For many years,surgical treatment of buried penis in children has been researched by several scholars,and numerous methods exist.This study aimed to explore the clinical effect of a modified fixation technique in trea...For many years,surgical treatment of buried penis in children has been researched by several scholars,and numerous methods exist.This study aimed to explore the clinical effect of a modified fixation technique in treating buried penis in children.Clinical data of 94 patients with buried penis who were treated using the modified penile fixation technique from March 2017 to February 2019 in Fujian Maternity and Child Health Hospital(Fuzhou,China)were retrospectively collected,compared,and analyzed.Clinical data of 107 patients with buried penis who were treated using traditional penile fixation technique from February 2014 to February 2017 were chosen for comparison.The results showed that at 6 months and 12 months after surgery,the penile lengths in the modified penile fixation group were longer than those in the traditional penile fixation group(both P<0.05).The incidence of postoperative skin contracture and penile retraction in the modified penile fixation group was less than that in the traditional penile fixation group(P=0.034 and P=0.012,respectively).When the two groups were compared in terms of parents'satisfaction scores,the scores for penile size,penile morphology,and voiding status in the modified penile fixation group were higher than those in the traditional penile fixation group at 2-week,6-month,and 12-month follow-ups after surgery(all P<0.05).We concluded that the modified penile fixation technique could effectively reduce the incidence of skin contracture and penile retraction and improve the penile length and satisfaction of patients'parents.展开更多
Background: The triple arthrodesis was described early by Myerson in 1923 and has been the gold standard surgical procedure for various conditions with the goal to reduce pain, improve deformity and facilitate functio...Background: The triple arthrodesis was described early by Myerson in 1923 and has been the gold standard surgical procedure for various conditions with the goal to reduce pain, improve deformity and facilitate function. Methods: The procedure consists of fusion of the subtalar joint, talonavicular joint and calcaneocuboid joint [1]. The procedure is traditionally done with internal fixation, however, Marinet al. has shown it to be performed with external fixation [2]. Dr. Marin and the associates have developed an alternative technique to perform a triple arthrodesis using internal and external fixation. This paper describes a step-by-step technique to perform a triple arthrodesis with both internal and external fixation. It will demonstrate the use of the prefabricated arches on the footplate for more precise and accurate placement of transosseous wires using arch-wire technique [3]. Results/Conclusion: We believe this technique will not only help increase the ability to achieve fusion with a less chance of non-union, but may also decrease healing time, which may allow patients to be mobile from the first week post-operatively and may diminish the risks associated with being non-weightbearing.展开更多
Objective: to analyze the clinical application value of different position fixation in radiotherapy for thoracic and abdominal tumors. Methods: 90 patients who received radiotherapy for thoracic and abdominal tumors i...Objective: to analyze the clinical application value of different position fixation in radiotherapy for thoracic and abdominal tumors. Methods: 90 patients who received radiotherapy for thoracic and abdominal tumors in the department of oncology of our hospital from September 2019 to September 2021 were screened and divided into 3 groups according to the differences of clinical treatment with different postural fixation schemes: groups A, B and C. Among them, group A chose the vacuum pad fixed position, and group B chose the body membrane fixation position, and group C chose the vacuum pad combined membrane fixation position. The number of patients in each group was 30 cases, and then compared the changes of the body position mobility, movement error and other indicators in each group. Results: regarding the mobility rate of patients, the mobility rate of group C was 6.00%, which was much lower than 24.00% and 34.00% of groups A and B, and the difference was prominent, with statistical advantages, P0.05;for the mobility error of patients, for example, groups A, B and C were (1.21±0.24) mm, (3.77±0.54) mm, and (4.23±0.88) mm, respectively, and the differences were significant, with statistical advantages, P0.05;in terms of positional measurement deviation, group C was much smaller than groups A and B, and the difference was prominent, with a statistical advantage, P0.05. Conclusions: for patients with thoracic and abdominal tumors, in the process of receiving radiation therapy, the choice of vacuum pad combined with body membrane fixation position for treatment has significant advantages. Compared with the single implementation of vacuum pad and body membrane fixation position, it can greatly reduce the movement error, swing measurement deviation, and also reduce the mobility rate as much as possible, so this is a postural fixation solution worthy of wide application.展开更多
Objective: To investigate the effectiveness of the plate screw internal fixation technique on the clinical outcomes of patients with traumatic fractures of long bones in the lower extremities. Methods: From January 20...Objective: To investigate the effectiveness of the plate screw internal fixation technique on the clinical outcomes of patients with traumatic fractures of long bones in the lower extremities. Methods: From January 2022 to December 2023, 70 patients with traumatic fractures of long bones in the lower extremities were admitted to the hospital and randomly divided into two groups: the control group and the observation group, each consisting of 35 cases. The control group underwent traditional closed interlocking intramedullary nailing, while the observation group received internal fixation with steel plates and screws. Relevant surgical indicators, treatment effectiveness, and postoperative complication rates were compared between the two groups. Results: The observation group exhibited significantly short surgical duration (80.65 ± 5.01 vs. 88.36 ± 5.26 minutes), fracture healing time (13.27 ± 0.32 vs. 15.52 ± 0.48 weeks), and hospitalization days (10.49 ± 1.13 vs. 16.57 ± 1.15 days) compared to the control group (P = 0.000). The effective treatment rate was significantly higher in the observation group (29/82.86%) than in the control group (21/60.00%), with a significant difference observed (χ2 = 4.480, P = 0.034). Additionally, the complication rate in the observation group (2/5.71%) was significantly lower than that in the control group (8/22.86%), with a correlated difference (χ2 = 4.200, P = 0.040). Conclusion: The plate screw internal fixation technique demonstrates significant clinical efficacy in treating traumatic fractures of long bones in the lower extremities. It improves the healing rate, reduces complications, and represents a safe and effective treatment strategy worthy of widespread use and application.展开更多
To explore the value of helical CT volume rendering technique (VRT) in post-operative evaluation of screw fixation of axis fractures.Methods There were 21 cases of screw fixation of axis fractures between February 200...To explore the value of helical CT volume rendering technique (VRT) in post-operative evaluation of screw fixation of axis fractures.Methods There were 21 cases of screw fixation of axis fractures between February 2002 and May 2004 in the study including six cases with fractures on axis body,five on odontoid process and 10 on axis body and odontoid process.All cases received X-ray plain film,helical CT scanning,multi-planar reformatting(MPR) and VRT.Results Screw fixation through axis body and massa lateralis atlantis was performed in 10 cases and that through axis body and odontoid process in 11.VRT could clearly display full aperture of screw orbit,location of screw and angle of fixation and hence was superior to X-ray plain film and MPR.Multi-angle VRT displayed asymmetrical space of odontoid process and massa lateralis atlantis in four cases and medial deviation of 2～5 mm of half screw in screw fixation through axis body and massa lateralis atlantis in six.Conclusion VRT can eliminate false shadow of fixation screw,clearly display full aperture of screw orbit and hence supply improtant imaging evidence for post-operative evaluation of screw fixation of axis fractures.7 refs,1 fig,1 tab.展开更多
Management of post-traumatic long-bone defects remains relevant and cha-llenging despite the rapid development of approaches to their treatment.Do-minant positions are occupied by the Ilizarov method,bone autogenous g...Management of post-traumatic long-bone defects remains relevant and cha-llenging despite the rapid development of approaches to their treatment.Do-minant positions are occupied by the Ilizarov method,bone autogenous grafting and the Masquelet induced membrane technique(IMT).The IMT is aimed at reducing extensive defect treatment duration and for this reason has gained great popularity.However,the assessment of its effectiveness is difficult due to a limited number of clinical series.The varying clinical manifestations of bone defect severity do not allow a comprehensive evaluation of IMT effectiveness.One of them is infection in the defect area.The purpose of our literature review is an analysis of studies on IMT application in infected vs non-infected long-bone defects of the lower extremities published over the last 10 years.It focuses on the investigation of similarities and fundamental differences in the need for antibiotics,timing of spacer fixation,methods of collecting donor bone and fixators used for consolidation.The studies show that the IMT has been globally used in aseptic and osteomyelitic defects due to its clinical effectiveness.Authors’variations and improvements in its practical implementation indicate the ongoing development and the interest of researchers in this technique.展开更多
Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge ev...Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge even for the most experienced surgeon.In this study,we describe in detail a novel unlocking closed reduction technique(UCRT)frame that allows strong traction for bilateral posterior pelvic ring displacement and presents preliminary clinical outcomes.Methods We retrospectively reviewed 32 patients with bilateral displaced posterior pelvic ring disruptions(AO/OTA 61-C2 and C3)who were initially treated with this technique between July 2017 and July 2022.According to the AO/OTA clas-sification,there were 9 cases(28.12%)of 61-C2,and 23 cases(71.88%)of 61-C3.There were 11 males,21 females,with an average age of 38.1 years.The interval from injury to operation was 4-27 days,with a cut-off of 12.5 days(receiver operat-ing characteristic curve).Operative time,blood loss,and postoperative radiographic findings were recorded.The functional outcomes and complications were followed.Results A total of 30(93.8%)patients achieved successful closed reduction,whereas 2 required open reduction.The success-ful closed reduction rate was 95.5%(21/22)in patients whose injury-to-operation time was less than 12.5 days.The vertical displacement percent correction of the obviously displaced hemipelvis was 70.20%±16.79%on average.The average degree of pelvic deformity correction was 64.86%±17.71%.Thirty patients were followed up for at least 12 months(12-36 months),and no complications of nonunion or redisplacement were observed.The Matta-Tornetta scoring standard revealed that the excellent(25/30)and good(4/30)rate was 96.7%.The Majeed clinical efficacy score revealed that the overall excellent and good rate was 100%.One patient had INFIX-related infection,and 2 reported numbness in the lateral thigh.The numbness was improved after INFIX removal.Conclusions This study presents an updated technique for closed reduction using a UCRT frame for bilateral posterior pelvic ring disruption,which has been shown to be effective,as indicated by excellent surgical and functional outcomes.展开更多
Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxi...Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxity of children, and the relative rarity of the disorders all play a part in difficulty of treatment. The benefits of modern posterior cervical instrumentation in children, defined as rigid screw–rod systems, have been shown to be many including: improved arthrodesis rates, diminished times in halo-vest immobilization, and improved reduction of deformities. The anatomy of children and the corresponding pathology seen frequently is at the upper cervical spine and craniocervical junction given the relatively large head size of children and the horizontal facets at these regions predisposing them to instability or deformity. Posterior screw fixation, while challenging, allows for a rigid base to allow for fusion in these upper cervical areas which are predisposed to pseudarthrosis with non-rigid fixation. A thorough understanding of the anatomy of the cervical spine, the morphology of the cervical spine, and the available screw options is paramount for placing posterior cervical screws in children. The purpose of this review is to discuss both the anatomical and clinical descriptions re-lated to posterior screw placement in the cervical spine in children.展开更多
BACKGROUND Tillaux fractures occur primarily in adolescents due to the pattern of physeal closure and are classified as Salter-Harris type III physeal fractures.Operative management with screw fixation is recommended ...BACKGROUND Tillaux fractures occur primarily in adolescents due to the pattern of physeal closure and are classified as Salter-Harris type III physeal fractures.Operative management with screw fixation is recommended for more than 2 mm of displacement or more than 1 mm of translation.However,the efficacy and complications of trans-physeal vs all-physeal screw fixation have not been investigated extensively.AIM To compare the clinical and functional outcomes of trans-physeal(oblique)and all-epiphyseal(parallel)screw fixation in management of Tillaux fractures among pediatric patients.METHODS This was an ethics board approved retrospective review of pediatric patients who presented to our tertiary children’s care facility with Tillaux fractures.We included patients who had surgical fixation of a Tillaux fracture over a 10 year period.Data analysis included demographics,mode of injury,management protocols,and functional outcomes.The patients were divided into group 1(oblique fixation)and group 2(parallel fixation).Baseline patient characteristics and functional outcomes were compared between groups.Statistical tests to evaluate differences included Fisher’s Exact or Chi-squared and independent samples t or Mann Whitney tests for categorical and continuous variables,respectively.RESULTS A total of 42 patients(28 females and 14 males)were included.There were no significant differences in body mass index,sex,age,or time to surgery between the groups[IK2].Sports injuries accounted for 61.9%of the cases,particularly non-contact(57.1%)and skating(28.6%)injuries.Computed Tomography(CT)scan was ordered for 28 patients(66.7%),leading to diagnosis confirmation in 17 patients and change in management plan in 11 patients.[GRC3]Groups 1 and 2 consisted of 17 and 25 patients,respectively.For mid to long-term functional outcomes,there were 14 and 10 patients in groups 1 and 2,respectively.Statistical analysis revealed no significant differences in the functional outcomes,pain scores,or satisfaction between groups.No infections,non-unions,physeal arrest,or post-operative ankle deformities were reported.Two(4.8%)patients had difficulty returning to sports post-surgery due to pain.One was a dancer,and the other patient had pain while running,which led to hardware removal.Both patients had parallel fixation.Hardware removal for groups 1 and 2 were 4(23.5%)and 5(20.0%)patients,respectively.The reasons for removal was pain in 2 patients,and parental preference in the remaining.CONCLUSION This is the largest reported series of pediatric patients with Tillaux fractures comparing functional outcomes of different methods of screw fixation orientation to the physis,which showed no difference regarding functional outcomes.展开更多
AIM: To assess the results of a modified technique for scleral fixation of a posterior chamber intraocular lens(IOL) in eyes which had deficient of posterior capsular support.METHODS: This retrospective study was comp...AIM: To assess the results of a modified technique for scleral fixation of a posterior chamber intraocular lens(IOL) in eyes which had deficient of posterior capsular support.METHODS: This retrospective study was comprised of ten patients with deficient posterior capsular support who underwent one-haptic fixation of posterior chamber IOLs, between February 2010 and October 2011. IOL as implanted with one haptic supported on the capsular remnant and the other haptic drawn into the sulcus by anchoring suture without a knot. All patients were evaluated for pre- and postoperative visual acuity, lens centration, intra-and postoperative complications.RESULTS: A knotless, one-haptic fixation of posterior chamber IOLs has successfully been performed on ten eyes. All cases had inadequate capsular support(i.e. a capsular tear ranged from 5 to 7 clock hours). The average age was 74.25 ±8.87y(SD). The average postoperative uncorrected visual acuity was 0.51 log MAR.Complications included hyphema in one eye, a mild inflammatory reaction in the anterior chamber in two eyes, and a transient rise in IOP in one eye. Neither IOL tilt nor dislocation was observed and there were no later complications.CONCLUSION: In the presence of insufficient capsular support, a knotless, one-haptic fixation of posterior chamber IOLs is a safe and viable option which reduces the operation time, and minimizes postoperative suture-related complications.展开更多
AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This ...AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This retrospective consecutive case series included patients with subluxated lenses by more than 180 degrees who underwent lens extraction,transcapsular scleral fixation of the standard CTR through equatorial capsulotomy,in-the-bag IOL implantation and with at least 6mo follow-up.Preoperative and postoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),complications,and postoperative IOL tilt and decentration were recorded.RESULTS:Nine eyes of 7 patients with a mean followup of 11.0±3.7mo were included in this study.The BCVA was significantly improved from 0.64±0.22 logMAR preoperatively to 0.21±0.19 logMAR postoperatively(P<0.001).The IOP was within the normal range postoperatively.The mean tilt of the IOL was 4.30°±2.31°(range,1.0°to 8.9°)and the mean decentration of the IOL was 0.37±0.12 mm(range,0.14 to 0.50 mm).No visually threatened intraoperative and postoperative complications were detected during the follow-up period.CONCLUSION:This is a safe and effective surgical technique for managing patients with severely subluxated lenses.It has achieved favorable outcomes with fewer surgical manipulations and less need for advanced capsular support devices.展开更多
The unit modular technique is one in which unit modules are prefabricated in a factory and then constructed at a construction site. That is why an important process, transport of unit module, is added in this techniqu...The unit modular technique is one in which unit modules are prefabricated in a factory and then constructed at a construction site. That is why an important process, transport of unit module, is added in this technique. However, it is not easy to transport a unit module that is high prefabrication ratio （prefab. ratio） （70-90%）, since the walls and interior and exterior materials installed in it can become broken when the unit module is fixed using general fixation tools, including ropes and fixing belts. When the external wall, windows, etc. are damaged during the transportation, the efficiency of unit modular method is deteriorated. Taking this into account, the purpose of this study is to develop an improved fixation device that is convenient for fixing a unit module with a high prefab, ratio to a vehicle and securing the safety while running. The L-type adapter block proposed in this study was evaluated the structural safety through simulation method. The result of the simulation is that it seems desirable to set the working load of the L-type adapter block as 15 kN for Case 1 and 30 kN for Case 2. Therefore, when the L-type adapter block is utilized under the conditions in which the same load is applied as in Case 2, it is expected that safety will be improved.展开更多
This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft ...This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft fixation techniques.The paper explores and comments on a recently published review by Dai et al,titled"Research progress on preparation of lateral femoral tunnel and graft fixation in ACLR",while providing insight into its relevance within the field of ACLR,and recommendations for future research.展开更多
Purpose To evaluate the refractive prediction error of common intraocular lens(IOL)power calculation formulae in patients who underwent intrascleral IOL fixation using two different techniques.Methods This is a prospe...Purpose To evaluate the refractive prediction error of common intraocular lens(IOL)power calculation formulae in patients who underwent intrascleral IOL fixation using two different techniques.Methods This is a prospective,randomized,longitudinal,single-site,single-surgeon study.Patients who underwent intrascleral IOL implantation using the Yamane or the Carlevale technique were followed up for a period of six months postoperatively.Refraction was measured using the best-corrected visual acuity at 4 m(EDTRS chart).Lens decentration,tilt and effective lens position(ELP)were assessed using an anterior segment optical coherence tomography(AS-OCT).The prediction error(PE)and the absolute error(AE)were evaluated for the SRK/T,Hollayday1 and Hoffer Q formula.Subsequently,correlations between the PE and axial length,keratometry,white to white and ELP were assessed.Results In total,53 eyes of 53 patients were included in the study.Twenty-four eyes of 24 patients were in the Yamane group(YG)and 29 eyes of 29 patients were in the Carlevale group(CG).In the YG,the Holladay 1 and Hoffer Q formulae resulted in a hyperopic PE(0.02±0.56 D,and 0.13±0.64 D,respectively)while in the SRK/T formula the PE was slightly myopic(−0.16±0.56 D).In the CG,SRK/T and Holladay 1 formulae led to a myopic PE(−0.1±0.80 D and−0.04±0.74 D,respectively),Hoffer Q to a hyperopic PE(0.04±0.75 D).There was no difference between the PE of the same formulae across both groups(P>0.05).In both groups the AE differed significantly from zero in each evaluated formula.The AE error was within±0.50 D in 45%–71%and was within±1.00 D in 72%–92%of eyes depending on the formula and surgical method used.No significant differences were found between formulae within and across groups(P>0.05).Intraocular lens tilt was lower in the CG(6.45±2.03°)compared to the YG(7.67±3.70°)(P<0.001).Lens decentration was higher in the YG(0.57±0.37 mm)than in the CG(0.38±0.21 mm),though the difference was not statistically significant(P=0.9996).Conclusions Refractive predictability was similar in both groups.IOL tilt was better in the CG,however this did not influence the refractive predictability.Though not significant,Holladay 1 formula seemed to be more probable than the SRK/T and Hoffer Q formulae.However,significant outliers were observed in all three different formulae and therefore remain a challenging task in secondary fixated IOLs.展开更多
文摘For many years,surgical treatment of buried penis in children has been researched by several scholars,and numerous methods exist.This study aimed to explore the clinical effect of a modified fixation technique in treating buried penis in children.Clinical data of 94 patients with buried penis who were treated using the modified penile fixation technique from March 2017 to February 2019 in Fujian Maternity and Child Health Hospital(Fuzhou,China)were retrospectively collected,compared,and analyzed.Clinical data of 107 patients with buried penis who were treated using traditional penile fixation technique from February 2014 to February 2017 were chosen for comparison.The results showed that at 6 months and 12 months after surgery,the penile lengths in the modified penile fixation group were longer than those in the traditional penile fixation group(both P<0.05).The incidence of postoperative skin contracture and penile retraction in the modified penile fixation group was less than that in the traditional penile fixation group(P=0.034 and P=0.012,respectively).When the two groups were compared in terms of parents'satisfaction scores,the scores for penile size,penile morphology,and voiding status in the modified penile fixation group were higher than those in the traditional penile fixation group at 2-week,6-month,and 12-month follow-ups after surgery(all P<0.05).We concluded that the modified penile fixation technique could effectively reduce the incidence of skin contracture and penile retraction and improve the penile length and satisfaction of patients'parents.
文摘Background: The triple arthrodesis was described early by Myerson in 1923 and has been the gold standard surgical procedure for various conditions with the goal to reduce pain, improve deformity and facilitate function. Methods: The procedure consists of fusion of the subtalar joint, talonavicular joint and calcaneocuboid joint [1]. The procedure is traditionally done with internal fixation, however, Marinet al. has shown it to be performed with external fixation [2]. Dr. Marin and the associates have developed an alternative technique to perform a triple arthrodesis using internal and external fixation. This paper describes a step-by-step technique to perform a triple arthrodesis with both internal and external fixation. It will demonstrate the use of the prefabricated arches on the footplate for more precise and accurate placement of transosseous wires using arch-wire technique [3]. Results/Conclusion: We believe this technique will not only help increase the ability to achieve fusion with a less chance of non-union, but may also decrease healing time, which may allow patients to be mobile from the first week post-operatively and may diminish the risks associated with being non-weightbearing.
文摘Objective: to analyze the clinical application value of different position fixation in radiotherapy for thoracic and abdominal tumors. Methods: 90 patients who received radiotherapy for thoracic and abdominal tumors in the department of oncology of our hospital from September 2019 to September 2021 were screened and divided into 3 groups according to the differences of clinical treatment with different postural fixation schemes: groups A, B and C. Among them, group A chose the vacuum pad fixed position, and group B chose the body membrane fixation position, and group C chose the vacuum pad combined membrane fixation position. The number of patients in each group was 30 cases, and then compared the changes of the body position mobility, movement error and other indicators in each group. Results: regarding the mobility rate of patients, the mobility rate of group C was 6.00%, which was much lower than 24.00% and 34.00% of groups A and B, and the difference was prominent, with statistical advantages, P0.05;for the mobility error of patients, for example, groups A, B and C were (1.21±0.24) mm, (3.77±0.54) mm, and (4.23±0.88) mm, respectively, and the differences were significant, with statistical advantages, P0.05;in terms of positional measurement deviation, group C was much smaller than groups A and B, and the difference was prominent, with a statistical advantage, P0.05. Conclusions: for patients with thoracic and abdominal tumors, in the process of receiving radiation therapy, the choice of vacuum pad combined with body membrane fixation position for treatment has significant advantages. Compared with the single implementation of vacuum pad and body membrane fixation position, it can greatly reduce the movement error, swing measurement deviation, and also reduce the mobility rate as much as possible, so this is a postural fixation solution worthy of wide application.
文摘Objective: To investigate the effectiveness of the plate screw internal fixation technique on the clinical outcomes of patients with traumatic fractures of long bones in the lower extremities. Methods: From January 2022 to December 2023, 70 patients with traumatic fractures of long bones in the lower extremities were admitted to the hospital and randomly divided into two groups: the control group and the observation group, each consisting of 35 cases. The control group underwent traditional closed interlocking intramedullary nailing, while the observation group received internal fixation with steel plates and screws. Relevant surgical indicators, treatment effectiveness, and postoperative complication rates were compared between the two groups. Results: The observation group exhibited significantly short surgical duration (80.65 ± 5.01 vs. 88.36 ± 5.26 minutes), fracture healing time (13.27 ± 0.32 vs. 15.52 ± 0.48 weeks), and hospitalization days (10.49 ± 1.13 vs. 16.57 ± 1.15 days) compared to the control group (P = 0.000). The effective treatment rate was significantly higher in the observation group (29/82.86%) than in the control group (21/60.00%), with a significant difference observed (χ2 = 4.480, P = 0.034). Additionally, the complication rate in the observation group (2/5.71%) was significantly lower than that in the control group (8/22.86%), with a correlated difference (χ2 = 4.200, P = 0.040). Conclusion: The plate screw internal fixation technique demonstrates significant clinical efficacy in treating traumatic fractures of long bones in the lower extremities. It improves the healing rate, reduces complications, and represents a safe and effective treatment strategy worthy of widespread use and application.
文摘To explore the value of helical CT volume rendering technique (VRT) in post-operative evaluation of screw fixation of axis fractures.Methods There were 21 cases of screw fixation of axis fractures between February 2002 and May 2004 in the study including six cases with fractures on axis body,five on odontoid process and 10 on axis body and odontoid process.All cases received X-ray plain film,helical CT scanning,multi-planar reformatting(MPR) and VRT.Results Screw fixation through axis body and massa lateralis atlantis was performed in 10 cases and that through axis body and odontoid process in 11.VRT could clearly display full aperture of screw orbit,location of screw and angle of fixation and hence was superior to X-ray plain film and MPR.Multi-angle VRT displayed asymmetrical space of odontoid process and massa lateralis atlantis in four cases and medial deviation of 2～5 mm of half screw in screw fixation through axis body and massa lateralis atlantis in six.Conclusion VRT can eliminate false shadow of fixation screw,clearly display full aperture of screw orbit and hence supply improtant imaging evidence for post-operative evaluation of screw fixation of axis fractures.7 refs,1 fig,1 tab.
文摘Management of post-traumatic long-bone defects remains relevant and cha-llenging despite the rapid development of approaches to their treatment.Do-minant positions are occupied by the Ilizarov method,bone autogenous grafting and the Masquelet induced membrane technique(IMT).The IMT is aimed at reducing extensive defect treatment duration and for this reason has gained great popularity.However,the assessment of its effectiveness is difficult due to a limited number of clinical series.The varying clinical manifestations of bone defect severity do not allow a comprehensive evaluation of IMT effectiveness.One of them is infection in the defect area.The purpose of our literature review is an analysis of studies on IMT application in infected vs non-infected long-bone defects of the lower extremities published over the last 10 years.It focuses on the investigation of similarities and fundamental differences in the need for antibiotics,timing of spacer fixation,methods of collecting donor bone and fixators used for consolidation.The studies show that the IMT has been globally used in aseptic and osteomyelitic defects due to its clinical effectiveness.Authors’variations and improvements in its practical implementation indicate the ongoing development and the interest of researchers in this technique.
基金supported by the National Key Research and Development Program of China(2022YFC2504303)Innovation Foundation of National Clinical Research Center for Orthopaedics,Sports Medicine&Rehabilitation(2021-NCRC-CXJJ-ZH-24)Medical Innovation and Transformation Incubation Project of Tongji Hospital(2022ZHFY10).
文摘Objective Close reduction and internal fixation have gained popularity for the treatment of pelvic fractures.However,the closed reduction of bilateral displaced posterior pelvic ring disruption is a great challenge even for the most experienced surgeon.In this study,we describe in detail a novel unlocking closed reduction technique(UCRT)frame that allows strong traction for bilateral posterior pelvic ring displacement and presents preliminary clinical outcomes.Methods We retrospectively reviewed 32 patients with bilateral displaced posterior pelvic ring disruptions(AO/OTA 61-C2 and C3)who were initially treated with this technique between July 2017 and July 2022.According to the AO/OTA clas-sification,there were 9 cases(28.12%)of 61-C2,and 23 cases(71.88%)of 61-C3.There were 11 males,21 females,with an average age of 38.1 years.The interval from injury to operation was 4-27 days,with a cut-off of 12.5 days(receiver operat-ing characteristic curve).Operative time,blood loss,and postoperative radiographic findings were recorded.The functional outcomes and complications were followed.Results A total of 30(93.8%)patients achieved successful closed reduction,whereas 2 required open reduction.The success-ful closed reduction rate was 95.5%(21/22)in patients whose injury-to-operation time was less than 12.5 days.The vertical displacement percent correction of the obviously displaced hemipelvis was 70.20%±16.79%on average.The average degree of pelvic deformity correction was 64.86%±17.71%.Thirty patients were followed up for at least 12 months(12-36 months),and no complications of nonunion or redisplacement were observed.The Matta-Tornetta scoring standard revealed that the excellent(25/30)and good(4/30)rate was 96.7%.The Majeed clinical efficacy score revealed that the overall excellent and good rate was 100%.One patient had INFIX-related infection,and 2 reported numbness in the lateral thigh.The numbness was improved after INFIX removal.Conclusions This study presents an updated technique for closed reduction using a UCRT frame for bilateral posterior pelvic ring disruption,which has been shown to be effective,as indicated by excellent surgical and functional outcomes.
文摘Treatment of children with cervical spine disorders requiring fusion is a challenging endeavor for a variety of reasons. The size of the patients, the corresponding abnormal bony anatomy, the inherent ligamentous laxity of children, and the relative rarity of the disorders all play a part in difficulty of treatment. The benefits of modern posterior cervical instrumentation in children, defined as rigid screw–rod systems, have been shown to be many including: improved arthrodesis rates, diminished times in halo-vest immobilization, and improved reduction of deformities. The anatomy of children and the corresponding pathology seen frequently is at the upper cervical spine and craniocervical junction given the relatively large head size of children and the horizontal facets at these regions predisposing them to instability or deformity. Posterior screw fixation, while challenging, allows for a rigid base to allow for fusion in these upper cervical areas which are predisposed to pseudarthrosis with non-rigid fixation. A thorough understanding of the anatomy of the cervical spine, the morphology of the cervical spine, and the available screw options is paramount for placing posterior cervical screws in children. The purpose of this review is to discuss both the anatomical and clinical descriptions re-lated to posterior screw placement in the cervical spine in children.
文摘BACKGROUND Tillaux fractures occur primarily in adolescents due to the pattern of physeal closure and are classified as Salter-Harris type III physeal fractures.Operative management with screw fixation is recommended for more than 2 mm of displacement or more than 1 mm of translation.However,the efficacy and complications of trans-physeal vs all-physeal screw fixation have not been investigated extensively.AIM To compare the clinical and functional outcomes of trans-physeal(oblique)and all-epiphyseal(parallel)screw fixation in management of Tillaux fractures among pediatric patients.METHODS This was an ethics board approved retrospective review of pediatric patients who presented to our tertiary children’s care facility with Tillaux fractures.We included patients who had surgical fixation of a Tillaux fracture over a 10 year period.Data analysis included demographics,mode of injury,management protocols,and functional outcomes.The patients were divided into group 1(oblique fixation)and group 2(parallel fixation).Baseline patient characteristics and functional outcomes were compared between groups.Statistical tests to evaluate differences included Fisher’s Exact or Chi-squared and independent samples t or Mann Whitney tests for categorical and continuous variables,respectively.RESULTS A total of 42 patients(28 females and 14 males)were included.There were no significant differences in body mass index,sex,age,or time to surgery between the groups[IK2].Sports injuries accounted for 61.9%of the cases,particularly non-contact(57.1%)and skating(28.6%)injuries.Computed Tomography(CT)scan was ordered for 28 patients(66.7%),leading to diagnosis confirmation in 17 patients and change in management plan in 11 patients.[GRC3]Groups 1 and 2 consisted of 17 and 25 patients,respectively.For mid to long-term functional outcomes,there were 14 and 10 patients in groups 1 and 2,respectively.Statistical analysis revealed no significant differences in the functional outcomes,pain scores,or satisfaction between groups.No infections,non-unions,physeal arrest,or post-operative ankle deformities were reported.Two(4.8%)patients had difficulty returning to sports post-surgery due to pain.One was a dancer,and the other patient had pain while running,which led to hardware removal.Both patients had parallel fixation.Hardware removal for groups 1 and 2 were 4(23.5%)and 5(20.0%)patients,respectively.The reasons for removal was pain in 2 patients,and parental preference in the remaining.CONCLUSION This is the largest reported series of pediatric patients with Tillaux fractures comparing functional outcomes of different methods of screw fixation orientation to the physis,which showed no difference regarding functional outcomes.
文摘AIM: To assess the results of a modified technique for scleral fixation of a posterior chamber intraocular lens(IOL) in eyes which had deficient of posterior capsular support.METHODS: This retrospective study was comprised of ten patients with deficient posterior capsular support who underwent one-haptic fixation of posterior chamber IOLs, between February 2010 and October 2011. IOL as implanted with one haptic supported on the capsular remnant and the other haptic drawn into the sulcus by anchoring suture without a knot. All patients were evaluated for pre- and postoperative visual acuity, lens centration, intra-and postoperative complications.RESULTS: A knotless, one-haptic fixation of posterior chamber IOLs has successfully been performed on ten eyes. All cases had inadequate capsular support(i.e. a capsular tear ranged from 5 to 7 clock hours). The average age was 74.25 ±8.87y(SD). The average postoperative uncorrected visual acuity was 0.51 log MAR.Complications included hyphema in one eye, a mild inflammatory reaction in the anterior chamber in two eyes, and a transient rise in IOP in one eye. Neither IOL tilt nor dislocation was observed and there were no later complications.CONCLUSION: In the presence of insufficient capsular support, a knotless, one-haptic fixation of posterior chamber IOLs is a safe and viable option which reduces the operation time, and minimizes postoperative suture-related complications.
基金Supported by Wenzhou Basic Research Foundation(No.2024Y1244).
文摘AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This retrospective consecutive case series included patients with subluxated lenses by more than 180 degrees who underwent lens extraction,transcapsular scleral fixation of the standard CTR through equatorial capsulotomy,in-the-bag IOL implantation and with at least 6mo follow-up.Preoperative and postoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),complications,and postoperative IOL tilt and decentration were recorded.RESULTS:Nine eyes of 7 patients with a mean followup of 11.0±3.7mo were included in this study.The BCVA was significantly improved from 0.64±0.22 logMAR preoperatively to 0.21±0.19 logMAR postoperatively(P<0.001).The IOP was within the normal range postoperatively.The mean tilt of the IOL was 4.30°±2.31°(range,1.0°to 8.9°)and the mean decentration of the IOL was 0.37±0.12 mm(range,0.14 to 0.50 mm).No visually threatened intraoperative and postoperative complications were detected during the follow-up period.CONCLUSION:This is a safe and effective surgical technique for managing patients with severely subluxated lenses.It has achieved favorable outcomes with fewer surgical manipulations and less need for advanced capsular support devices.
文摘The unit modular technique is one in which unit modules are prefabricated in a factory and then constructed at a construction site. That is why an important process, transport of unit module, is added in this technique. However, it is not easy to transport a unit module that is high prefabrication ratio （prefab. ratio） （70-90%）, since the walls and interior and exterior materials installed in it can become broken when the unit module is fixed using general fixation tools, including ropes and fixing belts. When the external wall, windows, etc. are damaged during the transportation, the efficiency of unit modular method is deteriorated. Taking this into account, the purpose of this study is to develop an improved fixation device that is convenient for fixing a unit module with a high prefab, ratio to a vehicle and securing the safety while running. The L-type adapter block proposed in this study was evaluated the structural safety through simulation method. The result of the simulation is that it seems desirable to set the working load of the L-type adapter block as 15 kN for Case 1 and 30 kN for Case 2. Therefore, when the L-type adapter block is utilized under the conditions in which the same load is applied as in Case 2, it is expected that safety will be improved.
文摘This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft fixation techniques.The paper explores and comments on a recently published review by Dai et al,titled"Research progress on preparation of lateral femoral tunnel and graft fixation in ACLR",while providing insight into its relevance within the field of ACLR,and recommendations for future research.
文摘Purpose To evaluate the refractive prediction error of common intraocular lens(IOL)power calculation formulae in patients who underwent intrascleral IOL fixation using two different techniques.Methods This is a prospective,randomized,longitudinal,single-site,single-surgeon study.Patients who underwent intrascleral IOL implantation using the Yamane or the Carlevale technique were followed up for a period of six months postoperatively.Refraction was measured using the best-corrected visual acuity at 4 m(EDTRS chart).Lens decentration,tilt and effective lens position(ELP)were assessed using an anterior segment optical coherence tomography(AS-OCT).The prediction error(PE)and the absolute error(AE)were evaluated for the SRK/T,Hollayday1 and Hoffer Q formula.Subsequently,correlations between the PE and axial length,keratometry,white to white and ELP were assessed.Results In total,53 eyes of 53 patients were included in the study.Twenty-four eyes of 24 patients were in the Yamane group(YG)and 29 eyes of 29 patients were in the Carlevale group(CG).In the YG,the Holladay 1 and Hoffer Q formulae resulted in a hyperopic PE(0.02±0.56 D,and 0.13±0.64 D,respectively)while in the SRK/T formula the PE was slightly myopic(−0.16±0.56 D).In the CG,SRK/T and Holladay 1 formulae led to a myopic PE(−0.1±0.80 D and−0.04±0.74 D,respectively),Hoffer Q to a hyperopic PE(0.04±0.75 D).There was no difference between the PE of the same formulae across both groups(P>0.05).In both groups the AE differed significantly from zero in each evaluated formula.The AE error was within±0.50 D in 45%–71%and was within±1.00 D in 72%–92%of eyes depending on the formula and surgical method used.No significant differences were found between formulae within and across groups(P>0.05).Intraocular lens tilt was lower in the CG(6.45±2.03°)compared to the YG(7.67±3.70°)(P<0.001).Lens decentration was higher in the YG(0.57±0.37 mm)than in the CG(0.38±0.21 mm),though the difference was not statistically significant(P=0.9996).Conclusions Refractive predictability was similar in both groups.IOL tilt was better in the CG,however this did not influence the refractive predictability.Though not significant,Holladay 1 formula seemed to be more probable than the SRK/T and Hoffer Q formulae.However,significant outliers were observed in all three different formulae and therefore remain a challenging task in secondary fixated IOLs.
