AIM: To systematically review and analyze the overall impact and effectiveness of bony surgical procedures, the triangle tilt and humeral surgery in a comparative manner in permanent obstetric brachial plexus injury(O...AIM: To systematically review and analyze the overall impact and effectiveness of bony surgical procedures, the triangle tilt and humeral surgery in a comparative manner in permanent obstetric brachial plexus injury(OBPI) patients.METHODS: We conducted a literature search and identified original full research articles of OBPI patients treated with a secondary bony surgery, particularly addressing the limitation of shoulder abduction and functions. Further, we analyzed and compared the efficacy and the surgical outcomes of 9 humeral surgerypapers with 179 patients, and 4 of our secondary bony procedure, the triangle tilt surgical papers with 86 patients. RESULTS: Seven hundred and thirty-one articles were identified, using the search term "brachial plexus" and obstetric or pediatric(246 articles) or neonatal(219 articles) or congenital(188 articles) or "birth palsy"(121 articles). Further, only a few articles were identified using the bony surgery search, osteotomy "brachial plexus" obstetric(35), "humeral osteotomy" and "brachial plexus"(17), and triangle tilt "brachial plexus"(14). Of all, 12 studies reporting pre- and postoperative or improvement in total Mallet functional score were included in this study. Among these, 9 studies reported the humeral surgery and 4 were triangle tilt surgery. We used modified total Mallet functional score in this analysis. Various studies with humeral surgery showed improvement of 1.4, 2.3, 5.0 and 5.6 total Mallet score, whereas the triangle tilt surgery showed improvement of 5.0, 5.5, 6.0 and 6.2.CONCLUSION: The triangle tilt surgery improves on what was achieved by humeral osteotomy in the management of shoulder function in OBPI patients.展开更多
Objective:To evaluate the therapeutic effect of dynamic fixation with a hook plate-double loop plate internal fixation system for high-energy acromioclavicular joint complex dislocation(denoted as HACD,i.e.,Rockwood t...Objective:To evaluate the therapeutic effect of dynamic fixation with a hook plate-double loop plate internal fixation system for high-energy acromioclavicular joint complex dislocation(denoted as HACD,i.e.,Rockwood type III-V dislocation).Methods:Fifty-eight patients with HACD were selected and evenly divided by drawing lots.The experimental group underwent ligament reconstruction treatment,while the reference group received hook plate fixation treatment.The efficacy and other indicators were compared between the groups.Results:The overall effective rates between the groups were similar(P>0.05).The experimental group had a longer surgical duration,lower pain scores at 6 months postoperatively,higher shoulder joint function scores,and a lower complication rate,with P<0.05 when compared between groups.Conclusion:The effectiveness of the double loop plate internal fixation system ligament reconstruction treatment for patients with HACD is comparable to that of hook plate fixation treatment.Although the surgical duration is slightly longer,postoperative pain is milder,facilitating the recovery of shoulder joint function in patients and offering higher safety.展开更多
目的探讨经筋刺血疗法联合低频脉冲电刺激治疗脑卒中后肩手综合征(Shoulder hand syndrome,SHS)的临床价值。方法选择太和县人民医院确诊的156例SHS患者,按随机数字表法分为对照Ⅰ组、对照Ⅱ组、治疗组,各52例。3组患者均给予脑卒中康...目的探讨经筋刺血疗法联合低频脉冲电刺激治疗脑卒中后肩手综合征(Shoulder hand syndrome,SHS)的临床价值。方法选择太和县人民医院确诊的156例SHS患者,按随机数字表法分为对照Ⅰ组、对照Ⅱ组、治疗组,各52例。3组患者均给予脑卒中康复期基础治疗与功能康复锻炼,在此基础上,对照Ⅰ组患者给予低频脉冲电刺激,对照Ⅱ组患者给予经筋刺血疗法治疗,治疗组患者给予低频脉冲电刺激+经筋刺血疗法,治疗4周后,观察3组患者临床疗效、安全性及治疗前后病损评分(Shoulder hand syn-drome score,SHSS)、疼痛评分(Visualanaloguescale,VAS)、关节活动度评分、生活质量评分(Stroke-specific quality of life,SS-QOL)的变化。结果(1)治疗4周后,治疗组患者临床总有效率(96.0%)高于对照Ⅰ组患者(82.35%)与对照Ⅱ组患者(80.77%),差异均有统计学意义(P<0.05);(2)治疗4周后,3组患者SHSS评分均较治疗前下降,且治疗组患者最低,与对照Ⅰ、Ⅱ组患者比较差异均有统计学意义(P<0.05);(3)治疗4周后,3组患者VAS评分均较治疗前下降,且治疗组患者最低,与对照Ⅰ、Ⅱ组患者比较差异均有统计学意义(P<0.05);(4)治疗4周后,3组患者关节活动度评分均较治疗前增加,且治疗组患者最高,与对照Ⅰ、Ⅱ组患者比较差异均有统计学意义(P<0.05);(5)治疗4周后,3组患者SS-QOL活动能力、心情、自理、上肢功能领域评分均较治疗前增加,且治疗组患者最高,与对照Ⅰ、Ⅱ组患者比较差异均有统计学意义(P<0.05);(6)治疗期间,3组患者均未见与治疗直接相关的不良反应与事件。结论经筋刺血疗法联合低频脉冲电刺激治疗脑卒中后SHS安全、有效,有利于减轻病损程度,缓解疼痛,改善患者功能状态与生存质量。展开更多
文摘AIM: To systematically review and analyze the overall impact and effectiveness of bony surgical procedures, the triangle tilt and humeral surgery in a comparative manner in permanent obstetric brachial plexus injury(OBPI) patients.METHODS: We conducted a literature search and identified original full research articles of OBPI patients treated with a secondary bony surgery, particularly addressing the limitation of shoulder abduction and functions. Further, we analyzed and compared the efficacy and the surgical outcomes of 9 humeral surgerypapers with 179 patients, and 4 of our secondary bony procedure, the triangle tilt surgical papers with 86 patients. RESULTS: Seven hundred and thirty-one articles were identified, using the search term "brachial plexus" and obstetric or pediatric(246 articles) or neonatal(219 articles) or congenital(188 articles) or "birth palsy"(121 articles). Further, only a few articles were identified using the bony surgery search, osteotomy "brachial plexus" obstetric(35), "humeral osteotomy" and "brachial plexus"(17), and triangle tilt "brachial plexus"(14). Of all, 12 studies reporting pre- and postoperative or improvement in total Mallet functional score were included in this study. Among these, 9 studies reported the humeral surgery and 4 were triangle tilt surgery. We used modified total Mallet functional score in this analysis. Various studies with humeral surgery showed improvement of 1.4, 2.3, 5.0 and 5.6 total Mallet score, whereas the triangle tilt surgery showed improvement of 5.0, 5.5, 6.0 and 6.2.CONCLUSION: The triangle tilt surgery improves on what was achieved by humeral osteotomy in the management of shoulder function in OBPI patients.
文摘Objective:To evaluate the therapeutic effect of dynamic fixation with a hook plate-double loop plate internal fixation system for high-energy acromioclavicular joint complex dislocation(denoted as HACD,i.e.,Rockwood type III-V dislocation).Methods:Fifty-eight patients with HACD were selected and evenly divided by drawing lots.The experimental group underwent ligament reconstruction treatment,while the reference group received hook plate fixation treatment.The efficacy and other indicators were compared between the groups.Results:The overall effective rates between the groups were similar(P>0.05).The experimental group had a longer surgical duration,lower pain scores at 6 months postoperatively,higher shoulder joint function scores,and a lower complication rate,with P<0.05 when compared between groups.Conclusion:The effectiveness of the double loop plate internal fixation system ligament reconstruction treatment for patients with HACD is comparable to that of hook plate fixation treatment.Although the surgical duration is slightly longer,postoperative pain is milder,facilitating the recovery of shoulder joint function in patients and offering higher safety.
文摘目的探讨经筋刺血疗法联合低频脉冲电刺激治疗脑卒中后肩手综合征(Shoulder hand syndrome,SHS)的临床价值。方法选择太和县人民医院确诊的156例SHS患者,按随机数字表法分为对照Ⅰ组、对照Ⅱ组、治疗组,各52例。3组患者均给予脑卒中康复期基础治疗与功能康复锻炼,在此基础上,对照Ⅰ组患者给予低频脉冲电刺激,对照Ⅱ组患者给予经筋刺血疗法治疗,治疗组患者给予低频脉冲电刺激+经筋刺血疗法,治疗4周后,观察3组患者临床疗效、安全性及治疗前后病损评分(Shoulder hand syn-drome score,SHSS)、疼痛评分(Visualanaloguescale,VAS)、关节活动度评分、生活质量评分(Stroke-specific quality of life,SS-QOL)的变化。结果(1)治疗4周后,治疗组患者临床总有效率(96.0%)高于对照Ⅰ组患者(82.35%)与对照Ⅱ组患者(80.77%),差异均有统计学意义(P<0.05);(2)治疗4周后,3组患者SHSS评分均较治疗前下降,且治疗组患者最低,与对照Ⅰ、Ⅱ组患者比较差异均有统计学意义(P<0.05);(3)治疗4周后,3组患者VAS评分均较治疗前下降,且治疗组患者最低,与对照Ⅰ、Ⅱ组患者比较差异均有统计学意义(P<0.05);(4)治疗4周后,3组患者关节活动度评分均较治疗前增加,且治疗组患者最高,与对照Ⅰ、Ⅱ组患者比较差异均有统计学意义(P<0.05);(5)治疗4周后,3组患者SS-QOL活动能力、心情、自理、上肢功能领域评分均较治疗前增加,且治疗组患者最高,与对照Ⅰ、Ⅱ组患者比较差异均有统计学意义(P<0.05);(6)治疗期间,3组患者均未见与治疗直接相关的不良反应与事件。结论经筋刺血疗法联合低频脉冲电刺激治疗脑卒中后SHS安全、有效,有利于减轻病损程度,缓解疼痛,改善患者功能状态与生存质量。
