There were 35 males and 25 females aged between 20 and 73 years (mean age 43.7). Exclusion criteria: (1) Patients with concurrent severe fractures or vascular and nerve injury at the same joint, (2) The follow-up time was less than 12 months, (3) less than 18 years old. (3) The fracture separative shift shown in CT scan or X-ray is more than 5 mm. (2) The width of the avulsed fracture bone is greater than 10 mm, which is larger than the opening of the hook plate. Inclusion criteria: (1) Avulsion fractures that were fit for the treatment of hook plate fixation, including the fractures of the humeral greater tuberosity, humeral condyle, ulna olecranon, ulnar styloid, ankle joint, and tibial condyle. More importantly, it was our goal to assess the necessity of surgery, the flaw of the mainstream internal fixation as well as the specific characteristics and therapeutic outcomes of hook plate.Ī total of 60 patients who met the criteria were recruited for this study from January 2011 to June 2016. The purpose of the present study was to summarize clinical data of patients with avulsion fractures around joints of the extremities treated with hook plate fixation. Based on these findings, we proposed that the hook plate might be a compatible fixation instrument for treating avulsion fractures around joints. have reported the excellent outcomes of mini-hook plate treating for phalangeal fractures. found that the hook plate fixation provided stronger fixation relative to a suture anchor for thumb ulnar collateral ligament (UCL) fracture-avulsions. Recently, accumulating evidence has strongly implied that the hook plate fixation has the advantages of more stable fixation of the fragments regardless of the bone quality and high accurate reduction in fracture with small fragments in the treatment of avulsion fractures. K-wire and stainless-steel wire fixation also shows unfavorable outcome, such as poor stability of the joint, which increases the risk of internal fixation failure. However, the stability of screw fixation was not sufficient to meet the requirement of early rehabilitation exercise for patients with osteoporosis. Internal fixation using lag screws or absorbable screws is recommended to fix large fragments, while K-wire and stainless-steel wire fixation is used to fix small fragments in order to avoid fracture nonunion. There are several fixations used to treat avulsion fractures, mainly including screw fixation, percutaneous Kirschner wire (K-wire) fixation, bone grafting, and plating fixation. The conservative treatment often has a poor therapeutic effect on avulsion fractures around joints, easily leading to fracture nonunion, joint instability and joint adhesion. Most avulsion fractures were intra-articular fractures, while relatively small fracture fragments are commonly attached to the ligament and capsule, making the joint difficult to return to the normal anatomical position. As reported, the contractile properties of muscle and the attachment of tendons and ligaments at both ends of bone collectively contributed to the muscle contraction, so unexpected contraction of the muscles could lead to avulsion fractures at the site of tendon or ligament attachment. Avulsion fractures occur when the capsule, ligaments or tendons are avulsed from the bone due to unexpected contraction of the muscles or mechanical force. Joints are surrounded by articular capsule, ligaments and tendons. Hook plate fixation has the therapeutic effect on treating avulsion fractures around joints of extremities with the advantages of reliable fixation, early rehabilitation after operation, high recovery rates of joint function, wide indications, and convenient uses. In the last follow-ups, the functional score of the affected limb was markedly greater than that in the 3-month follow-ups ( p < 0.05). Three patients with humeral avulsion fracture of the greater tuberosity had shoulder joint adhesion and peri humeral inflammation at the last follow-up due to the poor cooperation for early rehabilitation exercise. A total of 57 patients were well recovered with the excellent and good rate of 95%. At the last follow-up, no instability of joints, looseness of internal fixation or traumatic arthritis was observed. The average follow-up period was 18.1 months. ![]() ![]() ResultsĪll the patients were healed within 3 months after surgery with stage I healing incision without vascular or nerve injuries. Functional recovery was evaluated using the Lysholm knee score, Kaikkonen ankle injury score, Mayo elbow and wrist function score, and Neer shoulder function score. MethodsĪ total of 60 patients with avulsion fractures of joints admitted in our hospital between January 2011 and June 2016 were performed the surgery of hook plate fixation. This study proposed to access the clinical outcome of avulsion fractures around joints of extremities using the hook plate.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |