中华创伤杂志最新文献

{"title":"Application of vacuum sealing drainage in limb salvage of multiple trauma patients with Gustilo type III C open fracture","authors":"Xiang Wang, Fan Yang, Jie Xie, Jia-jun Chen, Xian-zhou Song, Xiangjun Bai","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.07.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.07.012","url":null,"abstract":"Objective \u0000To investigate the safety and effectiveness of vacuum sealing drainage treatment on limb salvage in multiple trauma patients combined with Gustilo type IIIC fracture. \u0000 \u0000 \u0000Methods \u0000A retrospective case control study was conducted to analyze the clinical data of 102 patients diagnosed with multiple trauma combined with Gustilo type III C fracture admitted to Tongji Hospital from October 2005 to October 2015. There were 66 males and 36 females, aged 17-65 years [(34.2±10.1)years]. The injury severity score (ISS) ranged from 18 to 26 points [(19.8±3.2)points]. There were 34 patients with femur fracture, 66 with tibia/fibula fracture, 35 with femur and tibia/fibula fracture. Among the patients, 58 were treated with VSD (VSD group) and 44 were treated with routine dressing change after emergency operation (routine group). The two groups were compared for active bleeding, re-vascular exploration, osteofascial compartment syndrome, wound infection and necrosis, gas gangrene, delayed amputation, systemic inflammatory response syndrome (SIRS), sepsis, deep venous thrombosis (DVT) incidence, per capita debridement times, length of stay, skin graft/skin flap rate, fracture fixation rate, incidence of refractory wounds, incidence of nonunion, incidence of complete nerve damage, British medical research council (BMRC) score, and amputation rate/salvage rate. \u0000 \u0000 \u0000Results \u0000All patients were followed up for 6-14 months [(8.4±2.1)months]. There was no significant difference in limb salvage rate between the two groups after operation (P>0.05). Among the indexes of limb salvage treatment after operation, no significant differences were found between the routine group and VSD group in active bleeding, gas gangrene, re-vascular exploration and delayed amputation (P>0.05); the wound infection and necrosis rates were 32% and 15% (P<0.05); the incidence rates of osteofascial compartment syndrome were 22% and 7% (P<0.05). During the hospital stay, there were no significant differences in DVT incidence and fracture internal fixation rate between the two groups; SIRS incidence rates of routine group and VSD group were 92% and 73% (P<0.05); the incidence rates of sepsis were 28% and 10% (P<0.05); the per capita debridement times in routine group and VSD group were 4.2 times and 3.2 times, respectively (P<0.05); hospitalization durations were 42.1 days and 30.2 days (P<0.05); skin graft/skin flap rates were 69% and 46% (P<0.05). In the follow-up results, there was no significant difference in the amputation rate/salvage rate between the two groups (P<0.05). The incidence of refractory wounds was 28% in routine group and 10% in VSD group (P<0.05); the incidence of nonunion was 22% and 6% (P<0.05); the incidence of complete neurological damage was 36% and 12% (P<0.05); the excellent and good rate of BMRC score was 83% and 96% (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000VSD technology can promote wound healing after operation, prevent complications, reduce the number of debridement","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"647-652"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43668703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical guideline for perioperative management of acute spinal cord injury","authors":"Disease Prevention","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.07.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.07.001","url":null,"abstract":"The incidence of acute spinal cord injury is increasing year by year, but there still lacks clinical guideline for perioperative management. In order to provide a standardized management for the perioperative period of acute spinal cord injury, the specialists from Spinal Disease Prevention and Control Group, Spinal Cord Injury Disease Prevention Society of Chinese Preventive Medicine Committee and Basic Research Group, Spinal Cord Committee of Chinese Society of Rehabilitation Medicine have developed a guideline after retrieval of domestic and foreign literature, discussion and voting on the basis of practical and scientific principles. This guideline focuses on 12 perioperative management issues of acute spinal cord injury, involving admission evaluation, admission diagnosis, complications management, preoperative preparation, surgical indication, timing selection, surgical mode selection, complications management, pain management, drug treatment, rapid rehabilitation and nursing care. Based on evidence-based medicine, the aim of this guideline is to provide scientific advices for perioperative management after acute spinal cord injury so as to effectively improve the surgical treatment and prognosis of spinal cord injury. \u0000 \u0000 \u0000Key words: \u0000Spinal cord injuries; Perioperative care; Practice guideline","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"577-587"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45413312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of bone morphogenetic protein 2 on ossification of posterior longitudinal ligament and possible mechanism","authors":"Yuan He, Liang Yan, Liang Li, Songchuan Zhao, D. Hao, B. He","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.07.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.07.005","url":null,"abstract":"Objective \u0000To investigate the effect of bone morphogenetic protein 2(BMP2)on ossification of the posterior longitudinal ligament (OPLL) and its relationship with transforming growth factor-β (TGF-β)/Smad signaling pathway. \u0000 \u0000 \u0000Methods \u0000The expression vectors of wild type pcDNA3.1-BMP2 (WT), mutant pcDNA3.1-BMP2 (37G), mutant pcDNA3.1-BMP2 (190T) and mutant pcDNA3.1-BMP2 (37G/190T) were constructed and identified by agarose gel electrophoresis. The constructed vector was transfected into mouse embryonic fibroblasts C3H10T1/2 mediated by liposome to detect the expression of BMP2. Six groups were divided according to the transfection situation: (1) the non-transfection group; (2) empty vector pcDNA3.1 transfection group; (3) pcDNA3.1-bmp2 (WT) transfection group; (4) pcDNA3.1-bmp2 (37G) transfection group; (5) pcDNA3.1-bmp2 (190T) transfection group; (6) pcDNA3.1-bmp2 (37G/190T) transfection group. The experimental and control group were defined according to whether BMP2 polymorphism was included. Therefore, the non-transfection group and empty vector pcDNA3.1 transfection group were control groups, and the other groups were experimental groups. The expression of phosphorylated Smad1/5/8 and Smad4 in positive cell clones were detected by western blotting, and the alkaline phosphatase (ALP) was detected by quantitative detection kits. The protein expressions were compared among the experimental groups. \u0000 \u0000 \u0000Results \u0000Two fragments digested from pcDNA3.1-BMP2 represented 1.2 kb and 5.4 kb by agarose electrophoresis. The direct sequencing results were in accordance with target gene sequence. BMP2 gene was successfully transfected and stably expressed in C3H10T1/2 cells. Western blotting showed that the expression of phosphorylated Smad1/5/8 protein in the experimental groups was increased significantly after transfection, with significant difference between the experimental groups and the control groups (P 0.05). The expressions of Smad4 protein transfected by wild or mutation type pcDNA3.1-BMP2 were significantly higher than those in the control groups (P 0.05). However, there were significant differences between the two groups and other experimental groups (P<0.05). The Ser37Ala (T/G) polymorphism in exon 2 of BMP2 gene was positively correlated with ALP activity in stably transfected C3H10T1/2 cells. \u0000 \u0000 \u0000Conclusion \u0000The Ser37Ala (T/G) polymorphism in exon 2 of BMP2 gene promotes OPLL ossification through TGF-β/Smad signaling pathway, the possible mechanism for which is to up-regulate the protein expressions of Smad4 and ALP. \u0000 \u0000 \u0000Key words: \u0000Ossification, posterior longitudinal ligament; Bone morphogenetic protein 2; Signal transduction; Single nucleotide polymorphisms","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"605-611"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45736046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy comparison between plate fixation with in situ reinforcing ulnar nerve and anterior transposition for humeral intercondylar fracture","authors":"Jun Cai, Y. Qi, Xiaomin Gu","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.07.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.07.010","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy of plate fixation with in situ reinforcing ulnar nerve and anterior transposition by olecranon osteotomy approach in the treatment of type C2 and C3 humeral intercondylar fractures. \u0000 \u0000 \u0000Methods \u0000A retrospective case control study was conducted to analyze the clinical data of 23 patients with humeral intercondylar fractures admitted to the Affiliated Hospital of Hangzhou Normal University from June 2014 to January 2017. There were 17 males and six females, aged 19-56 years, with an average of 41.2 years. According to AO classification, there were 15 patients with type C2 and eight with type C3. All patients were treated with plate internal fixation by olecranon osteotomy approach. The patients were divided into anterior group (11 patients) which was treated with ulnar nerve release anterior transposition and in situ reinforcing group (12 patients) which was treated with ulnar nerve release in situ. The operation time, intraoperative blood loss, fracture healing time, elbow flexion and extension range, elbow joint Mayo score, and excellent and good rate were compared between the two groups. Postoperative complications were recorded. \u0000 \u0000 \u0000Results \u0000All patients were followed up for 15-43 months, with an average of 26.7 months. All patients had no need of blood transfusion. There were no significant differences between anterior group and in situ reinforcing group in operation time [(219.1±15.1)minutes vs. (211.2±17.1)minutes], intraoperative blood loss [(263.6±35.3)ml vs. (237.5±25.6)ml] and fracture healing time [(18.2±2.4)weeks vs. (18.9±1.7)weeks] (P>0.05). No significant differences were found between the two groups in elbow flexion [(120.3±7.1)° vs. (120.3±4.1)°], straightness [(3.7±2.7)° vs. (4.1±2.4)°], Mayo score [(89.09±9.17)points vs. (86.67±10.29)points] and excellent and good rate [ 91% (10/12) vs. 83% (10/12)] (P>0.05). After operation, no complications such as infection, heterotopic ossification, ulnar neuritis, elbow valgus deformity, or internal fixation failure occurred. \u0000 \u0000 \u0000Conclusions \u0000For humeral intercondylar fracture, the plate fixation with in situ reinforcing ulnar nerve and anterior transposition by olecranon osteotomy approach both have advantages such as small surgical trauma, strong fixation, fewer complications, satisfactory recovery of elbow function. Ulnar nerve anterior transposition or not does not affect the occurrence of ulnar neuritis, and both can obtain satisfactory clinical efficacy. \u0000 \u0000 \u0000Key words: \u0000Humeral fractures; Intra-articular fractures; Fracture fixation, internal; Ulnar nerve","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"638-643"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45750962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of enhanced recovery after surgery in nursing of patients with thoracolumbar fracture with nerve injury","authors":"L. Deng, Yong-hong Ding, Xu Zhang, Xiaohua Chen","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.07.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.07.013","url":null,"abstract":"Objective \u0000To investigate the application of enhanced recovery after surgery (ERAS) in the nursing of thoracolumbar fracture with nerve injury. \u0000 \u0000 \u0000Methods \u0000A retrospective case-control study was conducted to analyze the clinical data of 64 patients with bilateral thoracolumbar fractures with nerve injury admitted to the Chongqing General Hospital from November 2013 to November 2017. There were 52 males and 12 females, aged 26-62 years, with an average age of 43 years. The injured segments were located at T11-T12 in 28 patients, T12-L1 in 15 patients, L1-L2 in 10 patients, and L2-L3 in 11 patients. According to the Frankel classification of neurological function, there were 14 patients at grade A, 18 at grade B, 24 at grade C and eight at grade D. All patients were treated with common pedicle screw placement under direct vision combined with dome shaped decompression through small incision. Among the patients, 32 received ERAS rehabilitation nursing (ERAS group) and 32 received routine rehabilitation nursing (routine group). The incidence of complications, hospitalization time, hospitalization expense, patients' satisfaction with nursing work, visual analogue scale (VAS), Oswestry dysfunction index (ODI) and Frankel classification of neurological function at 3 months after operation were compared between the two groups. \u0000 \u0000 \u0000Results \u0000The patients were followed up for 8-12 months [(10.2±1.3)months]. In the ERAS group, one patient had pulmonary infection; in the routine group one patient had wound infection, one had bedsore, and one had venous thrombosis in lower limb (P<0.01). The hospitalization time of ERAS group was significantly shorter than that of routine group [(9.3±1.2)days ∶ (15.6±1.8)days] (P<0.01). The hospitalization expense of ERAS group was significantly lower than that of routine group [(52±13)thousand yuan (RMB) vs. (63±17)thousand yuan (RMB)] (P<0.05). The satisfaction rates of ERAS group and routine group were 84% (27/32) and 56%(18/32), respectively (P<0.05). At 3 months after operation, the ERAS group had significantly lower VAS [(2.6±1.2)points vs. (3.8±1.5)points] and ODI (11.4±2.1)points vs. (15.8±2.5)points] than the routine group (P<0.05 or 0.01). At 3 months after operation, according to the Frankel grading, there was one patient at grade A, five at grade B, nine at grade C, five at grade D, and 12 at grade E in the ERAS group; while there were three patients at grade A, seven at grade B, seven at grade C, nine at grade D, and six at grade E. The recovery rate of Frankel grade 1 and/or above in ERAS group was significantly higher than that in routine group [97%(31/32) vs. 91%(29/32), P<0.05]. \u0000 \u0000 \u0000Conclusion \u0000Rehabilitation nursing measures of ERAS can help reduce perioperative complications, hospitalization time and hospitalization expenses, relieve pain, promote functional recovery, and gain satisfactory feedbacks from the patients. \u0000 \u0000 \u0000Key words: \u0000Rehabilitation nursing; Spinal fractures; Spinal cord injuries; Enhanc","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"653-658"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47978589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of edaravone in alleviating prognosis of rats following traumatic brain injury","authors":"Zhang Bingqian, T. Quan, Dong‐xia Zhang, Liu Xuetao, L. Bin, Chao Luo, Guang Wang","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.07.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.07.014","url":null,"abstract":"Objective \u0000To investigate the effects of edaravone on improving the prognosis of TBI rats. \u0000 \u0000 \u0000Methods \u0000A total of 150 SD male rats were divided into normal control group (10 rats), TBI group (70 rats) and edaravone group (70 rats). In the edaravone treatment group, the rats were injected intraperitoneally once a day continously for 2 weeks with the injection dose of 5.4 mg·kg-1·d-1. At 6 hours, 12 hours, 24 hours, 48 hours, 72 hours, 1 week and 2 weeks after injury, the neurobehavioral and motor function scores of rats were monitored respectively, with 10 rats monitored at each time point. Serum and cerebrospinal fluid samples were collected and the levels of β-endorphin and gonadotropin-releasing hormone (GnRH) were determined by radioimmunoassay (RIA). \u0000 \u0000 \u0000Results \u0000In the edaravone group, the neurobehavioral and motor function scores were higher than those of the TBI group at 6 hours, 12 hours, 24 hours, 48 hours, 72 hours, 1 week and 2 weeks after injury. At 48 hours after injury, the neurobehavioral scores of the TBI group and the edaravone treatment group were (8.2±0.9)points and (10.3±0.7)points, respectively (P<0.05), and the motor function scores were (5.9±1.0)points and (6.9±1.2)points respectively (P<0.05). Meanwhile, the contents of β-endorphin in blood and cerebrospinal fluid of the normal control group were (50.2±9.5)pg/ml and (16.2±2.8)pg/ml, and the contents of GnRH were (75.2±11.2)pg/ml and (36.2±10.8)pg/ml, respectively.The levels of β-endorphin and GnRH in serum and cerebrospinal fluid were significantly increased at 6 hours, 12 hours, 24 hours, 48 hours, 72 hours, 1 week and 2 weeks after injury. The levels of β-endorphin and GnRH in the edaravone group were lower than those of TBI group. At 72 hour after injury, the levels of β-endorph in serum in TBI group and edaravone group were (165.2±8.5) pg/ml and (109.5±6.3)pg/ml respectively (P< 0.05), and the levels of β-endorph in cerebrospinal fluid were (63.3±3.1)pg/ml and (38.2±2.3)pg/ml respectively (P<0.05). At 72 hour after injury, the levels of GnRH in serum in TBI group and edaravone group were (203.7±17.1)pg/ml and (110.4±19.2)pg/ml respectively (P<0.05), and the levels of GnRH in cerebrospinal fluid is (153.0±13.4)pg/ml and (93.2±10.5)pg/ml respectively (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000During acute and recovery periods after TBI, continuous treatment with edaravone can obviously reduce the levels of β-endorphin and GnRH, which is beneficial to alleviate the secondary brain injury after TBI in rats, promote the recovery of nerve and function, and improve the prognosis. \u0000 \u0000 \u0000Key words: \u0000Brain injuries; β-Endorphin; Gonadotropin-releasing hormone; Edaravone","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"659-664"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42024185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional finite element analysis of mechanical stability of double screw internal fixation for talar neck fracture","authors":"Z. Fan, Ying Wang, Ming‐jie Kuang, Lei Sun, Bin Lu, Jian-xiong Ma, Xinlong Ma","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.06.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.06.010","url":null,"abstract":"Objective \u0000The three-dimensional finite element analysis was done to analyze the mechanical stability of double screw internal fixation for talus neck fracture, the methods with different approaches and different placement methods as well as the optimal biomechanical environment of fracture section were discussed so as to provide reliable mechanical arguments for the selection of clinical internal fixators. \u0000 \u0000 \u0000Methods \u0000The acquired male adult ankle CT data were imported into Mimics for 3D reconstruction of the ankle joint model. After the model was fitted with the surface by Geomagic software, the model was imported into Solidwork software to establish the talus neck fracture model and the corresponding screw. The fixtures were assembled with the anterior-posterior parallel double screw, the anterior-posterior cross-double screw, the posterior-anterior parallel double screw, and the posterior-anterior cross-double screw, respectively. The model data were imported to Abaqus 6.14 for analysis and calculation, followed by the meshing pretreatment using software Hypermesh 13.0. The Von Mises stress distribution of the lag screw and displacement of the fracture end were observed under different fixation modes. \u0000 \u0000 \u0000Results \u0000In the displacement and stress cloud diagrams of the fracture ends of the four groups, the displacement peaks of the fractures of the anterior to posterior double-screw parallel and cross-fixed groups were 0.399 3 mm and 0.418 6 mm, and the peak pressures were 7.721 MPa and 8.124 MPa, respectively. The displacement peaks of posterior to anterior double-screw parallel and cross-groups were 0.418 3 mm and 0.418 5 mm, the fracture end peak pressures were 4.848 MPa and 5.692 MPa, respectively. In the screw stress cloud diagram of the four internal fixation modes, the Von Mises stress peaks of the anterior-posterior parallel screw group and cross-screw group were 45.11 MPa and 50.18 MPa, and those of the posterior-anterior parallel screw group and cross-screw group were 30.65 MPa and 37.68 MPa, respectively. \u0000 \u0000 \u0000Conclusion \u0000In the posterior-anterior parallel screw fixation, the fracture end has the lowest stress, and the screw has dispersive stress and the stress peak is the lowest, which is superior to other three groups. Therefore, the posterior-anterior screw is better than anterior-posterior fixation, and the parallel fixation is better than cross fixation. \u0000 \u0000 \u0000Key words: \u0000Talus; Fracture fixation, internal; Finite element analysis; Imaging, three-dimensional","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"543-548"},"PeriodicalIF":0.0,"publicationDate":"2019-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46551999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of different treatment methods for severe chest trauma in Tibetan Plateau","authors":"Zhu-ron Luo, Qiongda Dawa, B. Cai, Dunzhu Ciren, Pingchuo Laba, Weijiang Li, Muzhen Dan, Weigang Guo","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.06.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.06.011","url":null,"abstract":"Objective \u0000To compare the efficacy of operative and non-operative methods in the treatment of severe thoracic trauma in Tibetan Plateau. \u0000 \u0000 \u0000Methods \u0000A retrospective case-control study was conducted to analyze 286 patients with severe thoracic trauma admitted to the Shigatse People's Hospital from August 2016 to October 2018. There were 206 males and 80 females, aged 13-71 years [(34.3±11.6)years]. The duration from injury to hospital ranged from 2 to 49 hours [(22.8±8.3)hours]. The causes of injury including fall from height in 109 patients, traffic injury in 98, crush injury in 32, blunt injury in 29, cattle head injury in 9, knife stab injury in 6 and other causes in 3. The injury severity score (ISS) varied from 16 to 48 points on admission [(24.2±8.8)points]. A total of 159 patients underwent operation (Operation group) and 127 patients underwent non-operative treatment (Non-operation group). The ISS score was (25.2±8.3)points in Operation group and (23.7±7.9)points in Non-operation group. The length of hospital stay, intensive care unit (ICU) care time, complication rate and mortality were recorded in two groups. The correlation of ISS and age with mortality was investigated. \u0000 \u0000 \u0000Results \u0000The length of hospital stay was (12.2±3.8)days in the Operation group and (19.7±5.8)days in the Non-operation group (P 0.05). There were statistically significant differences in the age of death between the Operation group and the Non-operation group (P<0.05). The differences in the ISS score and age between the survival and death patients within the two groups were statistically significant (P<0.05). Logistic regression analysis showed age (OR=1.090, 95%CI 1.002-1.186) and ISS (OR=1.058, 95%CI 1.027-1.090) were slqnificantly related to mortality. \u0000 \u0000 \u0000Conclusions \u0000For severe thoracic trauma in Tibetan Plateau, operative treatment can shorten the length of hospital stay and ICU care time and reduce the incidence of complications. The mortality ratio of the two groups has no significant difference. Age and ISS may be the high risk factors for death of severe thoracic trauma patients. \u0000 \u0000 \u0000Key words: \u0000Thoracic injuries; Surgical procedures, operative; Tibetan Plateau","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"549-555"},"PeriodicalIF":0.0,"publicationDate":"2019-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49416212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy evaluation of arthroscopic Broström-Gould procedure for chronic lateral ankle instability","authors":"Xiao-hui Gu, Xiaohua Pan, Jia Yu, Q. Bi, Jinsong Hong","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.06.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.06.009","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy of arthroscopic Brostrom-Gould procedure for chronic lateral ankle instability (CLAI). \u0000 \u0000 \u0000Methods \u0000A retrospective case series study was conducted to analyze the clinical data of 36 CLAI patients admitted to Zhejiang Provincial People's Hospital, Second Affiliated Hospital of Shenzhen University, Institute of Orthopedics of Soochow University, and Guangzhou Orthopedic Hospital from August 2016 to July 2017. There were 21 males (21 ankles) and 15 females (15 ankles), aged 18-42 years [(26.5 ± 8.6)years]. The duration from injury to operation ranged from 6 to 30 months [(10.8±1.6)months]. All patients received arthroscopic Brostrom-Gould procedure (anterior talofibular ligament repair, capsular constriction, subextensor ligament reinforcement). The operation time and arthroscopic intra-articular lesions and treatment were recorded, and the wound healing and complications were recorded. The visual analogue score (VAS), front drawer test and varus stress test results, American Orthopedic Foot and Ankle Surgery Society (AOFAS) ankle-hind foot score and Karlsson-Peterson ankle function score were compared before operation, 6 weeks after operation and at the last follow-up. \u0000 \u0000 \u0000Results \u0000All 36 patients were followed up for 18-29 months [(20.5±6.3)months]. The operation time ranged from 45 to 115 minutes [(67.2±18.6)minutes]. During the operation, synovitis hyperplasia of ankle joint was found in 35 patients, scar tissue around ligament in 32, talus cartilage injury in 10, osteophyte in 19 and free body in 5, all of which were treated accordingly. All incisions were healed in the first stage after operation, without joint infection, superficial sural nerve injury or thread stimulation. The ankle varus was slightly limited in two patients after operation and improved after functional rehabilitation. No revision operation was needed at the last follow-up. Front drawer test and inverted stress test results were negative (-). The VAS score was (5.9±1.6)points before operation, (1.9±1.0)points at 6 weeks after operation, and (1.6±0.3)points at the last follow-up, with significant difference compared with that before operation (P<0.01). The AOFAS ankle-hind foot score was (67.4±7.4)points before operation, (89.2±6.8)points at 6 weeks after operation, and (91.7±5.3)points at the last follow-up, with significant difference compared with that before operation (P<0.01). Karlsson-Peterson ankle function score was (65.3±9.6)points before operation, (88.6±5.3)points at 6 weeks after operation, and (90.6±3.8)points at the last follow-up, with significant difference compared with that before operation (P<0.01). \u0000 \u0000 \u0000Conclusion \u0000For CLAI, the arthroscopic Brostrom-Gould procedure can treat the intra-articular lesions and reliably restore the stability of the lateral ankle. At the same time, quick motion recovery can be achieved, with satisfactory short-term curative effect. \u0000 \u0000 \u0000Key words: \u0000Lateral ligament, ankle; Arth","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"534-542"},"PeriodicalIF":0.0,"publicationDate":"2019-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46033307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior intervertebral autogenous bone grafting combined with long-segment fixation for type C thoracolumbar fractures","authors":"Zhi-jing Zhang, Yi-sheng Lu, Jian-Dong Shi, Bing Li","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.06.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.06.007","url":null,"abstract":"Objective \u0000To investigate the efficacy of posterior intervertebral autogenous bone grafting combined with long-segment fixation for type C thoracolumbar fractures. \u0000 \u0000 \u0000Methods \u0000A retrospective case series study was performed in 28 patients with type C thoracolumbar fractures admitted to the 903 Hospital of PLA from January 2013 through January 2016.There were 20 males and eight females, aged 25-55 years, with an average of 36.8 years. All patients had type C fractures according to the new AO classification system. The injury occurred at T11-12 segment in 5 patients, T12-L1 segment in 8, L1-2 segment in 9, and L2-3 segment in 6. These patients were scored 7-9 points [(8.0±1.1 )points] according to the thoracolumbar injury classification and severity score (TLICS) and 7-10 points [(8.5±1.4)points]according to Load sharing score (LSC). There were 20 patients with grade A and eight patients with grade B based on the American Spine Injury Association (ASIA). All patients were treated with posterior intervertebral autogenous bone grafting combined with long-segment fixation.The operation time and volume of blood loss were recorded. Kyphosis Cobb angle, visual analogue scale(VAS)and Oswestry disability index (ODI) were compared between before operation and 1 week, 3 months, 12 months and 24 months after operation.Bone grafting union was evaluated during the follow-up period by CT scan. ASIA grade was used to evaluate the functional recovery. \u0000 \u0000 \u0000Results \u0000All patients were followed up for average 26 months (range, 24-36 months). The operation time was (135.8±30.5)minutes and the intraoperative blood loss was (350.5±50.7)ml, respectively.No serious complications occurred during the operation such as blood vessel or nerve injury aggravation.No serious complications occurred after operation such as incision infection and internal fixation loosening or fracture. Cobb angles of local kyphosis at 1 week, 3, 12 and 24 months after operation were significantly improved compared with preoperative Cobb angle (P<0.01). VAS and ODI were also significantly improved at 1 week, 3, 12 and 24 months after operation (P<0.01). The last follow-up found that all the intervertebral bone grafts were fused. At the last follow-up, ASIA grading results were as follows: grade A in 20 patients, grade B in 3 and grade C in 5. \u0000 \u0000 \u0000Conclusion \u0000Posterior intervertebral autogenous bone grafting combined with long-segment fixation has the advantages of simple operation, short operation time, minimal trauma, good fusion effect, significant relief of the pain and improvement of neurological function, indicating a surgical option for the treatment of type C thoracolumbar fracture. \u0000 \u0000 \u0000Key words: \u0000Spinal fractures; Thoracic vertebrae; Lumbar vertebrae; Fracture fixation, internal; Autologous transplant","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"520-526"},"PeriodicalIF":0.0,"publicationDate":"2019-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44696709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}