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简介：AbstractPurpose:In the surgical treatment of paediatric forearm fractures, plate-screw and titanium elastic nails are used. During the transformation of ligamento-osseous structures from adolescence form into adult form, more stable fixation is required. The aim of this study was to evaluate the results of locked intramedullary nail fixation in adolescent forearm fractures.Methods:A retrospective examination was made on 36 adolescent patients who underwent surgery with locked intramedullary nail fixation due to a forearm fracture. The included patients were in the adolescent age group (12-17 years), did not meet conservative follow-up criteria and had unstable fractures (>10° angulation and <50% cortex continuity after plaster casting). Patients were excluded from the study if they were aged >18 years or <12 years, had Gustilo-Anderson type 2/3 open fractures, multi-trauma, history of physeal injuries or could not be contacted during follow-up. Patients’ age, gender, body mass index, affected side, and the pronation and supination values during follow-up were noted. Functional evaluation of the patients was performed with disabilities of the arm, shoulder and hand score and the surgical outcomes were evaluated according to the Price criteria. The time to union, infection during follow-up, re-fracture and vascular nerve damage were also examined. Data were analyzed using SPSS 22 Windows package program software.Results:The patients comprised 30 males and 6 females (ratio, 5:1) with a mean age of (14.7 ± 2.1) years (range, 12-18 years). According to the Price criteria, the results of 33 patients were excellent, 3 were good and there were no moderate or poor cases. The mean disabilities of the arm, shoulder and hand score was 11.2 ± 6.1 (range, 4-28). The mean time to union was (8.7 ± 2.2) weeks (range, 6-14 weeks), while patients aged >15 years had prolonged time to union ([11.1 ± 1.8] weeks). There were no non-unions, re-fractures or infections. No complications were observed during implant removal. None of the patients had sensorial radial nerve injury or tendon damage.Conclusion:The locked intramedullary nailing technique, which is minimally invasive and provides biological fixation, was found to be successful and safe in the treatment of adolescent forearm fractures.

简介：ObjectiveStudies证明代替的midclavicular破裂的钉的有弹性的稳定的intramedullary(ESIN)有优秀结果，以及高复杂并发症率和特定的问题。目的fractures.MethodsTotally是讨论midshaft的ESIN锁骨的60个合格病人(年老的18-63年)被使随机化到在2007年1月和2008年5月之间的ESIN组或非起作用的组。锁骨的弄短在损伤和骨状的巩固以后被测量。X光线照相术的联合和复杂并发症被估计。包括经常的肩膀分数和手臂，肩膀和手(破折号)的残疾的功能分析得分在15月的follow-up.ResultsESIN导致了一signifcantly更短的时间到联合以后，被执行，特别为简单破裂。在ESIN组，所有病人得到了骨折联合，5个盒子有中间的皮激怒，因为，1个病人需要修订外科植入失败。在nonoperative组，有3个不属于工会的盒子，2征兆的malunions发展了要求校正截骨术。在在intramedullary稳定以后的15个月，在ESIN组的病人是对肩膀和全面结果的外观满意的更多，并且他们从traumatic以后的大改进有益于很多锁骨的弄短。而且，破折号分数更低，经常的分数与非起作用的group.ConclusionESIN相对照是显著地更高的是有更低的复杂并发症率，到每日的活动的更快的回来，优秀化妆品和更好功能的结果的一种安全最低限度地侵略的外科的技术，为对待中间柄的锁骨的破裂的锁骨的长度的恢复，导致高全面的满足，它能作为板固定或mid-shaf的nonoperative治疗的一种选择是问候

简介：Objective:Thepurposeofthismeta-analysisistodeterminewhetherplatingorintramedullarynailing(IMN)foradultdiaphysealboth-boneforearmfractures(BBFF)providesbetterclinicaloutcomes.Methods:MEDLINE,EMBASE,GoogleScholarandTheCochraneLibrarywerecomprehensivelysearcheduntilJuly31,2016.BothretrospectivestudyandprospectivetrailsaboutcomparisonofdualIMNorhybridfixationversusdualplatingfixationinthetreatmentofadultdiaphysealBBFFwereincluded.UsingRevMan5.3software,dataoffunctionalrecovery,theuniontime,operatingtimeandcomplicationwasextractedformeta-analysis.Results:Thepooledanalysisshowedsimilarresultsintheuniontime,functionalrecoveryandtheratesofcomplications,butshowedasignificantdifferenceinoperatingtime.Conclusion:Thismeta-analysisdemonstratessimilarradiographicoutcomes,functionaloutcomesandcomplicationswithplatesorIMNusedinthetreatmentofadultdiaphysealBBFF.IMNfixationforthesefracturesseemstobeanalternativeandeffectivetreatmentwithshorteroperatingtimesandminimallyinvasive.

简介：AbstractPurpose:Treatment of distal tibia fractures poses significant challenge to orthopedic surgeon because of poor blood supply and paucity of soft tissue coverage. There is considerable controversy regarding the superior option of treatment for distal tibia fracture between the minimally invasive percutaneous plate osteosynthesis (MIPPO) technique and intramedullary interlocking (IMIL) nailing for extra-articular distal tibia fractures. The aim of our study is to compare the functional outcome between the two treatment methods.Methods:This was the prospective comparative study of 100 patients with distal third tibia fractures divided into two groups. The first group of patients were treated with MIPPO technique while the second group of patients were managed by IMIL nailing. Patients were followed up in outpatient department to assess the functional outcomes, malunion, delayed union, nonunion, superficial and deep infection between the two groups. Statistical analyses were performed using the SPSS software (version 16.0).Results:Average malunion (degrees) in the MIPPO group was 5 (3—7) ± 1.41 vs. 10.22 (8—14) ± 2.04 in the IMIL group (p= 0.001). Similarly postoperative knee pain in the IMIL group was 10% vs. 2% in the MIPPO group (p= 0.001). In terms of superficial infection and nonunion, the results were 8% vs. 4% and 2% vs. 6% for the MIPPO and IMIL group, respectively (p= 0.001).Conclusion:Both procedures have shown the reliable method of fixation for distal extra-articular tibia fractures preserving the soft tissue, bony vascularity and fracture hematoma that provide a favourable biological environment for fracture healing. Considering the results of the study, we have slightly more preference for the MIPPO technique.