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Objectives: Unilateral percutaneous kyphoplasty (UPKP) has been effective in reducing the operative time, cement volume, and cement leakage (CL) rate compared with bilateral kyphoplasty. However, no device can help to determine the trajectory during operation, especially the inner inclination angle. To assess the safety and efficacy of a novel guide device (GD) for UPKP in the treatment of thoracolumbar osteoporotic vertebral fractures (TLOVFs). Methods: From January 2019 to May 2021, 31 patients diagnosed with single TLOVF who underwent UPKP were retrospectively reviewed. The patients were divided into two groups: traditional UPKP (UPKP group, 15 patients) and UPKP assisted with GD (UPKP‐GD group, 16 patients). Pre‐procedure demographic, clinical and radiologic characteristics, operative procedure details, and clinical and radiologic outcomes at 1 day and 12 months post‐procedure were collected. Statistical analyses were carried out using SPSS 24.0. The baseline characteristics of the two groups were compared by the independent sample t test or the χ2 test. The anterior height or local kyphotic angle (LKA) of the fractured vertebrae, visual analog scale (VAS) score, and Oswestry Disability Index (ODI) within groups were compared using the paired t test. Results: A total of 31 patients (five men and 26 women; age range: 58–90 years) completed the full 12‐month postoperative follow‐up schedule. No significant differences were observed between treatment groups with respect to sex, age, body mass index, preoperative bone mineral density, or surgical level. Compared with the UPKP group, the operation time in the UPKP‐GD group was significantly shorter (40.8 ± 5.5 min vs. 48.5 ± 8.5 min, p = 0.005), and the number of intraoperative fluoroscopy times in the UPKP‐GD group was significantly decreased (20.6 ± 4.5 vs. 25.2 ± 2.4, p = 0.001). Five (31.3%) patients in the UPKP‐GD group and four (26.7%) patients in the UPKP group had bone CL. The VAS and ODI scores, anterior height and LKA of the fractured vertebrae were significantly improved after surgery in each group. No significant differences in postoperative VAS and ODI scores, anterior height or LKA of the fractured vertebrae, volume of injected cement or CL were observed between the two groups. Conclusion: Unilateral puncture using a novel GD is a safe and effective technique for patients with TLFs and UPKP assisted with a novel GD is associated with fewer intraoperative fluoroscopy times and shorter operation time. [ABSTRACT FROM AUTHOR]

Purpose. Fractures are common among all types of paediatric injuries, with differences in incidence over time. Here, we present the epidemiologic features of traumatic fractures in a population of youth ≤ 18 years of age who were admitted to our university-affiliated hospitals from 2002 to 2010. Methods. We retrospectively reviewed 2450 children and adolescents who had traumatic fractures. The data include variables such as age, sex, date of injury, and the mechanism of injury. For the period of 2002-2010, there were 2450 injury events that resulted in at least 1 fracture. Results. Low falls (1042, 42.5%) and upper limb fractures (1068, 43.6%) were the most common aetiologies and fracture sites. With increasing age, the proportion of injuries due to motor vehicle collisions (MVCs) decreased and the injuries due to being hit by others and due to sprains increased. With increasing age, the proportion of craniofacial fractures (CFFs) decreased, and lower limb fractures (LLFs), spinal fractures (SFs), and fractures of ribs and the sternum (RSFs) increased. Over time, the proportion of injuries due to MVCs and mechanical injury decreased. Male patients presented with a significantly higher proportion of injuries due to low falls, being struck by an object, being hit by others, and due to sprains. There were a significantly lower proportion of injuries due to MVCs in female patients. Male patients presented with a significantly higher proportion of ULFs in the ≤6-year-old age group and a significantly lower proportion of LLFs and SFs in the 12-18-year-old age group than did female patients. Conclusions. Low falls and upper limb fractures were the leading cause and fracture sites. To further improve the prevention and treatment of traumatic fractures in children and adolescents, policy makers should pay attention to these characteristics. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the incidence and pattern of traumatic fractures resulting from motor vehicle collisions in a population of children and adolescents (≤18 years old) and to determine the risk factors for nerve injury.Methods: We retrospectively reviewed 734 patients admitted to our university-affiliated hospitals from 2001 to 2010.Results: This study enrolled 498 male (67.8%) and 236 female (32.2%) patients aged 10.9 ± 5.3 years old. The most common injuries were to pedestrians, and the most common fracture sites (438, 59.7%) were to lower extremities (n = 441, 60.0%). A total of 201 (27.4%) patients experienced a nerve injury. Univariate logistic regression analysis showed that age (P = 0.014), lower-extremity (P = 0.000), craniofacial (P = 0.000) and spinal (P = 0.000) fractures were risk factors for nerve injury. Multivariate logistic regression analysis indicated that craniofacial [odds ratio (OR) = 9.003, 95% confidence interval (CI) 5.159-15.711, P = 0.000)] and spinal (experiencedOR = 10.141, 95% CI: 4.649-22.121, P = 0.011) fractures were independent risk factors for nerve injury.Conclusions: Patients in the 15- to 18-years old group and drivers had the largest sex ratio and highest frequencies of both nerve injury and early complications. Craniofacial and spinal fractures were independent risk factors for nerve injury. It is therefore important to focus on these risk factors to determine the presence of a nerve injury so that early, timely diagnosis and targeted treatment can be provided. [ABSTRACT FROM AUTHOR]

In order to illustrate the epidemiology of traumatic spinal fractures among the elderly, with an emphasis on exploring gender differences in clinical characteristics, we retrospectively reviewed hospital records on all elderly patients with traumatic spinal fractures who were 60 years of age or older at two university-affiliated hospitals between January 2001 and December 2010. A total of 642 elderly patients with traumatic spinal fractures were identified, of whom 249 were male and 393 were female. Accidental falls from low heights were the most common cause of traumatic spinal fractures among the elderly (50.8%). Frequencies of falls from high heights and direct collisions with a blunt object were significantly higher in male than in female elderly patients ( P < 0.05). Frequencies of falls from low heights, daily life injuries and jolt injuries in female patients were significantly higher than in male patients ( P < 0.05). There were 984 vertebral body fractures, with the thoracolumbar segment involved in 60.3% of cases (227/984). Frequencies of cervical spinal fractures, spinal cord injuries, associated non-spinal injuries (ASOIs) and mean injury severity scores (ISSs) were significantly higher in males than in females ( P < 0.05). Frequencies of thoracic and thoracolumbar spinal fractures in females were significantly higher than in males ( P < 0.05). Clinicians should make their diagnoses and direct their injury prevention strategies according to gender differences in the clinical characteristics of traumatic spinal fractures among the elderly. [ABSTRACT FROM AUTHOR]

Background: To compare the biomechanical characteristics of different posterior intermediate screw fixation techniques (ISFTs) with hybrid monoaxial pedicle screws (Mps) and polyaxial pedicle screws (Pps) used in thoracolumbar burst fractures. Methods: Fixation techniques are compared with regard to the von Mises stress (VMS) of the instrumentations and intradiscal pressures (IDPs) of the adjacent segments by finite element method (FEM). Results: The redistributed ROM of the fixation models with Pps fixed at the lowest segment was twice of the other fixation models in flexion and extension. The largest value of maximal VMS of a pedicle screw was located at the lowest pedicle screws when Mps are fixed at the lowest segment. The largest value of maximal VMS of the rods was decreased when more Pps are fixed at the models. Maximal IDPs of the upper adjacent segments were all larger than those of the lower adjacent segments. The maximal IDPs of the fixation model with MPs fixed at the lowest segment were larger than the other fixation models in flexion and extension. Conclusions: Polyaxial pedicle screws could be placed at the upper or the median segment for the facilitated efficient application of the connecting rod. We should focus on the adjacent segmental degeneration especially the upper adjacent segment in the fixation model with Mps fixed at the lowest segment. [ABSTRACT FROM AUTHOR]