ObjectiveTo evaluate the clinical therapeutic effect of support plates on Schatzker type Ⅳ tibial plateau fractures.MethodsPatients with Schatzker type Ⅳ tibial plateau fractures underwent support plates treatment between April 2013 and September 2014 by using the medial incision or posterior medial incision, if necessary, with other auxiliary incisions, with limited contact compression plate, 1/3 tubular plate or " T” plate to support the fracture. ResultsA total of 14 patients including 6 males and 8 females with an average age of (35.2±9.8) years (ranged from 20 to 52 years) were enrolled in this study and followed up for 12–25 months with an average of (16.3±4.0) months. The knee joints were flexed 80–130° with an average of (97.9±13.1)° one month after the surgery and 90–140° with an average of (119.3±12.1)° three months after the surgery. One year postoperatively, the mean Hospital of Special Surgery knee score ranged from 78 to 96 with an average of 88.4±4.9. Last follow-up assessment of knee function according to Rasmussen scoring system showed excellent in 8 cases, good in 4 cases, and fair in 2 cases; the excellent and good rate was 85.7%. No postoperative complications such as infection, nonunion, vascular nerve injury, or internal fixation failure occurred. ConclusionThe support plates for the treatment of Schatzker type Ⅳ tibial plateau fractures can maintain good reduction, prevent the secondary collapse of the tibial plateau, ensure that knee joint has good alignment, less complications with vascular or nerve injuries, and finally get a satisfied function recovery.
Morel-Lavallée lesions manifest as a type of subcutaneous closed degloving injury, where the external violence creates a potential space between the subcutaneous tissue and the deep fascia, leading to the accumulation of fluid and the formation of infection within the cavity. The primary causes of Morel-Lavallée lesions include high-energy trauma, blunt force injuries, or compression injuries, with the lesions typically located around the greater trochanter. Due to the potential for clinical oversight, these lesions may result in complications such as infection at the fracture site. In light of these circumstances, this article provides a comprehensive review of the etiology, epidemiology, pathological mechanisms, clinical manifestations, imaging features, differential diagnosis, complications, and treatment modalities of Morel-Lavallée lesions. The aim is to enhance the awareness of trauma orthopedic surgeons regarding this injury, thereby offering insights for clinical decision-making.
Objective To explore the efficacy and safety of perioperative multiple intravenous tranexamic acid (TXA) administration in complex acetabular fracture. Methods The patients with complex acetabular fractures admitted to the Department of Orthopedic Surgery / Trauma Center of West China Hospital, Sichuan University between September 2021 and December 2022 for a planned surgery were selected. The patients were randomly divided into a control group and an experimental group according to TXA administration protocol. The general information, total blood loss, 48 h postoperative blood drainage, recessive blood loss, fibrinolysis index, transfusion rate, and incidence of venous thrombotic events of the included patients were observed. Results A total of 60 patients were included, including 41 males and 19 females; 30 cases in each group. There was no statistically significant difference in gender, age, body mass index, surgical approach, and surgical duration between the two groups of patients (P>0.05). There were statistically significant differences in total blood loss [(795.90±451.36) vs. (579.70±315.88) mL], 48 h postoperative blood drainage [(231.33±130.77) vs. (147.67±73.14) mL], recessive blood loss [(406.23±356.17) vs. (170.30±163.75) mL], and transfusion rate (63.3% vs. 36.7%) between the control group and the experimental group (P<0.05). There was no statistically significant difference in the preoperative incidence of intramuscular vein thrombosis and the postoperative incidence of deep vein thrombosis and intramuscular vein thrombosis between the two groups of patients (P>0.05). All patients did not experience pulmonary embolism after surgery. The hemoglobin and hematocrit of both groups showed a decreasing trend. But there was no statistically significant difference in hemoglobin and hematocrit between the two groups (P＞0.05). Both groups showed different trends in fibrinogen and D-dimer, and the experimental group was better than the control group (P<0.05). Conclusion Multiple intravenous administration of TXA in complex acetabular fractures patients has proven to decrease the total and hidden blood loss, decrease perioperative blood products transfusion rate, and do not expose to venous thrombotic diseases risks.
目的 觀察和評估活性多孔納米復合人工顆粒骨納米羥基磷灰石聚酰胺66（n-HA/PA66）骨修復下肢承重骨大塊良性腫瘤性骨缺損的臨床療效。 方法 選取2007年12月－2011年5月，良性骨腫瘤行股骨和脛骨手術術后骨缺損較大，需植骨填充且植骨量＞20 g的患者67例。其中骨巨細胞瘤26例，纖維結構不良18例，骨囊腫10例，其他良性骨腫瘤13例。腫瘤刮除后瘤腔大小為3.0 cm×2.0 cm×1.5 cm～7.0 cm×3.0 cm×3.0 cm。全部患者行病灶刮除、瘤腔滅活、大量打壓式植入n-HA/PA66人工骨，根據患者情況加用同種異體松質骨、含DBM人工骨，并根據皮質受累范圍及厚度選擇適當內固定。定期隨訪觀察傷口愈合情況、患者肝腎功能、免疫指標、關節活動度及植骨處愈合情況。 結果 67例患者全部獲得隨訪，隨訪時間7～45個月，平均31.3個月。所有患者傷口均I/甲愈合，術后無肝、腎功能損害，無免疫相關疾病發生。患者植骨愈合時間為術后3～9個月，平均4.6個月，愈合率95.2%。術后骨巨細胞瘤患者局部復發3例，均經再次手術，隨訪未再復發。 結論 n-HA/PA66顆粒骨可作為下肢承重骨大塊良性腫瘤性骨缺損的植骨填充材料。
This paper systematically summarizes the practical experience of the 2025 Dingri earthquake emergency medical rescue in Tibet. It analyzes the requirements for earthquake medical rescue under conditions of high-altitude hypoxia, low temperature, and low air pressure. The paper provides a detailed discussion on the strategic layout of earthquake medical rescue at the national level, local government level, and through social participation. It covers the construction of rescue organizational systems, technical systems, material support systems, and information systems. The importance of building rescue teams is emphasized. In high-altitude and cold conditions, rapid response, scientific decision-making, and multi-party collaboration are identified as key elements to enhance rescue efficiency. By optimizing rescue organizational structures, strengthening the development of new equipment, and promoting telemedicine technologies, the precision and effectiveness of medical rescue can be significantly improved, providing important references for future similar disaster rescues.