ABSTRACT. This study compared the efficacy between external fixator combined with palmar T-plate internal fixation and simple plate internal fixation for the treatment of comminuted distal radius fractures. A total of 61 patients classified as type C according to the AO/ASIF classification underwent surgery for comminuted distal radius fractures. There were 54 and 7 cases of closed and open fractures, respectively. Moreover, 19 patients received an external fixator combined with T-plate internal fixation, and 42 received simple plate internal fixation. All patients were treated successfully during 12-month postoperative follow-up. The follow-up results show that the palmar flexion and dorsiflexion of the wrist, radial height, and palmar angle were significantly better in those treated with the external fixator combined with T-plate compared to those treated with the simple plate only (P < 0.05); however, there were no significant differences in radial-ulnar deviation, wrist range of motion, or wrist function score between groups (P > 0.05). Hence, the effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures was satisfactory. Patients sufficiently recovered wrist, forearm, and hand function. Treatment of comminuted distal radius fracturesIn conclusion, compared to the simple T-plate, the external fixator combined with T-plate internal fixation can reduce the possibility of the postoperative re-shifting of broken bones and keep the distraction of fractures to maintain radial height and prevent radial shortening.

Objective: This research aimed at examining the volume of hidden blood loss (HBL) in lumbar fusion surgery with two kinds of screw implanting techniques and evaluating HBL-related factors in the patient population receiving lumbar fusion surgeryMethods: A retrospective study was conducted targeting 104 patients with lumbar degenerative diseases and treated with TLIF from January 2017 to December 2018, and the CBT (cortical bone trajectory) technique and conventional PS (pedicle screw) technique were applied to 45 and 59 patients, respectively. The collected data covered patients’ weight, height, BMI index, and operation time. It was followed by the recording of preoperative and postoperative hematocrit (HCT) of patients, based on which the blood loss was calculated by Gross’s formula. Results: The CBT and PS groups presented no significant difference in demographic characteristics (p > 0. 05), but the average HBL of 280±227 mL and 298±232 mL as well as the average TBL of 603±232 mL and 728±321 mL, respectively. It indicated the difference of the two groups in TBL, but no significant difference in HBL. In addition, an association of HBL of two screw techniques with operation time, concomitant disease and age was found from the data analysis.Conclusion: Large total blood loss incurred in lumbar fusion surgery, specifically with a lower value by the CBT technique than by the PS technique. Nonetheless, HBL occupied a large part of the total blood loss and it was identified in both groups. Thus, a good understanding of HBL will improve postoperative rehabilitation and guarantee patients’ safety.