ObjectiveTo investigate the effect of residual varus and valgus deformity on the stress distribution of the knee joint after tibial fracture malunion.MethodsFourteen adult cadaver specimens were selected to establish the models of tibial fractures, which were fixed subsequently at neutral position (anatomical reduction) and malunion positions (at 5°, 10°, and 15° valgus positions, and 5°, 10°, and 15° varus positions). The stress distribution on the medial and lateral plateau of the tibia was quantitatively measured using ultra‐low‐pressure sensitive film technology. The changes in the stress distribution of the knee joint after tibial fracture malunion and the relationship between the stress values and the residual varus or valgus deformity were analyzed.ResultsUnder 400 N vertical load, the stress values on the medial and lateral plateau of the tibia at the neutral position were 1.137 ± 0.139 MPa and 1.041 ± 0.117 MPa, respectively. When compared with the stress values measured at the neutral position, the stress on the medial plateau of the tibia was significantly higher at varus deformities and lower at valgus deformities, and the stress on the lateral plateau was significantly higher at valgus deformities and lower at varus deformities (all P < 0.05). The stress values on the medial plateau of the tibia were significantly higher than the corresponding data on the lateral plateau at neutral and 5°, 10°, and 15° varus deformities, respectively (all P < 0.05), and significantly lower than the corresponding data on the lateral plateau at 5°, 10°, and 15° valgus deformities, respectively (all P < 0.05).ConclusionResidual varus and valgus deformity after tibial fracture malunion can lead to obvious changes of the stress distribution of the knee joint. Therefore, tibial fractures should be reduced anatomically and fixed rigidly to avoid residual varus–valgus deformity and malalignment of lower limbs.
Objective This study was performed to explore major risk factors for traumatic fracture by comparing related data of hospitalized patients with traumatic fracture and patients with lumbar disc herniation. Methods Patients with traumatic fracture and patients with lumbar disc herniation requiring surgical treatment in the orthopedics department of our hospital from March to May 2018 were divided into a fracture group and a non-fracture group. Clinical data were collected from the two groups by questionnaires. Major risk factors for traumatic fracture were analyzed using multivariate logistic regression. Results Univariate analysis showed statistically significant differences in family history of fracture, smoking history, drinking history, sex, sleep duration, chronic disease history, osteoporosis history, age, body mass index, occupation, and education level between the two groups. Multivariate logistic regression analysis showed that patients aged 25 to 44 years were more prone to traumatic fracture than patients aged ≥65 years, male patients were more prone to fracture than female patients, drinking alcohol was a risk factor for traumatic fracture, and sufficient sleep duration (>7 hours/night) was a protective factor for traumatic fracture. Conclusion Young age, male sex, and drinking are risk factors for traumatic fracture, whereas sufficient sleep duration is a protective factor.
Objectives To investigate the effect of residual rotation deformity on the stress distribution of the knee joint after surgery to treat middle and upper tibial fractures. Methods Fourteen adult cadaver specimens that were preserved with formalin were included, and the tibias were randomly positioned at 0 degree, 5 degrees, 10 degrees, and 15 degrees from the line of force of the lower limb. These positions modeled deformities of 5 degrees, 10 degrees, and 15 degrees from the line of force. Low-pressure pressure-sensitive film technology measured the stress distribution of the knee joint under different degrees of rotation deformity. Results Under a vertical load of 400 N, the difference between the medial and lateral stress of the knee joint was significantly different between the different tibia deformities (P<0.05), and the medial stress of the knee joint was higher than the lateral stress. The current study showed that there were statistically significant differences in the medial stress on the knee joint at all angles (including the neutral position of 0 degrees) (F=89.753, P<0.001) . There was a statistically significant difference in the lateral stresses of the knee joint between different rotation deformities (including the neutral position of 0 degrees) (F=102.998, P<0.001). Conclusions Residual rotation deformity after fracture of middle and upper tibia can lead to poor alignment of lower limb force and change of articular contact characteristics of knee joint, especially external rotation of tibia.Therefore, orthopedic surgeons should correct the malalignment of lower limbs to the greatest extent and reduce the rotation deformity as far as possible.
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