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Abstract Background The clinical treatment of long bone defets in the extremities caused by trauma, infection, tumours, and nonunion has been a challenge for orthopaedic surgeons. Bone transport techniques have become the only way to treat such bone defects. However, inevitable difficulties and complications related to bone transport techniques have been reported in many studies. Aim The purpose of this study was to investigate the risk factors for complications and the effectiveness of the Ilizarov bone transport technique in the treatment of tibial bone defects. Methods The study was conducted in 199 patients who underwent treatment with the Ilizarov bone transport technique at our institution from May 2012 to September 2019. Patient demographic data, complications and clinical outcomes after a minimum of 2 years of follow-up were collected and retrospectively analysed. Additionally, a risk factor analysis was performed for the top three major complications. The clinical outcomes were evaluated using the Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria at the last clinical follow-up. Results A total of 199 patients underwent follow-up for 12–40 months, with an average of 23.5 months, and all achieved bone healing. A total of 310 complications occurred, with an average of 1.04 minor complications and 0.48 major complications per patient. The top three complications were pin tract infection in 48 cases (61.3%), axial deviation in 86 cases (43.2%), and delayed union in 50 cases (25.13%). Multivariate analysis showed that the bone defect length (P = 0.02, OR = 5.489), the number of previous surgeries (P = 0.003, OR = 2.204), and the external fixation index (P = 0.01, OR = 1.202) were significantly correlated with pin tract infection. Bone defects of the middle 1/3 (P

Abstract Background Treating long bone defects of the extremities caused by trauma, infection, tumours, and nonunion has been challenging for clinical orthopaedic surgeons. Bone transport techniques have the potential to treat bone defects. However, inevitable docking site complications related to bone transport techniques have been reported in many studies. The purpose of this study was to investigate the risk factors associated with docking site complications in patients who underwent the Ilizarov bone transport technique for the treatment of tibial bone defects. Methods This retrospective study included 103 patients who underwent bone transport for the treatment of large bone defects in the tibia from October 2012 to October 2019. Patient demographic data, complications and clinical outcomes after a minimum of 2 years of follow-up were collected and retrospectively analysed. Additionally, univariate analysis and logistic regression analysis were used to analyse the factors that may affect the development of docking site complications in patients with tibial bone defects treated with the Ilizarov bone transport technique. The clinical outcomes were evaluated using the Association for the Study and Application of the Ilizarov criteria (ASAMI) at the last clinical follow-up. Results All 103 patients with an average follow-up of 27.5 months. The docking site complications rate per patient was 0.53, and delayed union occurred in 22 cases (21.4%), axial deviation occurred in 19 cases (18.4%) and soft tissue incarceration occurred in 10 cases (9.7%). According to the results of the logistic regression analysis, the bone defect length (P = 0.001, OR = 1.976), and bone defect of distal 1/3 (P = 0.01, OR = 1.976) were significantly correlated with delayed union. Bone defect length (P

ObjectiveTo investigate the clinical efficacy of percutaneous microballoon compression in the treatment of recurrent TN.MethodsThis retrospective study included 33 patients who underwent percutaneous microballoon compression for the treatment of recurrent TN from March 2019 to May 2022. Postoperative pain recurrence and facial numbness were assessed according to the Barrow Neurological Institute (BNI) pain score. Patients’ anxiety and sleep status during follow-up were assessed according to the Self-rating Anxiety Scale (SAS) and Pittsburgh Sleep Quality Index (PSQI).ResultsAll patients (33 cases) were followed up for 12–38 months, with an average follow-up time of 23 months. On postoperative day 1, 31 patients (93.9%) reported no pain, and 2 patients were given drug treatment for pain relief, The total efficacy was 93.9%. Moreover, 2 patients (6.1%) reported significant pain relief 2 weeks postoperatively. There are many complications during and after PBC. The incidence of the trigeminocardiac reflex (TCR) during surgery was 100%, and the incidence of facial numbness, masseter muscle weakness, labial herpes and headache was 97, 60.6, 12.1 and 3%. No patient experienced severe facial numbness, hearing impairment, diplopia, injury to cranial nerves, Meningitis, intracranial haemorrhage or keratitis. 1 patient had recurrence of pain at 6 months post-op, which was relieved by oral medication. 81.8% suffered from anxiety and 54.5% had poor sleep quality before surgery. After the period of PBC, SAS and PSQI scores decreased continuously. There were significant improvements in anxiety and sleep status postoperatively compared with preoperatively.ConclusionPBC is a safe and effective option for the treatment of recurrent TN. The arduous and demanding nature of the clinical course subjects the patient to severe pain, mental, and physical stress. Thankfully, it significantly improves the symptoms of anxiety, depression, and sleep quality.

Abstract Background The most commonly used approach for distal radius fractures is the traditional Henry approach. However, it requires an intraoperative incision of the pronator quadratus (PQ) muscle, which results in a series of complications if the repair of the PQ fails. Aim The objective of this study was to investigate the efficacy of sparing the pronator quadratus for volar plating of the distal radius fractures. Methods Seventy-six patients who suffered from distal radius fractures of types 23-B, 23-C1, and 23-C2 as per the AO Foundation and Orthopaedic Trauma Association (AO/OTA) classification were treated with volar locking plate fixation using either the PQ muscle incision and repair (group A, n = 39) or the PQ muscle preservation approach (group B, n = 37). Intraoperative index, postoperative efficacy and complications of patients were recorded and evaluated. Results All patients were followed up for more than one year after surgery. All fractures achieved union. There were significant differences in mean operative time, mean intraoperative blood loss, and mean fracture healing time between the two groups. Still, there were no significant differences in limb function scores between the two groups at the 12-month postoperative follow-up. Outcomes assessed at 1 week, 1 month, and 3 months after surgery demonstrated significant differences in the mean range of motion and pain-related visual analog scale (VAS) between the two groups. As the range of motion and grip strength increased, the VAS scores decreased, and there was no significant difference between the two groups at 12 months postoperatively. Although tendon irritation and delayed carpal tunnel syndrome were more common in group A than in group B (7.6% vs. 0% and 5.1% vs. 0%, respectively), the differences were not statistically significant. Conclusion The modified Henry approach with sparing pronator quadratus muscle has no significant advantage in the range of wrist motion and upper limb function in the late stage. Nevertheless, the intraoperative placement of the plate under the pronator quadratus muscle can shorten the operation time, reduce intraoperative bleeding, reduce early postoperative pain, promote early activity, and improve the patient's quality of life. It is recommended that the pronator be preserved at the time of surgery.