The purpose of this study was to analyze the feasibility and accuracy of a newly developed guide apparatus for the percutaneous retrograde lag screw fixation of posterior column of acetabular fractures. 3D pelvic models were reconstructed from the helical computed tomographic data of 33 adult patients using the Mimics 10.01 software. The virtual cylindrical implants were placed along a line passing through the central point of the ischial tuberosity and the midpoint between the most prominent point of anterior superior iliac spine and that of posterior superior iliac spine. Some anatomical parameters were then measured, based on which a guide apparatus was developed, and its safety and accuracy were experimentally validated with pelvic and cadaveric specimens. The screws were successfully placed in all of the 66 hemipelves. There was a significant difference between the male and female groups in the AB distance (156.26 ± 7.28 mm and 151.38 ± 8.11 mm), OI distance (139.53 ± 7.56 mm and 125.15 ± 11.17 mm), and diameter (12.19 ± 1.97 mm and 10.19 ± 2.14 mm) of the virtual cylindrical implants. This guide apparatus was proved effective for percutaneous retrograde lag screw fixation of posterior column acetabular fractures by the experiments with the pelvic and cadaveric specimens. Screw fixation of posterior column fractures via OI is safe and feasible. We designed a new percutaneous retrograde screw fixation guide apparatus to assist internal fixation of posterior column acetabular fracture.
Objective: To investigate the clinical effect of minimally invasive technique applied to internal fixation removal in patients with healed long tubular bone fractures. Methods: The records of patients with internal fixation of long tubular bone fracture who underwent the removal of the internal fixation device after fracture healing in The Second Affiliated Hospital of Hainan Medical College from May 2020 to December 2021 were reviewed. According to the different operation methods of taking out the internal fixation device, patients were divided into minimally invasive group (n=40) and traditional group (n=45). The perioperative indexes, levels of inflammatory factors tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), Karnofsky Performance Score (KPS), visual analog scale (VAS) pain score and complications were compared between the two groups. Results: The drainage volume, bleeding volume, incision length and hospital stay in the minimally invasive group were significantly lower than those in the traditional group (P<0.05). The KPS score of minimally invasive group was significantly higher than that of traditional group at one week and one month after the operation, and the VAS score of minimally invasive group was significantly lower than that of traditional group at one day and one week after the operation (P<0.05). The levels of TNF-α and CRP in the observation group were significantly lower than those in the control group(P<0.05). There was one case of infection in the minimally invasive group, one case of secondary fracture and two cases of infection in the traditional group(P>0.05). Conclusions: Minimally invasive surgery for the removal of the internal fixation device in patients with healed long tubular bone fractures with internal fixation is associated with significantly improved clinical effect, relieved symptoms, reduced inflammatory response, and improved functional recovery of patients. doi: https://doi.org/10.12669/pjms.39.1.6967 How to cite this: Li C, Lin W, Wu G, Zhang L, Zhang P. Clinical effect of minimally invasive technique of internal fixation device removal in patients with healed long tubular bone fractures. Pak J Med Sci. 2023;39(1):91-95. doi: https://doi.org/10.12669/pjms.39.1.6967 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
TMCP treatments were carried out on B510L steel followed by using a pilot rolling mill. Effects of finish rolling temperature and coiling temperature on mechanical properties and microstructures of the steel were analyzed. The tensile and impact properties were measured and the microstructures were observed by OM, TEM and SEM. With a proper control of rolling and cooling conditions, the yield strength of 500MPa was obtained, which was much higher than that in normal production. The yield ratio and ductility of the experimental steel were also reasonable. It was revealed that a good combination of ferrite with bainite microstructure was ideal for good mechanical properties. It was also concluded that the strengthening mechanisms included solution hardening, fine ferrite grain hardening, bainite hardening and precipitation hardening. This work can provide an experimental basis for industrial productions.
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