Short story on Ma Chunguang Chen Xueming Zhu Xu 1! 19 years 4, December 2000, I opened the team at the junction of the èœ± èœ± èœ± ä¼‘ ä¼‘ ä¼‘ ä¼‘ ä¸¥é‡ ä¸¥é‡ ä¸¥é‡ ä¸¥é‡ ä¸¥é‡ ä¸¥é‡ ä¸¥é‡ ä¸¥é‡ ä¸¥é‡ ä¸¥é‡ ä¸¥é‡ ä¸¥é‡ ä¸¥é‡ å¦ å¦ å¦ å¦ å¦ å¦ å¦ å¦ å¦ å¦ å¦ å¦ å¦ å¥³æ€§ å¥³æ€§ å¥³æ€§ å¥³æ€§ å¥³æ€§ å¥³æ€§ å¥³æ€§ å¥³æ€§ å¥³æ€§ å¥³æ€§ å¥³æ€§. The injured vertebrae were stable and the arched nails were loosened in 2 cases. One of them had residual kyphosis after 15.1 postoperative injuries; the other one had local mass. The spine is unstable and the pseudoarthrosis is formed. Intraoperative incision has a small amount of fluid and granulation tissue. Consider aseptic inflammation caused by loosening of the arched nail. Remove the internal fixation. Scrape the granulation tissue. Replant bone fusion. The fifth case was a severe vertebral fracture. There is a bending of the cephalic nail.
The hospital used the internal fixation system to treat 26 patients with thoracolumbar fractures. Summarize the therapeutic effect and focus on the reasons for the internal fixation failure, in order to improve the role of the internal fixation.
The age is 2150 years old. The average is 366 years old. According to Zhang Guangkai, only 3 cases of Ding fracture were classified into 121 cases, 12 cases, 20 cases of burst fractures, 122 cases of Ding, and 128 cases of 128 cases. , 31. Valve. There were 3 cases of 122 cases and 1231 cases of dislocation and dislocation. Injury 1 was caused by falling imitation in 12 cases. 8 cases of car vortex. 6 cases of bruises. According to the classification of 1 Guan 1 , there are 1 case of human level, 1 case of 8th grade, and 5 cases of 0 grade. 10 cases of level 0, 9 cases of level. In 8 cases, the cause of surgery included vertebral body leading edge compression greater than 30. Spinal canal compression 30 50. Fracture dislocation. All patients underwent posterior incision and reduction, pedicle screw system internal fixation and posterior lateral bone graft fusion, 8 of which were simultaneously decompressed. The follow-up time was 5 years and 2 months, with an average of 2 years and 7 months.
Results There was no significant difference in the residual height of the injured vertebrae between the two groups. There was a significant difference in the residual height of the injured vertebrae between the two groups. 1. There was no neurological aggravation in this group. Patients with neurological injury were graded on average after surgery.
There were 5 cases of internal fixation failure in this group. It was found to be low back pain or asymptomatic at 6 months after operation. It was found during follow-up. In this group, the number of patients with anterior vertebral body height before operation is high. Preoperative vertebral body height is high. Preoperative, leaf and melon grading 15 Discussion The patient's nail failure rate reached 19.2. The reasons may include the following aspects: Related to the human system structure. The system has a prefabricated 6 or 12 tilt angle at the junction of the upper pedicle screw. Although this contributes to the reduction of the fracture, it also makes the joint between the upper bolt and the head side nut and the nail interface. The received date of the orthopedics of the Beijing Luhe Hospital 1049 is subject to greater stress. It is prone to metal fatigue fracture, especially in patients with large body; 2 the time from injury to surgery is too long, in order to restore the height and physiological lordosis of the fractured vertebral body, the excessive longitudinal expansion force increases the upper bolt and the head side Stress at the joint of the nut and the interface of the nail; 3 rupture of the vertebral body. The disc is severely damaged. Despite this burst fracture, the system still has better fracture vertebral complex height and physiological lordosis recovery. However, the empty shell effect of the fractured vertebral body and the widening of the intervertebral space are easily formed, and the fractured vertebral body and the intervertebral disc collapse can be caused by sitting and standing. Increased the stress on the interface between the upper bolt and the head side nut and the bone-cut interface; 4 lack of waist circumference or brace protection. The screw joint and the head-side nut interface and the nail-bone interface are greatly curved and fractured. The large stress at the nail-nail interface is easy to cause the necrosis of the bone around the pedicle screw due to excessive pressure, resulting in loosening of the pedicle screw. Or with aseptic inflammation. In order to avoid the above complications. Should pay attention to the following points 1 correctly choose the indications. The vertebral body fragmentation is severe or more than 71 times after the injury. Due to posterior surgery, the height of the vertebral body is poor. Should choose anterior surgery or combined anterior and posterior surgery; 2 to avoid excessive longitudinal expansion, to prevent the empty shell effect of the fractured vertebral body and intervertebral space, wide and late collapse; 3 improve the quality of bone graft bone graft fully decorticized, After the implantation of a sufficient amount of autologous bone, wear a wide waist or chest and waist brace to protect and strengthen the back muscle training. This is especially true for patients with large body weight; 5 avoid heavy physical labor before the bone graft is not fused.
1 piece of light cypress. Li Zirong. Zhang Xuezhe. Comprehensive classification and treatment of thoracolumbar injuries. Chinese Journal of Surgery.
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