mbt batai Hemiarthroplasty treatment of intertroch

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Hemiarthroplasty treatment of intertrochanteric fractures of 16 patients

Wang Qingsong column burst fracture of 35 cases, Dongguan City, Guangdong Province, Dasan Hospital Surgery (523382) 【Abstract】 Objective AF screw fixation and interlaminar bone grafting to treat thoracolumbar burst fracture is feasible. Methods Retrospective analysis of 35 cases of thoracolumbar burst fracture of AF screw fixation and interlaminar grafting of clinical efficacy. Operating time was 0.5 ~ 7d, the average 3d, used in all AF screw fixation and interlaminar bone grafting, selective decompression, c-arm x-ray machine positioning and understanding under the monitoring of vertebral height restoration, the upper and lower vertebral gap recovery, fracture fragment reattachment. After 2 weeks of bed and back muscle exercise ,6-8 weeks out of bed, waist protection of 1 to 2 months. Results 35 patients were followed up for 12-26 months, mean 18 months after x-ray films showed an average anterior vertebral height restored to 95%, CT showed spinal canal blocking, divided according to the modified Franke1 Class Act ... score: D Grade 2 cases; E 5 cases; F grade in 28 cases. Obtained 1 year after bone grafting and internal fixation were found in survival, 3 broken nails. Conclusion AF screw fixation and interlaminar fusion for thoracolumbar burst fracture is a good reduction, fixed, reliable, simple, minimally invasive, safe and effective internal fixation system. Key words bone grafting AF fixation of thoracolumbar fractures DOI: 10.3969 / j. issn. 1000-8535.2009.03.008 o07 since November 2002 our department in May during the application of AF nail fixation of thoracolumbar burst fracture of a single vertebra, 35 cases were followed up to achieve a satisfactory effect, these are as follows . 1 Data and methods 1.1 General information: The group of 35 patients in 21 males and 14 females. Aged 20-48 years, mean 3l years old. The causes of injury: 15 cases of traffic accidents, falls in 20 cases. Chest 11 fractures, 3 cases of 12 fractures of l0 cases of thoracic,[link widoczny dla zalogowanych], lumbar fractures in 16 cases 1, 2 lumbar fractures in 6 cases. ... According to the modified Franke1 grading rate: A (5 points) Grade 0 cases of complete injury; B (4 points) 0 cases of sensory level only; C level (3 points) but no function there Movement 4 cases; D-level ( 2 points), 8 cases of functional movement; E (1 point) level only sensory abnormalities, motor normal l5 cases; F (0 points) level normal in 8 cases. The average anterior vertebral height was 58%. 35 cases of ordinary X ray and CT, were burst fractures, spinal canal stenosis by Category]: 0 Ownership】 spinal stenosis,[link widoczny dla zalogowanych], 2 cases of spinal canal stenosis 1 / 3 of the 23 cases, spinal stenosis 2 / 3 and spinal stenosis in 3 / 3, no cases. 1.2 Treatment: operative time 0.5 ~ 7d,[link widoczny dla zalogowanych], the average 3d, used in all AF screw fixation and bone graft lamina asked, selective decompression. C-arm x-ray machine monitored by positioning the patient prone on a bracket in the spine, conventional disinfection shop sterile towel, take the middle after the longitudinal incision to expose the upper and lower vertebra, one each for the central spine of the spinous process, lamina, articular process and the transverse process, pedicle positioning method according to Weinsein positioning, drilling depth of 2.5-3.5cm, with a fine Kirschner wire after drilling the first detection of bone hole walls, to ensure that all bone, and placing one screw, Installation support sleeve rod, tighten the rear nut, and then softened to the longitudinal ligament tension between the right spine, C-arm X-ray monitoring of vertebral body height restoration, the upper and lower vertebral fracture gap and understanding of normal block reset conditions For decompression, the purposes of fenestration, remove the hematoma, smashing flat broke into the spinal canal of the bone. Finally, install the horizontal connecting rod,[link widoczny dla zalogowanych], and in the lamina bone graft, placing drainage, cut off 13, after 2 weeks in bed back muscles began to bed, bed 6 to 8 weeks after the start out of bed, waist protection of 1 to 2 months . 2 treatment results in this group 35 patients were followed up for 12 to 26 months, an average of 18 months. Within 1 year after implant removal were found graft survival, 3 broken nails, ... according to the modified Franke1 grading score: the original C-4 cases, 2 cases back to the D-class, back to the E-class 2; of the original D 8 cases, 3 cases of grade back to the E, F 5 cases; of the original 15 cases of E-class, were restored to the F-class; F 8 cases no change. The average postoperative anterior vertebral height restoration to 95%. Review cT blocking the spinal canal. 3 Discussion of thoracolumbar burst fracture is a common clinical spinal cord injury by buckling, axial compression, rotation and shear caused by such violence, instability is three dimensional, and most occur in the vertebral spinal column broke into the affected bone, resulting in spinal stenosis, spinal cord injury, whether in primary or secondary injury play an important role in both, vertebral burst fracture nerve injury was 20% to 40%, surgical decompression and stabilization purpose is to restore the spine physiological state and give a strong fixation and recovery of neurological function space, the secondary prevention of nerve damage.

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