Objective
To explore the ultrasonic images of radial neck fracture in children and evaluate the value of ultrasound in its diagnosis and treatment so as to provide an effective, safe and reliable method for its mini-invasive treatment.
Methods
A total of 14 patients of radial neck fracture were recruited. The types were O'Brien Ⅱ(n=10) and O'Brien Ⅲ (n=4). All patients underwent percutaneous Kirschner wire leverage (PKWL) guided by ultrasound, kirschner wire fixation and plaster external fixation. After 4-6 weeks later, functional exercise began after plaster removal and needle extraction.
Results
The average follow-up period was 10.6 (6-23) months. According to the postoperative X-ray by Metaizeau's standard, the outcomes were excellent (n=12) and fair (n=2). Based upon the Steel and Gtrham grading standard, elbow bending, stretching, pronation, supination activity and affirmative Angle were all excellent (100%) at the last follow-up.
Conclusions
As a noninvasive examination, ultrasound has great application prospects for percutaneous Kirschner wire leverage for accurate positioning in radial neck fracture. The advantages are mini-invasiveness, stable fixation, simple handling, early postoperative activity and fewer complications. Also it reduces the X-ray exposure of both children and medical staff.
Key words:
Radial neck fractures; Ultrasonography; Child
Subjecte To investigated the characteristics and diagnosis and treatment which were pre-hernia intervention of cascade hernia. Reduce rate of mortality and disability that is attention must be paid to prehospital intervention before the formation of a true cascade of brain herniation. clinical series of pre-hernia manifestations were rapidled that from sequential brain tissue displacement in part patients, and by developmenting. Leading to a clinical series of pre-hernia by fromed. The effect of pre-hernia intervention on prognosis which from timely onec. methods From June 2015 to December 2022, the 61 patients with unilateral acute frontotemporal parietal subdural hematoma were treated. From June 2015 to December 2022, 61 patients with unilateral frontotemporal acute subdural hematoma were evaluated according to GCS. Twenty-five patients with cascade cerebral hernia and 36 patients with cascade cerebral hernia before hernia underwent dynamic CT examination, and patients with pre-herniation of brain cascade hernia were treated with early intervention. Results The patients were followed up for 6 to 12 months. According to the Glasgow Outcom scale (GOS), there were 25 patients in the brain cascade hernia group; either with 3 cases of 1 point, 4 cases of 2 points, 5 cases 3 points, 4 cases 3 points, 2cases of 4 points, and 9 cases of 5 points. There were 36 patients in the prehernia group: 1 case of 1 point, 3 cases of 2 points, 4 cases of 3 points, 11 cases of 4 points and 17 cases of 5 points. Conclusions Unilatera supratentorial acute frontotemporal parietal acute subdural hematoma leading to the cascade cerebral hernia is easy to lead to instability of clinical vital signs or respiratory and circulatory failure. Patients were must be treated promptly at the early stage or stage I- III or in IV of cascade cerebral hernia in this group Pre-hernia intervention is the key to reduce e mortality and morbidity.
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