Hortoncheng1915

The aim of this study was to present early clinical and radiological outcomes of percutaneous pedicle screw fixation (PPSF) combined with vertebroplasty (VP) in the treatment of Kümmell's disease with intravertebral instability.

In this study, 21 consecutive patients (4 male and 17 female; mean age = 75.6 years; age range=65-86 years) who suffered from stage II and III Kümmell's disease with intravertebral instability were prospectively recruited from 2012 to 2016 and treated with PPSF combined with VP. The Cobb angle (CA) or wedge angle (WA) in both flexion and extension positions was measured using lateral radiographs, computed tomography, or magnetic resonance imaging. In addition to these radiological parameters, clinical outcome measures, including the visual analog scale (VAS) and the Oswestry Disability Index (ODI) were collected preoperatively; 1 week and 1, 3, 6, and 12 months postoperatively; and then annually. Complications were also recorded.

The mean follow-up was 19.3 (range=12-36) months. The mean operating time was 135.4 (range, 110-175) min, and the mean estimated blood loss was 106.9 (range, 50-165) mL. The mean VAS score and ODI significantly decreased from 7.7±1.1 and 65.3%±7.7% preoperatively to 3.4±0.6 and 30.0%±7.6% postoperatively, respectively (p<0.05). At the final follow-up, the mean VAS score and ODI were 2.5±0.8 and 21.5%±8.8%, respectively (p>0.05). CA and WA significantly decreased from 26.9°±9.7° and 21.3°±6.0° preoperatively to 12.7°±7.2° to 8.6°±4.5° postoperatively, respectively (p<0.05). At the final follow-up, CA was 4.2°±2.0°, and WA was 4.7°±1.8° (p>0.05). No major complications were encountered during the follow-up period.

PPSF combined with VP seems to be an effective surgical option for the treatment of Kümmell's disease with intravertebral instability.

Level IV, Therapeutic study.

Level IV, Therapeutic study.

This study aimed to evaluate the results of surgical treatment of tibial avulsion injuries of the posterior cruciate ligament (PCL) with a 3.5-mm locking compression hook plate (LCHP).

From June 2012 to June 2015, 16 consecutive patients (10 males and 6 females, mean age 38 (range 19-57) years) presented with isolated tibial avulsion injuries of the PCL. We used a 3.5-mm LCHP and lag screws for open reduction and internal fixation (ORIF) through the posterior medial approach. The operation time, quantity of bleeding, visual analog scale (VAS) scores, stability of posterior drawer test (PDT) results, and fracture healing time were studied to assess clinical efficacy. At the 12-month follow-up, a functional evaluation using knee range of motion (ROM) and the Lysholm knee scoring system (LKSS) was performed.

The data from a mean follow-up of 24.1 (range 14-33) months from 16 patients were recorded. No neurovascular complications, incision infections, or delayed union or nonunion were observed. The mean operation time was 61.4 (range 45-80) min. The mean quantity of bleeding was 41.6 (range 25-66) mL. The mean bone healing time was 11.8 (range 45-80) weeks. The mean VAS score was 1.63 (range 0-3) after surgery. The average LKSS and ROM of the knee were 51.75±7.67 and 50.94°±10.19° before surgery and 92.75±5.46 and 127.75°±6.13° at 1 year, respectively. The outcomes were judged to be excellent for 11 patients, good for 4, and fair for 1 (excellent and good rates 93.8% for 15/16). At the final follow-up (≥1 year), the PDT scores returned to normal.

The results showed that 3.5-mm LCHP provided reliable fixation following ORIF of isolated PCL tibial avulsion fractures and was a safe, simple, and effective procedure. This procedure may reduce complications and improve functional recovery relative to those of other procedures.

Chinese Clinical Trial Registry, ChiCTR-1900022920. Registered on 3 May 2019.

Level IV, Therapeutic study.

Level IV, Therapeutic study.

The aim of this study was to analyze the outcomes of treatment and the rate of complications in children treated with flexible intramedullary nailing (FIN) for radial neck fractures.

The study included 26 children (11 males and 15 females) with a median age of 9.5 years, treated with FIN for the radial neck fractures between May 2011 and May 2018. Immobilization after the surgery was not used. The median follow-up was 41 months. According to the Judet classification, 15 fractures were classified as type III and 11 as Type IV. For each patient, clinical, radiological, and disability of the arm, shoulder, and hand (DASH) scores were calculated.

All patients achieved complete radiographic healing at a median of 5 weeks. The nails were removed at a median of 4 months. The rate of complications was 11.5%, including 1 radial head necrosis, 1 angulation of 15°, and 1 displacement of the radial head. Twenty patients (76.9%) achieved a perfect clinical healing, while 23 patients (88.5%) achieved a perfect radiological healing. The median DASH score was 1.25. No cases of delayed healing were recorded. Zoligratinib clinical trial After removing of the nails, all patients returned to full function of the extremity and all complications were resolved.

The use of FIN for treating fractures of the radial neck in children shows very good functional and cosmetic results. It allows mobilization with rapid pain reduction. It is a minimally invasive, simple, and reproducible technique with a low rate of complication. Owing to excellent results, surgical stabilization of radial head and neck fractures using FIN is recommended in children and adolescents.

Level IV, Therapeutic study.

Level IV, Therapeutic study.

This study aimed to compare the perioperative clinical outcomes of trephine biopsy (TB) with the conventional open surgical method (COSM) in bone graft harvesting from the olecranon.

In this retrospective study, 130 patients who underwent bone graft harvesting from the olecranon using either TB or COSM were included. Patients were then divided into two groups the COSM group (48 patients; 36 men and 12 women; mean age=32 years; age range=18-52) and the TB group (82 patients; 61 men and 21 women; mean age=34 years; age range=20-62). The mean follow-up was 30 months (range=17-57) in the COSM group and 26.8 months (range=6-48 months) in the TB groups. The two groups were compared in terms of pain intensity, operating time, complication rate, elbow range of motion, and the scar sensitivity of the graft donor site. Pain intensity was measured using the visual analogous scale (VAS) on postoperative days 1 and 15. Other outcome measures were evaluated at the final follow-up.

In the TB group, the mean VAS score was 4±1.