Valenzuelathorpe8985

Twelve patients were followed up for 9 to 13 months. VAS sco re and uric acid content at different time points were observed and recorded. VAS score before operation ranged from 6 to 9, and decreased to 0 to 1 at 7 weeks after operation; the level of blood uric acid ranged from 443 to 501 μmol/L before operation, and decreased to 307 to 330 μmol/L at 7 weeks after operation. The first metatarsophalangeal joint deformity of foot was corrected and the shape was recovered at 5 to 7 months after operation. One patient occurred incision infection and flap edgenecrosis, and the wound healed by debridement and dressing change. CONCLUSION Staged operation for the treatment of giant gout stone on the first metatarsophalangeal joint of foot could correct joint deformity, restore shape of the first metatarsophalangeal joint, relieve pain of the affected foot, and beneficial for control content of serum uric acid, and has less complications.OBJECTIVE To explore clinical effects of fibular osteotomy and distal tibiofibular joint fusion for chronic valgus Pilon fracture malunion. METHODS From January 2014 to January 2017, 8 patients with chronic valgus Pilon fracture malunion were treated, including 7 males and 1 female, aged from 20 to 47 years old, 6 patients on the left side and 2 patients on the right side; according to Rüedi-Allgöwer classification, 1 case was typeⅠ, 3 cases were typeⅡand 4 cases were type Ⅲ; the time from injury to admission ranged from 7 to 21 months. All deformities were evaluated individually based on pre-operatively weight bearing X-ray and 3D CT scan, and 3D printing model was also used for preliminary surgery. Weight-bearing X-ray showed posterior subluxation of ankle joint in 5 cases. There were 5 cases of fibular fracture at primary injury, and 2 cases of fibular fracture malunion. Fibular osteotomy and distal tibiofibular syndesmosis fusion strategy was performed to reduce articular surface congruency and correct lower limb alignment. Postoperative complication, fracture healing time and reduction were regularly recorded. Clinical function was evaluated according to American Orthopedic Foot and Ankle Society (AOFAS) at 1 year after operation. RESULTS All patients were followed up from 12 to 30 months. All incisions were primarily healed. No infection, neurovascular injuries or implant failure, lost of reduction occurred. GSK-516 Fracture healing time ranged from 13 to 19 weeks with good lower limb alignment. AOFAS score at 1 year after operation was 63 to 90 points, 1 patient got excellent result, 4 good and 3 fair. Seven patients returned to work at 6 to 14 months after opertaion. CONCLUSION For chronic valgus Pilon fractures malunion, fibular osteotomy and distal tibiofibular syndesmosis fusion could effectively restore congruency and alignment, correct lower limb alignment, improve ankle joint function, reduce occurrence of complication, and receive short term clinical effects.OBJECTIVE To explore clinical effects of distal radius T-plates in treating vertical shear medial malleolus fractures. METHODS From March 2014 and March 2016, clinical data of 18 patients with vertical shear medial malleolus fractures were retrospectively analyzed, including 12 males and 6 females aged from 22 to 63 years old with an average of (41.3±5.2) years old; 6 patients were on the left side and 12 patients were on the right side; 5 patients combined with external malleolus fractures and 13 patients combined with external malleolus and posterior malleolus fractures. All patients were treated with distal radius T-plate fixation. Fracture healing time, loss of reduction, stability of internal fixation, occurrence of osteoarthritis were observed, postoperative AOFAS score at 12 months was used to evaluate clinical effects. RESULTS All patients were followed up from 18 to 36 months with an average of (22.5±4.3) months. All incisions healed well at stageⅠ. Review of X-ray showed that ankle joints were got anatomically reset. All fractures healed well ranged from 12 to 18 weeks with an average of (13.4±2.4) weeks. After surgery, patients resumed normal walking from 12 to 17 weeks with an average of (14.5±1.3) weeks. No complications such as loss of reduction, loosening or rupture of internal fixation, nonunion of fracture, radiographic appearance of osteoarthritis occurred during following up. AOFAS scores was 92.4 ±6.7 at 12 months after operation, and 15 patients got excellent result, 3 moderate. CONCLUSION Distal radius T-plates for treatment of vertical shear medial malleolus fractures have advantages of firm fixation, conforming to biomechanical requirements, better matching with plate anatomy, and less soft tissue stimulation. It could achieve early function exercise, obtain good recovery of function, and it is an ideal choice for the treatment of vertical shear medial malleolus fractures.OBJECTIVE To explore clinical effects of platelet rich plasma (PRP) injection in treating atrophic fracture nonunion. METHODS From March 2015 to March 2017, 15 patients with atrophic fracture nonunion were treated with PRP injection, including 10 males and 5 females, aged from 23 to 56 years old with an average age of (40.0±9.1) years old, the time of fracture nonunion ranged from 6 to 14 months with an average of (8.87±2.45) months. Preparing PRP by extracting 60 to 100 ml peripheral blood. PRP platelet count ranged from 587 to 1 246 with an average of (947.13±158.58) ×10 9 /L. Under the perspective, 13 to 20 ml PRP were injected into the fracture end, and each injection was performed once on the first and the second week of the treatment. Complications such as whether the limb was shortened, angulation, and rotational deformity and radiological examination were observed. RESULTS All patients were followed up from 6 to 12 months with an average of (6.8± 2.1) months. No shortening, angulation, and rotational deformity occurred. Thirteen patients had fracture healing, the time ranged from 4 to 6 months with an average of (4.8±0.7) months. Two patients had no completely porosis at 12 months during following up, and 1 patient occurred bolt loose. Other patients had no complications. CONCLUSION The stability of fracture ends of atrophic fracture nonunion after internal fixation is an indication for local PRP injection. PRP treatment for atrophic fractures could completed under local anesthesia, and it has advantages of safe operation and reliable efficacy.