Gamma 3U-Blade系统与Gamma 3钉固定治疗老年不稳定型股骨转子间骨折的近期疗效比较北大核心CSCD

目的比较Gamma 3U-Blade系统与Gamma 3钉固定治疗老年不稳定型股骨转子间骨折的近期疗效。方法回顾性分析2018年6月至2020年12月期间华中科技大学同济医学院附属武汉市第四医院骨科收治的70例老年骨质疏松性不稳定型股骨转子间骨折患者资料。根据内固定方式不同分为两组:U-Blade组35例,男14例,女21例;年龄为(77.7±4.8)岁;采用Gamma 3 U-Blade系统固定治疗。传统组35例,男14例,女21例;年龄为(79.3±5.2)岁;采用传统Gamma 3钉固定治疗。比较两组患者的手术时间、术中出血量、尖顶距、骨折愈合时间、术后并发症发生情况,以及术后2周、3个月及6个月起立行走(TUG)试验时间、术后9个月髋关节功能等。结果两组患者术前一般资料的比较差异均无统计学意义(P>0.05),具有可比性。两组患者的手术时间、术中出血量及尖顶距比较差异均无统计学意义(P>0.05)。U-Blade组患者的骨折愈合时间为(12.0±0.2)周、术后9个月髋关节Harris评分为90(90,91)分,与传统组患者[(12.0±0.3)周、91(89,91)分]比较差异也无统计学意义(P>0.05)。U-Blade组患者术后内固定相关并发症发生率[0%(0/35)]显著低于传统组患者[17.1%(6/35)],术后2周、3个月TUG时间[(80.2±3.6)、45(43,49)s]显著短于传统组患者[(89.3±4.2)、56(54,59)s],差异均有统计学意义(P<0.05)。结论与传统Gamma 3钉相比,Gamma 3U-Blade系统固定治疗老年不稳定型股骨转子间骨折可以减少内固定相关并发症的发生,有利于患者早期行走功能的恢复。     

Matrix Cauterization With Silver Nitrate in the Treatment of Ingrown Toenails in Children: Pilot Study

BackgroundAlthough partial onychectomy with chemical matricectomy has been described as the treatment of choice, there is sparse evidence in the literature regarding the use of silver nitrate for matricectomy. Our aim is to describe the effectiveness of silver nitrate for matrix cauterization after partial onychectomy.MethodsA prospective observational study was performed on patients with ingrown toenails stage 2–3 who underwent partial onychectomy with silver nitrate chemical matricectomy during 2018–2019 in our institution. All patients were evaluated in the outpatient clinic on the 7th and 30th post-operative day and a telephone evaluation was performed every 6 months after the surgical procedure to date.ResultsOne hundred and twenty-three patients, who underwent 231 partial onychectomies with silver nitrate chemical matricectomy were included, with a median follow-up of 21 months (interquartile range, 12–29). The procedure had an effectiveness of 95.3%, with only 11 recurrences (4.7%) reported so far on follow-up. Postoperative infections were observed in 4 patients (1.7%). Adverse effects, such as pain and postoperative drainage, were irrelevant in most patients.ConclusionsSilver nitrate matricectomy after partial onychectomy is an effective and safe alternative for the treatment of ingrown toenail in children, with scarce postoperative morbidity and low recurrence rate.     

爱惜邦缝线联合高强缝线Rigidfix系统固定自体肌腱重建前交叉韧带的疗效比较

目的探讨爱惜邦缝线联合高强缝线Rigidfix系统固定自体肌腱重建前交叉韧带(ACL)的疗效。方法 2011年10月-2013年8月采用Rigidfix系统固定自体肌腱重建ACL 48例,25例移植肌腱采用高强缝线联合爱惜邦5号线编织缝合(观察组),23例移植肌腱单独采用爱惜邦5号线编织缝合(对照组)。两组性别、年龄、损伤侧别、病程及术前Lachman试验、Lysholm评分、国际膝关节文献委员会(IKDC)评分等一般资料比较,差异均无统计学意义(P0.05)。术后两组处理方法和康复措施一致。结果两组术程顺利,术中无血管、神经及半月板损伤,术后无供腱区疼痛、肌无力等并发症发生。两组术后6个月及2年Lachman试验、Lysholm评分和IKDC评分明显优于术前(P0.05),但两组间比较差异均无统计学意义(P0.05)。结论采用Rigidfix系统固定自体肌腱重建ACL时,运用高强缝线联合爱惜邦5号线对移植肌腱进行编织缝合能够获得良好的临床疗效,但术中是否有必要采用高强缝线尚需要进一步探讨。     

Emergency iliosacral screw fixation assisted by TiRobot for unstable posterior pelvic ring fracture北大核心CSCD

Objective To evaluate the emergency iliosacral screw fixation assisted by TiRobot for unstable posterior pelvic ring fracture. Methods The 26 patients with unstable pelvic fracture were analyzed retrospectively who had undergone emergency iliosacral screw fixation at Department of Orthopedics & Traumatology, Beijing Jishuitan Hospital from June 2018 to December 2020. They were divided into 2 groups depending on whether orthopaedic TiRobot was used to assist screw insertion. In the observation group of 14 cases subjected to TiRobot-assisted insertion of iliosacral screws, there were 10 males and 4 females with an age of (45.9 ± 10.1) years; in the control group of 12 cases subjected to conventional manual insertion of iliosacral screws, there were 9 males and 3 females with an age of (49.2 ± 11.3) years. All the surgeries were conducted within 24 hours after injury. The 2 groups were compared in terms of screw insertion time, pin insertion, intraoperative blood loss, fluoroscopy time, postoperative screw position, fracture reduction and Harris hip score at the final follow-up. Results The 2 groups were comparable because there was no significant difference between them in their preoperative general clinical data or follow-up time (P>0.05). The screw insertion time [(16.1 ± 3.4) min] and fluoroscopy time [(8.1 ± 3.3) s] in the observation group were significantly shorter than those in the control group [(26.4 ± 5.4) min and (25.2 ± 7.4) s], and the pin insertions [1 (1, 2) times] and intraoperative blood loss [(10.5 ± 6.4) mL] in the former were significantly less than those in the latter [6 (3, 8) times and (24.8 ± 6.7) mL] (all P<0.05). Postoperatively, the sacroiliac screw position was excellent in 18 cases and good in 2 in the observation group while excellent in 14 cases, good in 2 and poor in 2 in the control group; the fracture reduction was excellent in 12 cases, good in one and fair in one in the observation group while excellent in 10 cases, good in one and fair in one in the control group, showing insignificant differences in the above comparisons (P>0.05). There was no significant difference either in the Harris hip score at the final follow-up between the 2 groups (P>0.05). Conclusion Compared with conventional manual insertion of iliosacral screws, emergency iliosacral screw fixation assisted by TiRobot can effectively decrease surgical time and reduce operative invasion due to a higher accuracy rate of screw insertion. © 2022 Chinese Journal of Orthopaedic Trauma. All rights reserved.