05), and further logistic regression analysis showed that excessive LD was the risk factor of LHF during SMO ( P<0.05). Too high or too low lateral hinge position during SMO may lead to LHF, but as long as appropriate treatment and rehabilitation measurements are taken, the early effectiveness is similar to that of patients without LHF.

Congenital dislocation of the knee complicated with bilateral hip dislocation: a case report and literature review

BackgroundCongenital dislocation of the knee is characterised by excessive knee extension or dislocation and anterior subluxation of the proximal tibia, and this disease can occur independently or coexist with different systemic syndromes. Nevertheless, significant controversy surrounds treating this disease when combined with hip dislocation. This paper presents a case of a 4-month-old patient diagnosed with bilateral hip dislocation combined with this disease. The study discusses the pathophysiology, diagnosis, and treatment methods and reviews relevant literature.Case presentationWe reported a case of a 4-month-old female infant with congenital dislocation of the right knee joint, which presented as flexion deformity since birth. Due to limitations in local medical conditions, she did not receive proper and effective diagnosis and treatment. Although the flexion deformity of her right knee joint partially improved without treatment, it did not fully recover to normal. When she was 4 months old, she came to our hospital for consultation, and we found that she also had congenital dislocation of both hip joints and atrial septal defect. We performed staged treatment for her, with the first stage involving surgical intervention and plaster orthosis for her congenital dislocation of the right knee joint, and the second stage involving closed reduction and plaster fixation orthosis for her congenital hip joint dislocation. Currently, the overall treatment outcome is satisfactory, and she is still under follow-up observation.ConclusionsEarly initiation of treatment is generally advised, as nonsurgical methods prove satisfactory for mild cases. However, surgical intervention should be considered in cases with severe stiffness, unresponsive outcomes to conservative treatment, persistent deformities, or diagnoses and treatments occurring beyond the first month after birth.

Correlation analysis between Pirani score and talo-navicular angle,calcaneo-cuboid angle and tibio-calcaneall angle of infant clubfoot under ultrasound

Objective: To explore the evaluation effect of ultrasonography and Pirani score on tarsal deformity, treatment effect and pseudo-correction of congenital clubfoot in infants and young children, and the correlation between the two methods. Methods: This is a retrospective case series study. The clinical data of 26 children (40 feet) with congenital clubfoot who were evaluated by ultrasonography in the Third Affiliated Hospital of Zhengzhou University from January 2020 to January 2023 were retrospectively collected. There were 16 males and 10 females. The age at the first ultrasound examination was (M(IQR)) 9.0 (18.0) days (range: 1 to 46 days). All patients were treated with Ponseti method by the same physician. The Pirani scores before and after treatment and at the last examination, and the talonavicular angle, calcaneocuboid angle and tibiocalcaneal angle measured by ultrasound were collected, and the treatment and follow-up were recorded. Paired sample t test, repeated measures analysis of variance or Kruskal-Wallis test were used for data comparison, and Spearman correlation analysis was used for correlation analysis. The receiver operating characteristic curve was used to calculate the efficacy of ultrasound in evaluating different Pirani scores. Results: The number of plaster fixation in 26 children was 4.0 (1.0) times (range: 2 to 8 times). The medial talonavicular angle and posterior tibiocalcaneal angle were significantly improved after treatment and at the last follow-up compared with those before treatment, and the differences were statistically significant (all P<0.01). There was no difference in lateral calcaneocuboid angle before and after treatment and at the last follow-up (F=1.971, P>0.05). Pseudo-correction occurred in 2 cases (2 feet) during the treatment, with an incidence of 5%. Correlation analysis showed that there was a moderate positive correlation between talonavicular angle and Pirani midfoot score (r=0.480, P<0.01). There was no correlation between calcaneocuboid angle and Pirani midfoot score (r=0.114, P=0.105). There was a moderate negative correlation between tibial heel angle and Pirani hindfoot score (r=-0.566, P<0.01). The cut-off point of Pirani midfoot score of 1.5 was 38.78°, the sensitivity was 0.90, the specificity was 0.56, and the area under the curve was 0.75. The cut-off value of angle was 27.51 °, the sensitivity was 0.16, the specificity was 0.92, and the area under the curve was 0.44.The cut-off points of Pirani midfoot score of 3.0 were 45.08°and 9.96°, the sensitivity was 0.94 and 0.91, the specificity was 0.37 and 0.42, and the area under the curve was 0.59 and 0.62, respectively. The cut-off values of Pirani hindfoot score of 2.0 and 3.0 were 167.46° and 160.15°, respectively. The sensitivity was 0.75 and 0.67, the specificity was 0.81 and 0.83, and the area under the curve was 0.78 and 0.71, respectively. Conclusion: Ultrasound can complement with Pirani score, visually and dynamically observe the morphology and position changes of talonavicular joint, calcaneocuboid joint and tibiotalocalcaneal joint, monitor the recovery and pseudo-correction of tarsal bones, and better evaluate the therapeutic effect.

Comparison And Analysis of Treatment Strategies for Radius Fractures: Internal Fixation Surgery Versus External Plaster Fixation Treatment

One of the most frequent forms of fractures is the radius fracture. This kind of fracture would have a significant negative impact on people's lives. There has been ongoing debate regarding the treatment options for radius fractures. This article conducts a comparative analysis of two treatment approaches for radius fractures: internal fixation surgery and non-surgical external plaster fixation treatment. This article provides a comprehensive elucidation and analysis of the principles, actual treatment outcomes, and various factors associated with these two treatment approaches. It separately outlines the treatment principles and real-world results for each of the two treatment methods, concluding with a summary and comparison. When viewed from a singular perspective, both treatment approaches demonstrate reasonable and excellent treatment outcomes. However, when these two approaches are compared, this article finds that surgical internal fixation typically outperforms non-surgical cast external fixation in a broader range of evaluations.

Transgluteal Ultrasonography in Spica Cast in the Post-reduction Assessment of Hip Developmental Dysplasia

Concentric circle reduction is one of the outcomes after reduction of developmental dysplasia of the hip (DDH). Radiography and magnetic resonance imaging (MRI) are used to confirm the reduction results. In this study, we evaluated the reduction results of the coronal section of the hip using transgluteal ultrasonography. We enrolled 46 children admitted to our hospital for closed or open reduction plaster fixation of DDH between January 2021 and December 2022. Thirty-eight patients had unilateral DDH, and eight patients had bilateral DDH. Transgluteal ultrasonography, radiography and MRI were done on the patients during the 7 d after reduction, and the results were interpreted by different radiologists. The covering of the femoral head and the distance between the medial margin of the femoral head and the acetabulum (HSD) were measured after calculating the maximum coronal surface of the iliac bone. MRI is regarded as the gold standard for determining hip reduction or dislocation. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of ultrasound and radiography were determined and compared. The sensitivity, specificity, PPV and NPV of transgluteal ultrasonography were 100% (confidence interval [CI]: 69.2%-100%), 97.7% (CI: 88%-99.9%), 90.9% (CI: 59%-98.6%) and 100%, respectively, higher than those of radiography, which were 50% (CI: 18.7%-81.3%), 86.4% (CI: 72.6%-94.8%), 45.5% (CI: 24%-68.7%) and 88.4% (CI: 80.2%-93.5%), respectively. Ultrasonography had a higher sensitivity (100% vs. 50%, p < 0.01) and positive predictive rate (90.9% vs. 45.5%, p < 0.01) than radiography. Ultrasonography revealed that a distance between the head and socket (HSD) >8 mm indicated a strong suspicion for a poor reduction. Transgluteal coronal ultrasound scan with semiquantitative assessment of acetabular femoral head coverage and measurement of HSD can effectively monitor the reduction relationship between the two in children after DDH reduction.

Research on Sports Injuries in Competitive Aerobics

As a branch of gymnastics, competitive aerobic gymnastics has not received the same attention as artistic gymnastics, rhythmic gymnastics, trampoline and acrobatic gymnastics. So, although aerobic gymnasts also face a variety of sports injuries, relatively little research has been done on them. This study searched relevant literature from two electronic databases (SPORTDiscus and PubMed) to integrate and analyze information related to sports injuries and treatment options for aerobic gymnasts. The study found that aerobic gymnasts suffered injuries mainly in the back, wrists and shoulders. There have been relatively comprehensive conservative and surgical treatment plans for the wrist and shoulder, among which the conservative plan for the wrist is mainly splinting or plaster fixation, and the conservative treatment of the shoulder injuries is rehabilitation training. There is no consensus on the most effective treatment for back injuries caused by isthmus. This study hopes to draw the public's attention to aerobic competitive gymnastics.

Comparing Conservative Treatment of Distal Ulna Fractures with Operative treatment

Objective: To compare the outcome of conservative treatment of distal ulna fractures with operative treatment Study design: A randomized control trial Place and duration: This study was conducted at Muhammad Medical College and Hospital Mirpurkhas from September 2021 to September 2022 Methodology:Patients with different types of ulnar fractures (base fractures, head fractures, and subchondral fractures) were divided into two groups based on a systematic approach that established the course of treatment for forearm fractures. The fractures of the distal radius in Group A were treated with plating osteosynthesis, while the fractures of the distal ulna were taken care of with a surgical procedure involving the implantation of an LCP Distal Ulna Plate (De PuySynthes, USA) Results: A total of 120 patients were enrolled in the study, 8 of whom had to be excluded due to the development of carpal ligament damage symptoms. The 112 patients who remained were divided into three groups: 36 in group A, 42 in group B, and 34 in group C. The results of distal forearm fractures were initially treated with closed repositioning in local anesthesia and plaster fixation in 89 cases. In 10 cases, external fixation was primarily applied due to soft tissue conditions. The definitive surgical procedure was performed on average 10 days (3-19) from the injury. In group A, osteosynthesis of both bones was performed during one operation in 30 patients. In 7 cases, it was necessary to perform a two-phase procedure due to the state of the soft tissues. Conclusion: Based on the study's results, osteosynthesis is the more successful treatment for sub-capital fractures, as it results in better early outcomes than a conservative approach. However, due to the low number of patients with this type of fracture, it is impossible to make definitive treatment recommendations Keywords: distal ulnar fracture, osteosynthesis, conservative treatment

Adjustable-Loop Cortical Button Fixation Results in Good Clinical Outcomes for Acute Tibial Avulsion Fracture of the Posterior Cruciate Ligament

To evaluate the clinical outcomes for arthroscopic treatment of acute posterior cruciate ligament (PCL) avulsion fractures with adjustable-loop cortical button fixation device. Patients with PCL tibial avulsion fractures treated with an adjustable-loop cortical button fixation device between October 2019 and October 2020 were retrospectively identified. Patients with type 1 were treated using plaster fixation as a conservative treatment, whereas patients with type 2 and 3 with displacement were treated using an arthroscopic adjustable-loop cortical button. Operating time, incision recovery, complications, and postoperative fracture healing time were monitored. All patient follow-up was done at 12 months' postoperatively. Lysholm Knee Score and the International Knee Documentation Committee score were used to assess knee function. A total of 30 patients were included in the study (20 male/10 female; mean age 45.5 years, range 35-68 years). The mean operative time was 67.5 minutes (range: 50-90 minutes). The postoperative incision healed at stage A without complications, such as medically induced vascular nerve injury, intra-articular hematoma, or infection. All 30 patients were tracked postoperatively for 12 to 14 months, with a mean follow-up period of 12.6 months. The Lysholm knee function score was 45.93 ± 6.15 before surgery and 87.10 ± 3.71 at 12 months after surgery, and the International Knee Documentation Committee score was 19.27 ± 4.40 before surgery and 95.47 ± 1.87 at 12 months after surgery, with a statistically significant difference. The treatment of PCL avulsion fractures with arthroscopic adjustable-loop cortical button fixation is easy to perform and shows good clinical results in our study. IV, therapeutic case series.

Effect analysis of different methods on radial neck fracture in children

To analyze the curative effect of varying treatment types in 75 pediatric cases of radial neck fracture and explore the prognosis-related factors. Clinical data of 75 children with radial neck fractures treated in our hospital from January 2015 to December 2016 were retrospectively collected. The relationship between age, fracture type, treatment method, X-ray examination after reduction, and prognosis was analyzed. Age was related to prognosis. The excellent and good rate of treatment was 89.25% for children with age ≤ 10 and 57.89% for children over 10 years old. The type of fracture was closely related to the curative effect, 95.0% of O’Brien type I fractures had good curative effects, and the excellent and good rates of O’Brien II type and III type fractures were 87.0 and 66.7%, respectively. According to the type of fracture, the excellent and good rate of patients treated with plaster fixation was the highest (96.42%), but the excellent and good rate was 72.3% in the patients who needed to be reduced by Kirschner wire or elastic intramedullary nail. Although open reduction is superior to closed reduction in imaging evaluation, the excellent and good rate is only 50%.The prognosis of children with radial neck fracture is related to age, type of fracture, and treatment method. In pediatric patients less than 10 years with light, shifted fractures, the excellent and good prognosis rate is higher with less operative intervention. We recommend treating patients with closed reduction and elastic nail fixation according to different fracture types.

Clinical Features and Surgical Strategies of Distal Radius Posttraumatic Deformity.

Objective To investigate the clinical features and surgical strategies of distal radius posttraumatic deformity. Methods A retrospective analysis was performed on the data of 30 patients with distal radius posttraumatic deformity treated by osteotomy and orthopedic surgery in the department of orthopedics, the First Affiliated Hospital of Nanjing Medical University, from February 2016 to November 2018. All the patients underwent preoperative anterior and lateral X-ray plain scanning of bilateral wrist joints, showing different degrees of radius shortening, inferior ulnar and radial mismatch, palmar angle, and ulnar deviation angle, among which 11 patients had an uneven joint surface. After a full evaluation, osteotomy and orthopedic surgery were performed to restore the original anatomical structure, plaster fixation was performed for two weeks after surgery, and regular outpatient follow-up was conducted. The function of the wrist was evaluated by the MMWS (wrist joint improvement) scoring scale before and after surgery, and the changes in the wrist joint-related treatment parameters were evaluated according to X-ray. Results All 30 patients had no neurological symptoms after surgery, and all wounds healed within the first stage. All patients were followed up for 6–12 months, with an average healing time of 3.5 months. There was no reduction loss, internal fixation loosening, or fracture in the regular postoperative review. Postoperative MMWS (wrist joint improvement) score scale data were significantly higher than those before surgery, and there were differences between groups (P < 0.05). Postoperative treatment parameters of wrist joints such as palmar inclination angle, ulnar deviation angle, radius height, and lower ulnar and radial matching were significantly improved, and there were differences between groups (P < 0.05). Conclusions The patients with distal radius posttraumatic deformity have the clinical characteristics of shortening of radius, mismatch of lower ulnar and radius, an abnormal inclination of palm, and ulnar declination. For patients with distal radius posttraumatic deformity, osteotomy and orthopedic surgery can effectively improve wrist function and improve patients' quality of life, which is worthy of clinical reference.

Risk factors for re-dislocation after closed reduction in children with developmental dysplasia of the hip.

To investigate the risk factors for re-dislocation after the closed reduction in children with developmental dysplasia of the hip (DDH). The clinical data of 88 children aged ≤ 18 months with DDH (103 hips) who were treated with adductor muscle relaxation + closed reduction + plaster fixation at the Children's Hospital, Zhejiang University School of Medicine from January 2015 to December 2017, were retrospectively analyzed. According to the diagnostic criteria of hip dislocation, patients were divided into two groups: reduction group and re-dislocation group. The univariate and multivariate logistic regression analysis were applied to identify the risk factors for the re-dislocation of children. Eighty-six patients (99 hips) successively underwent the treatment. 69 hips were fixed at the first intention, 9 hips at the second intention, and a total of 78 hips with no re-dislocation occurred till the last follow-up with a rate of 78.8%. The univariate analysis showed that preoperative acetabular index (AI), International Hip Dysplasia Institute (IHDI) grade, intraoperative hip flexion angle, and intraoperative head-socket spacing were significantly related to the occurrence of re-dislocation after closed-reduction. The multivariate logistic regression analysis showed that preoperative AI > 40.5° ( OR=5.57, P<0.01), flexion angle < 80.5° ( OR=4.93, P<0.01) and head-socket distance > 6.95 mm ( OR=8.42, P<0.01) were risk factors for the re-dislocation. The area under the receiver operator characteristic curve was 0.91 when preoperative AI > 40.5°, flexion angle < 80.5°, head-socket distance > 6.95 mm, and IHDI grade were used to predict the occurrence of re-dislocation, and the sensitivity and specificity were 0.72 and 0.87, respectively. Preoperative AI > 40.5°, intraoperative hip flexion angle < 80.5°, and head-socket distance > 6.95 mm are risk factors for postoperative re-dislocation in children with DDH. These risk factors combining with the IHDI grade would be better to predict the occurrence of re-dislocation.

Comparison of arthroscopic internal drainage and open excision for the treatment of popliteal cysts

BackgroundThe purpose of this study was to introduce the arthroscopic internal drainage with anterior-anteromedial approach for the treatment of popliteal cysts in children. To compare its clinical efficacy with open surgery.MethodsThis was a retrospective case–control study of 102 patients diagnosed with popliteal cysts from January 2018 to February 2020 who received surgery. The study included 27 cases with minimally invasive group (MI group) and 75 cases with open surgery group (OS group). The MI group included 21 males and 6 females, age 6.71 ± 2.16 years who received arthroscopic internal drainage of the cysts to adequately widen the valve opening between the cyst and the articular cavity, excised the fibrous diaphragm without complete excision of the cyst wall. The OS group included 57 males and 18 females, age 6.21 ± 1.67 years who received open excision. The clinical parameters regarding the preoperative characteristics and surgical results were compared. Ultrasound or MRI was used to identify the recurrence of the popliteal cysts. Rauschning-Lindgren grade was recorded to evaluate the clinical outcome.ResultsAll patients were followed up for at least 24 months. There were no significant differences between the two groups in age, gender, left and right sides, disease time, cyst size, length of hospitalization, preoperative Rauschning-Lindgren grade (p > 0.05). At the last follow-up, the preoperative and postoperative Rauschning-Lindgren grade was improved in both groups. Compared with the OS group, operation time was significantly shortened in the MI group (28.89 ± 4.51 min vs 52.96 ± 29.72 min, p < 0.05). The MI group was superior to the OS group in terms of blood loss and plaster fixation, with statistical significance (p < 0.05). There was obvious difference in recurrence rate between the two groups (0% vs 17.33%, p = 0.018). No postoperative complications occurred during the follow-up period.ConclusionsCompared with open excision, the treatment of popliteal cyst in children by arthroscopic internal drainage to expand the articular cavity and eliminate the “one-way valve” mechanism between the cyst and the articular cavity exhibits better clinical outcomes and significantly reduces the recurrence rate, which is worthy of further clinical promotion.

The Efficacy of Targeted Perioperative Management for Diabetic Patients with Traumatic Calcaneal Fractures.

Objective To assess the efficacy of targeted perioperative management for diabetic patients with traumatic calcaneal fractures. Methods Between April 2020 and December 2020, 100 diabetic patients with traumatic calcaneal fractures treated in our institution satisfying the inclusion criteria were enrolled and assigned to receive either conventional treatment with surgery or plaster fixation (observation group) or targeted treatment with surgery or plaster fixation (experimental group) via the random number table method, with 50 patients in each group. All eligible patients were followed up for 1 year postoperatively. Outcome measures included length of hospital stay, recovery time, fracture healing, duration of postoperative wound drainage, complication rate, blood glucose, and treatment satisfaction. The Maryland score was used for the assessment of foot function. Results The duration of postoperative wound drainage, length of hospital stay, and recovery time in the experimental group (3.63 ± 1.04 d, 12.13 ± 3.77 d, and 111.22 ± 16.24 d) were significantly shorter than those in the observation group (5.71 ± 2.34 d, 15.28 ± 4.42 d, 123.10 ± 22.82 d) (P < 0.01). The experimental group obtained a markedly higher complete healing rate versus the observation group (P < 0.001). A significantly lower complication rate was observed in the experimental group than in the observation group (P < 0.05). The Maryland scores results were dichotomized into good (≥75 points) and poor (<75 points). The experimental group showed significantly higher Maryland scores good rate and treatment satisfaction versus the observation group (P < 0.01). The experimental group patients were associated with better postoperative fasting glucose and 2 h postprandial glucose versus those in the observation group (P < 0.05). Conclusion Targeted treatment in the perioperative management of diabetic patients with traumatic calcaneal fractures significantly promotes the recovery of patients, reduces the incidence of complications, increases treatment satisfaction, and ameliorates the doctor-patient relationship.

An Analysis of the Clinical Efficacy of Early Dynamic Orthosis after Finger Extensor Digitorum Rupture.

Objective The main objective is to compare the clinical efficacy of the early use of dynamic orthosis in patients with a finger extensor digitorum rupture. Methods A total of 50 patients with hand and foot trauma who received surgical treatment in our hospital from March 2017 to February 2021 were selected, and two patients were excluded from the study. The patients were randomly divided into two groups. The control group (group A) was treated with plaster fixation and routine rehabilitation, and the study group (group B) underwent dynamic low-temperature thermoplastic plate fixation and routine rehabilitation. Total active motion (TAM) and total passive motion (TPM) of the injured finger before treatment, one month after treatment, two months after treatment, and after corrective treatment were compared. Results After treatment following a finger extensor digitorum rupture, the TAM and TPM of the injured fingers increased significantly in both groups. The TAM and TPM in group B were significantly better than those in group A after one and two months of treatment (P < 0.05). After two months of treatment, the rates of improvement in TAM and TPM in group B were significantly higher than those in group A. Conclusion The early use of dynamic orthosis can significantly improve the motor function and motion amplitude of the injured finger, increase the elasticity and extension of the finger extensor digitorum, and promote the recovery of muscle strength. It is an effective corrective method for tendon contracture after finger extensor digitorum rupture and has great value in clinical application.

The problem of osteoporotic fractures of the femur in children with cerebral palsy

The problem of osteoporotic fractures of the femur in children with cerebral palsy

Risk Analysis of Re-displacement After Conservative Treatment of Pediatric Unstable Fractures of Middle and Distal Forearm

Background: Fractures of the middle and distal diaphysis of the forearm are common in children. Conservative treatment is effective in this regard. Some studies have discussed the risk factors and predictive indicators of re-displacement; however, the objects of the study are all fixed with tubular plaster or double sugar splint. Objectives: This study was performed to determine the risk factors of re-displacement after closed reduction and double splint plaster fixation of unstable pediatric fractures of the middle and distal diaphysis of the forearm. Methods: This retrospective study was conducted on 57 patients undergoing closed reduction and plaster fixation after unstable diaphyseal fractures of the middle and distal forearm in Wuxi Children's Hospital of Nanjing Medical University within May 2014 to May 2020. A total of 35 male and 22 female subjects aged 6 - 9 years (average: 7.3 years) participated in this study. They were followed up for more than 6 weeks after fracture healing. According to whether experiencing a secondary displacement within 2 weeks after the fracture, the subjects were divided into two groups, namely displacement, and non-displacement. Gender, age, double fracture, reduction quality, and plaster fixation type were analyzed as relevant, effective factors. Results: All 57 patients were followed up, and all fractures reached clinical healing standards at the last follow-up. Moreover, 20 and 37 cases were in the shift and non-shift groups, respectively. No statistically significant difference was reported in gender (c2 = 0.168; P = 0.780), age (t = 1.003; P = 0.217), double fracture (c2 = 0.021; P = 1), and plaster fixation type (c2 = 0.416; P = 0.699) between the two groups. The reduction quality (c2 = 7.480; P = 0.025) showed a statistically significant difference. Binary logistic regression analysis showed that reduction quality was a risk factor for fracture relocation providing a predictive value. Conclusions: Good reduction quality can reduce the risk of fracture displacement.

Clinical effects of bridge-type continuous negative pressure suction in postoperative fixation of upper limb soft tissue defect wound repaired with pedicled abdominal flap

Objective: To observe the clinical effects of bridge-type continuous negative pressure suction in postoperative fixation of upper limb soft tissue defect wound repaired with pedicled abdominal flap. Methods: The retrospective observational study was conducted. From April 2018 to October 2020, ninety-five patients who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 55 males and 40 females, aged 5-78 years, with a defect wound area of 82 (9, 216) cm2. All patients underwent abdominal flap repair for soft tissue defects of hand and forearm. According to the different fixation methods adopted in the operation area, the patients were divided into negative pressure group (n=48) and plaster group (n=47). Wounds of the injury sites of patients in the 2 groups were repaired by flap transplantation after debridement. The negative pressure suction device was placed after dry gauze dressing to form a "bridge" to fix the affected upper limb and chest and abdomen in negative pressure group. Patients in plaster group were treated with conventional dry gauze matting and plaster fixation. On post surgery day (PSD) 1, 3, 5, 7, and 14, flap blood circulation and pain intensity of patients in the 2 groups were calculated by self-made blood flow scoring scale and Changhai Pain Ruler, respectively. On PSD 5, the common complications in operative area and surrounding skin were observed and their incidences were calculated. On PSD 7, satisfaction degree of patients was scored. During follow-up of one month after pedicle division, the appearance and functional recovery of the affected limb were observed. Data were statistically analyzed with analysis of variance for repeated measurement, independent samples t est, Cochran & Cox approximate t test, chi-square test, and Wilcoxon rank-sum test. Results: On PSD 1, 3, 5, 7, and 14, the flap blood circulation scores of patients in negative pressure group did not change significantly, while that of patients in plaster group showed a time-dependent decrease, and the flap blood circulation scores of patients in negative pressure group were significantly higher than those in plaster group (t=2.259, 2.552, 2.784, 2.821, 3.003, P<0.05 or P<0.01). There were no significant changes in the pain intensity scores of patients in negative pressure group, while those of patients in plaster group increased in a time-dependent manner, and the pain intensity scores of patients in negative pressure group were significantly lower than those in plaster group (t=-4.818, -4.944, -5.011, -5.976, -6.721, P<0.05). On PSD 5, the incidences of common complications in operative area and surrounding skin of patients in negative pressure group were significantly lower than those in plaster group (χ2=6.773, 5.269, P<0.05 or P<0.01). On PSD 7, the satisfaction score of patients in negative pressure group was 14.7±1.1, which was significantly higher than 7.4±1.8 in plaster group (t=23.934, P<0.01). During follow-up of one month after pedicle division, the appearance and function of the affected limb of patients in the 2 groups recovered well. Conclusions: After repairing the upper limb soft tissue defect wound with pedicled abdominal flap, the bridge-type continuous negative-pressure suction fixation can effectively immobilize the affected limbs, chest and abdomen, reduce the incidence of common complications in the operative area and surrounding skin, relieve the pain of immobilization of patients, improve the blood circulation of flap and patient's satisfaction. Thus, it is an effective, portable, comfortable, and easy-to-operate method.

Preliminary analysis of the clinical characteristics of 1 012 patients with secondary lower limb deformity of spina bifida from QIN Sihe Orthopedic Surgery Case Data between October 12, 1986 and December 31, 2020

To analyze the characteristics of patients with secondary lower limb deformity of spina bifida based on the QIN Sihe Orthopedic Surgery Case Data, and provide the references for clinical research, diagnosis, and treatment. A clinical data of 1 012 patients with secondary lower limb deformity of spina bifida between October 12, 1986 and December 31, 2020 selected from QIN Sihe Orthopedic Surgery Case Data was retrospectively analyzed. Among them, 231 cases (22.83%) had undergone orthopedic surgery for lower extremity deformities in other hospitals. The gender, age at surgery, indicators related to spina bifida (deformity side, comorbidity, sensory disturbance level), and information related to surgery (operating time, surgical site, postoperative fixation method) were analyzed. Of the 1012 patients, 457 were males and 555 were females. The age was 3-51 years at the time of surgery, with a median of 18.0 years; among them, the 15-30 years old group had the most patients, accounting for 53.16%. Most deformities involved both lower limbs (652 cases, 64.43%). There were 111 cases of ulcers in the weight-bearing area of the foot, 265 cases of gatism, 554 cases of sensory disturbance, and 85 cases of abnormal hair on the waist. From 2010 to 2019, there were significantly more patients undergoing surgery than before 2010, reaching 61.17%. Sensory disturbances mostly occurred in the ankle and foot. A total of 1 149 sites were treated with surgery, of which the most ankle joint deformities were corrected by surgery, accounting for 84.33%. The main fixation methods after orthopedic surgery were external fixation, including Ilizarov external fixation (442 cases), combined external fixation (315 cases), and plaster fixation (189 cases). Spina bifida can be secondary to severe deformities of the lower limbs, mainly in the ankles. Common complications include ulcers in the weight-bearing area, dysfunction of urine and feces, and sensory disturbances; external fixation is the main method of fixation after surgery.

Design and Research of Wrist-Assisted Recovery Robot Hand

With the gradual development of the times, people’s material life has been greatly improved. All kinds of sports have become an indispensable part of people’s life, but sports are always accompanied by certain risks. People injured by sports show an increasing trend every year. However, it can be found that among many rehabilitation instruments, there is not much research on wrist rehabilitation instruments, which leads to the restoration of bandage splint or plaster fixation in most of the time. These traditional methods have the problems of slow recovery cycle, difficult disassembly and complex replacement. At the same time, most of the wrist rehabilitation instruments that have been developed are large and medium-sized instruments, which can not be carried, can not play a real-time protective role, and can not be well applied to daily life. Therefore, a wearable periodic recovery robot with traditional strap splint, modern transmission and flexible positioning is proposed.