Treatment Of Limb Fractures Research Articles

Observation of the Effect of Locking Compression Plate in the Treatment of Limb Fractures

Observation of the Effect of Locking Compression Plate in the Treatment of Limb Fractures

Clinical Efficacy Analysis of Locking Compression Steel Plate in the Treatment of Limb Fracture

Clinical Efficacy Analysis of Locking Compression Steel Plate in the Treatment of Limb Fracture

Treatment of limb fractures in children with multiple and concomitant injuries

Experience in treatment of bone fractures in 105 patients with multiple and concomitant traumata is presented. There were 228 limb bones fractures. In 64 patients (61 %) conservative treatment including closed reposition, plaster immobolization, skeletal traction was used. Forty one patients (39%) were treated surgically, mainly by extrafocal osteosynthesis with external rod fixatives elaborated in our clinic. In the majority of patients (72%)) osteosynthesis was performed within the period from 4 to 7 days after trauma. In patients with crus and femur fractures the surgical treatment efficacy (by 100 points scale) for femur fractures was 37.9%), for crus fractures - 48.2%). In cases of combination of shoulder and forearm fractures the surgical efficacy treatment was 41.8%o and 42.3%o, respectively. In patients with unilateral femur and crus fractures the efficacy of treatment using rod fixatives made up 47.2%o. Efficacy was higher in all cases of extrafocal osteosynthesis as compared with traditional methods of treatment.

Clinical Efficacy and Safety of Locking Compression Plate in Treatment of Limb Fracture

Clinical Efficacy and Safety of Locking Compression Plate in Treatment of Limb Fracture

Clinical Effect Analysis of Locking Compression Plate in Treatment of Limb Fracture

Clinical Effect Analysis of Locking Compression Plate in Treatment of Limb Fracture

Plate Removal after Internal Fixation of Limb Fractures: A Retrospective Study of Indications and Complications in 48 Horses.

The aim of this study was to determine the indications for, and complications of, plate removal surgery in horses that underwent internal fixation of limb fractures. Medical records of horses presented to our hospital between 1990 and 2015 for the removal of plates after treatment of limb fractures were reviewed. Data collected at the time of initial presentation, including signalment, history, fracture features and treatment and information about the indications, timing and complications of implant removal were reviewed. The most common bones involved were the ulna (n = 19) and third metacarpal and metatarsal bones (n = 14). A total of 63 plates were removed from 48 horses during 53 separate surgeries, and the complication rate was 6/48; six horses had complications related to implant removal, which included persistent infection (n = 1) and refracture (n = 5). Complications related to implant removal were associated with comminuted fractures (p = 0.002), age > 3 years (p = 0.016) and the presence of surgical site infection (p = 0.001). Plate removal after fracture healing is necessary in patients with implant-associated clinical signs. There is a strong relationship between the complication rate and the degree of comminution of the original fracture, increasing age and the presence of surgical site infection. The surgeon must be aware of these risk factors when planning plate removal.

Efficacy of acetaminophen with and without oxycodone for analgesia in non-operative treatment of extremity fractures in adults: protocol for a double-blind randomized clinical trial

BackgroundOpioids and acetaminophen are both widely used to relieve pain after non-operative treatment of limb fractures, but evidence for the superiority of opioids versus acetaminophen is lacking. In this study, we aim to determine whether acetaminophen is non-inferior to the acetaminophen/oxycodone combination for pain relief after non-operative fixation of an extremity limb fracture. We hypothesize that acetaminophen is non-inferior to the acetaminophen/oxycodone combination.MethodsA double-blind randomized controlled trial will be conducted. Power analysis determined that 1226 participants will be needed (P <0.05, power 90%). Patients with acute limb fracture who receive non-operative treatment will be recruited and randomly allocated into two groups: the intervention group will receive oral oxycodone (10 mg) and acetaminophen (650 mg), and the control group will receive acetaminophen (650 mg) only. All participants will be instructed to take one pill of study medication on an as-needed basis and no more frequently than once every 8 h. The primary outcome measure will be scores on the 11-point Numeric Rating Scale (NRS-11) over 14 days. Secondary outcome measures are scores on the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), EuroQol five-dimension questionnaire (EQ-5D), self-rated satisfaction with the analgesia produced, self-reported nighttime sleep duration, number of intervention or control pills used, and total duration for taking intervention or control medication. Change of pain scores and the number of times that analgesic drugs were taken in the two groups will be statistically evaluated with Student t tests according to their fracture site.DiscussionThis study will be a randomized controlled trial that is adequately powered to test the hypothesis that acetaminophen is non-inferior to the combination of acetaminophen and oxycodone in relieving objectively measured pain after non-operative treatment of limb fractures in adults. It will hopefully provide a safe and effective analgesic plan for such patients.Trial registrationChiCTR registry: ChiCTR1800017015. Registered on July 8, 2018.

Effect of ultrasound transdermal delivery in children with swelling and pain after supracondylar fracture of the humerus

Objective To investigate the effect of ultrasound transdermal delivery in children with swelling and pain after supracondylar fracture of the humerus. Methods Totally 103 cases of humeral supracondylar fractures from January to June 2017 were divided into control group (50 cases) and experimental group (53 cases) by random number table method. The control group was treated with conventional detumescence and intravenous drug therapy,while the experimental group was given the local target ultrasonic percutaneous delivery in accordance with the doctor′s advice on the basis of routine treatment. By comparing the two groups in terms of postoperative pain, swelling relief, starting time for getting out of bed, hospitalization time, and parental satisfaction of children, we investigated the effect of ultrasonic ultrasound transdermal delivery on children with swelling and analgesia after supracondylar fracture of the humerus. Results Postoperative pain relief and swelling relief were significantly reduced in the experimental group compared with the control group, and the difference between the two groups was statistically significant (P<0.05).The time of starting to get out of bed activity and hospitalization were respectively (8.20 ± 0.25) hours and (5.12 ± 0.27) days, and the control group was (23.80 ± 0.15) hours, (7.35 ± 0.38) days, respectively.The comparison was statistically significant (t=24.241, 7.654, all P<0.05). The parents' satisfaction in the experimental group was very satisfied, relatively satisfied, basically satisfied and unsatisfied, respectively 88.68% (47/53), 7.55% (4/53), 3.77% (2/53), 0, the control group was 64.00% (32/50), 26.00% (13/50), 10.00% (5/50), 0(0/50), the difference between the two groups was statistically significant (χ2=5.294 2, P<0.05). Conclusions The accuracy of ultrasonic percutaneous local target placement for the treatment of supracondylar fractures of the humerus in children is effective in the intervention of pain and swelling, and the comfort is better. It is a new choice for the treatment of limb fractures with pain in children. Key words: Ultrasound drug iontophoresis treatment; Fracture; Swelling; Analgesia

Clinical observation of surgical treatment of limb fractures with locking and compression plate

Objective To observe the clinical effect of locking and compression plate in the treatment of limb fractures. Methods 80 patients with limb fractures were selected.According to the internal fixation method, the patients were divided into observation group and control group, 40 cases in each group.The observation group was treated with percutaneous compression and compression plate fixation.The control group was treated with plain plate fixation.The operation time, length of stay, postoperative bleeding and bone healing time, the clinical efficacy, joint function recovery and postoperative complications of the two groups were observed. Results In the observation group, the operation time was (94.61±3.84)min, which was significantly lower than (117.45±4.72)min in the control group(t=10.64, P<0.05), the hospitalization time was (13.91±4.82)d, which was significantly lower than (18.97±5.26)d in the control group(t=5.23, P<0.05), the postoperative bleeding volume was (91.48±14.52)mL, which was significantly less than (265.95±32.17)mL in the control group(t=17.49, P<0.05), the bone healing time was (14.64±3.91)d, which was significantly lower than (24.16±5.73)d in the control group(t=11.36, P<0.05). The excellent rate of clinical curative effect in the observation group was 92.5%, which was significantly higher than 82.5% in the control group(χ2=9.64, P<0.05). The excellent and good rate of joint function in the observation group was 95.0%, which was significantly higher than 80.0% in the control group(χ2=11.45, P<0.05). The incidence rate of complication in the observation group was 2.5%, which was significantly lower than 12.5% in the control group(χ2=10.57, P<0.05). Conclusion Locking compression plate internal fixation is effective in the treatment of limb fractures.It can shorten the time of bone healing, reduce postoperative complications and improve the safety of treatment.It is worthy of clinical application. Key words: Fractures, bone; Extremities; Fracture fixation, internal

Treatment of pediatric femoral and tibial fractures with titanium elastic nails

Objective To investigate the effect of intramedullary stabilization of lower limb fractures with titanium elastic nails (TENs) in children.Methods From June 2004 to October 2010,278 children were stabilized with TENs in our hospital,including 181 boys and 97 girlsat average age of 7.6 years (range,3.0-14 years).There were 162 patients with femoral fractures,of which 35 underwent open reduction and the rest closed reduction.There were 116 patients with tibial fractures,which was treated with closed reduction.Postoperative fixation lasted for 3-4 weeks.The mean hospital stay was seven days.Of all the patients,272 patients received the removal of the TENs six months after operation and 242 received more than one year of follow-up to have a further observation on the limb length,hip and knee mobility and gait condition in children.Results All the patients were followed up for 6-66 months (mean,33 months).All fractures were healed in good alignment without severe complications.There were no intraoperative complications like infections,delayed union,nonunion,TEN broken and femoral or tibial epiphysis injuries.Ten patients suffered from swell and skin irritation in the nail' s position 3-4 months after operation,and the nails were removed in advance.Nineteen patients showed unequal lengths ( within 1 cm) of the lower limbs,with normal function of the lower limb joint but with no obvious limp.According to the Flynn evaluation standard,the excellent and good rate was 100％.Conclusions Characterized by good stability,rapid healing,small incision,anatomic reduction,unimpaired periosteum,short hospital stay and few complications,intramedullary stabilization with titanium elastic nails can achieve effective fixation in the treatment of lower limb fractures in children. Key words: Fracture fixation, internal; Femoral fractures; Tibial fractures; Titanium elastic nails

Nursing care in the treatment of limb fracture with multifunctional extemal fixators

目的 探讨多功能外固定支架治疗四肢骨折患者的护理. 方法 根据骨折的三期的愈合过程,制定康复训练程序表,饮食营养处方,配合患肢肿痛护理,针眼护理,预防感染及关节僵硬,局部皮肤过敏反应等综合护理. 结果 提高了患者对自身骨折知识的知晓,促进护患关系的良好发展.通过护士对患者全面指导和护理,使患者最大限度的恢复四肢功能及生活能力. 结论 根据患者不同时期、不同部位进行全面、细致、准确、到位的护理,促进了多功能外固定支架治疗四肢骨折患者的康复。

Treatment of severe open limb fractures with vacuum sealing technique and external fixator

目的 探讨真空负压封闭技术(VS)加外固定器治疗四肢严重开放性骨折的效果.方法近4年来收治63例四肢严重开放性骨折患者,采用VS加外固定器治疗,清创后骨折用Orthofix单边外固定器固定,创面或创腔内用Vacuseal材料覆盖,接负压封闭吸引,6～10d后二期缝合、植皮或皮瓣转移.结果63例患者创面均愈合,浅表感染3例(4.8%)和针道感染13例19针(7.5%);骨折愈合53例(84.1%),延迟愈合或不愈合10例(15.9%).平均愈合时间6.5个月.结论VS技术结合外固定架固定治疗四肢严重开放性骨折,在迅速有效地稳定骨折的同时,能安全有效地封闭创面,缩短二期创面修复时间,促进骨折愈合,减少并发症;其方法简单有效,值得临床推广应用。

L’embrochage centro-médullaire coulissant dans l’ostéogenèse imparfaite: Quatorze cas avec un recul moyen de 8 ans

Purpose of the study Elastic sliding centromedullary nailing (ESCN) proposed by Métaizeau in 1987 for the prevention and treatment of limb fractures in osteogenesis imperfecta has never been evaluated. A multicentric serie was studied in order to evaluate results of these procedure. Material and methods Thirty-six ESCN procedures were performed in fourteen patients. Percutaneous pinning was used for the femur and distal tibia and arthrotomy for the distal femur as needed and in all cases for the proximal tibia. The pins were bent in compliance with the principles of the ESCN system. The ends of the pins were bent back to form a U pushed into the epiphysis. Reaxing osteotomies required minimal incisions. Age at the first procedure, the number of procedures and complications, and time between procedures were recorded. Pin overlap and the angle formed were also recorded. Pin gliding was evaluated. Ability to walk with or without assistance was noted. Results The medullary canal measured 4 to 10 mm. The first procedure was performed at a mean age of four years (range 15 days to 10 years). Follow-up was eight years (range 1-12). There were 2.5 procedures per patient (range 1-5). Pins had to be changed in 75% of the bone segments. Mean time between two procedures was 3.2 years. There were no cases of defective sliding or infection. There were four cases of secondary fracture with a mean 30% pin overlap, two pin migrations, one nonunion, and one shortening. The majority of the complications occurred after the age of five years. At last follow-up, three patients could not walk, four walked with aids, and eight without aids. Discussion The advantages of the technique (size of the pins, nailing without reaming, pin sliding in all cases, low cost) must not overshadow the drawbacks (risk of pin deformation and migration, secondary fracture). Secondary fractures might be limited by discrete valgus of the femoral shaft and preventive pin change when the angle formed approaches 30° and when there is only 30% overlap left. Use of telescopic nails before the age of five years increases the risk of complications while most of the complications observed with ESCN occur after the age of five years. Twenty-five percent of the ESCN complications involved only the femur. The percent of secondary fractures was less than with telescopic nailing (3.6% versus 11%) but there were more cases of nail migration. All pins slid, compared with 6% failure of elongation with telescopic nails. Although proof is not available, surgical treatment of osteogenesis imperfecta before the age of five years appears to provide more rapid functional progress. Conclusion Sliding centromedulary nailing is an attractive alternative before the age of five years. In older children and to the end of growth, telescopic nail or pinning should be discussed although pinning may permit more secondary fractures which can be limited by rigorous surveillance of pin position.

On the causes of unsuccessful outcomes in the treatment of closed limb fractures

In this article, I do not touch at all the causes of failure in the treatment of limb fractures, depending on the pathology of the body, and I mean to focus on the causes of failure, depending mainly on the attending staff and "partly on the attitude to the treatment of patients themselves. that unsuccessful outcomes in the treatment of limb fractures very often depend, firstly, on the wrongly chosen method of treatment, in other words, on the wrong indications for one method or another; secondly, on the wrong application of the chosen method and, finally, on underestimation of the subsequent follow-up treatment, which is almost always required for all methods of treating fractures in the form of baths, massage, gymnastics, in a word, mechano-therapy. These facts need to be emphasized; they play a prominent role in the failure reach colossal numbers (Hoff, Hanel, Kaufmann, Carlsson, Paul).