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[Application of personalized three-dimensional printed customized prostheses in severe Paprosky type acetabular bone defects].
Q3 Medicine Pub Date : 2025-01-15 DOI: 10.7507/1002-1892.202409099
Shuailei Li, Hao Chai, Yongqiang Sun

Objective: To analyze the short-term effectiveness and safety of personalized three-dimensional (3D) printed customized prostheses in severe Paprosky type Ⅲ acetabular bone defects.

Methods: A retrospective analysis was conducted on 8 patients with severe Paprosky type Ⅲ acetabular bone defects and met the selection criteria between January 2023 and June 2024. There were 3 males and 5 females, with an average age of 64.6 years ranged from 56 to 73 years. All primary replacement prostheses were non-cemented, including 1 ceramic-ceramic interface, 1 ceramic-polyethylene interface, and 6 metal-polyethylene interfaces. The time from the primary replacement to the revision was 4 days to 18 years. The reasons for revision were aseptic loosening in 5 cases, revision after exclusion in 2 cases, and repeated dislocation in 1 case. The preoperative Harris score was 39.5±3.7 and the visual analogue scale (VAS) score was 7.1±0.8. The operation time, intraoperative blood loss, hospital stay, and complications were recorded. The hip function was evaluated by Harris score, and the degree of pain was evaluated by VAS score. The acetabular cup abduction angle, anteversion angle, rotational center height, greater trochanter height, and femoral offset were measured on X-ray film.

Results: The operation time was 95-223 minutes, with an average of 151.13 minutes. The intraoperative blood loss was 600-3 500 mL, with an average of 1 250.00 mL. The hospital stay was 13-20 days, with an average of 16.88 days. All 8 patients were followed up 2-12 months, with an average of 6.4 months. One patient had poor wound healing after operation, which healed well after active symptomatic treatment. One patient had lower limb intermuscular vein thrombosis, but no thrombosis was found at last follow-up. No serious complications such as aseptic loosening, infection, dislocation, and periprosthetic fracture occurred during the follow-up. At last follow-up, the Harris score was 72.0±6.2 and the VAS score was 1.8±0.7, which were significantly different from those before operation ( t=-12.011, P<0.001; t=16.595, P<0.001). On the second day after operation, the acetabular cup abduction angle ranged from 40° to 49°, with an average of 44.18°, and the acetabular cup anteversion angle ranged from 19° to 26°, with an average of 21.36°, which were within the "Lewinneck safety zone". There was no significant difference in the rotational center height, greater trochanter height, and femoral offset between the healthy side and the affected side ( P>0.05).

Conclusion: The use of personalized 3D printed customized prostheses for the reconstruction of severe Paprosky type Ⅲ acetabular bone defects can alleviate pain and enhances hip joint function, and have good postoperative prosthesis position, without serious complications and have good safety.

{"title":"[Application of personalized three-dimensional printed customized prostheses in severe Paprosky type <b>Ⅲ</b> acetabular bone defects].","authors":"Shuailei Li, Hao Chai, Yongqiang Sun","doi":"10.7507/1002-1892.202409099","DOIUrl":"10.7507/1002-1892.202409099","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the short-term effectiveness and safety of personalized three-dimensional (3D) printed customized prostheses in severe Paprosky type Ⅲ acetabular bone defects.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 8 patients with severe Paprosky type Ⅲ acetabular bone defects and met the selection criteria between January 2023 and June 2024. There were 3 males and 5 females, with an average age of 64.6 years ranged from 56 to 73 years. All primary replacement prostheses were non-cemented, including 1 ceramic-ceramic interface, 1 ceramic-polyethylene interface, and 6 metal-polyethylene interfaces. The time from the primary replacement to the revision was 4 days to 18 years. The reasons for revision were aseptic loosening in 5 cases, revision after exclusion in 2 cases, and repeated dislocation in 1 case. The preoperative Harris score was 39.5±3.7 and the visual analogue scale (VAS) score was 7.1±0.8. The operation time, intraoperative blood loss, hospital stay, and complications were recorded. The hip function was evaluated by Harris score, and the degree of pain was evaluated by VAS score. The acetabular cup abduction angle, anteversion angle, rotational center height, greater trochanter height, and femoral offset were measured on X-ray film.</p><p><strong>Results: </strong>The operation time was 95-223 minutes, with an average of 151.13 minutes. The intraoperative blood loss was 600-3 500 mL, with an average of 1 250.00 mL. The hospital stay was 13-20 days, with an average of 16.88 days. All 8 patients were followed up 2-12 months, with an average of 6.4 months. One patient had poor wound healing after operation, which healed well after active symptomatic treatment. One patient had lower limb intermuscular vein thrombosis, but no thrombosis was found at last follow-up. No serious complications such as aseptic loosening, infection, dislocation, and periprosthetic fracture occurred during the follow-up. At last follow-up, the Harris score was 72.0±6.2 and the VAS score was 1.8±0.7, which were significantly different from those before operation ( <i>t</i>=-12.011, <i>P</i><0.001; <i>t</i>=16.595, <i>P</i><0.001). On the second day after operation, the acetabular cup abduction angle ranged from 40° to 49°, with an average of 44.18°, and the acetabular cup anteversion angle ranged from 19° to 26°, with an average of 21.36°, which were within the \"Lewinneck safety zone\". There was no significant difference in the rotational center height, greater trochanter height, and femoral offset between the healthy side and the affected side ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>The use of personalized 3D printed customized prostheses for the reconstruction of severe Paprosky type Ⅲ acetabular bone defects can alleviate pain and enhances hip joint function, and have good postoperative prosthesis position, without serious complications and have good safety.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 1","pages":"13-19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Lenthening and reconstruction progress of achondroplastic short arm deformity].
Q3 Medicine Pub Date : 2025-01-15 DOI: 10.7507/1002-1892.202410047
Baofeng Guo, Sihe Qin

Objective: To describe the characteristics of short arm deformity in patients with achondroplasia, and summarize the progress of its lenthening and reconstruction, so as to provide reference for clinical diagnosis and treatment.

Methods: The literature on the lenthening of upper limb with achondroplastic short arm deformity at home and abroad in recent years was reviewed, and the characteristics, extension methods, postoperative management, effectiveness evaluation, and related complications of short arm deformity were summarized.

Results: Achondroplastic short arm deformity affect the patient's daily perineal hygiene activities. Although the upper limb is proportionately shortened, the humerus is mainly short limb deformity. Bilateral humeral lengthening is a common treatment method, and the traditional lengthening tools are mainly external fixation, guided by Ilizarov distraction osteogenesis concept; intramedullary lengthening is the latest treatment method. Lengthening percentage and healing index are commonly used for clinical evaluation indexes, and complications such as nerve injury may occur during upper limb lengthening.

Conclusion: In addition to appearance improvement, achondroplastic short arm lengthening is of great significance in achieving self-management of individual perineal hygiene. Lenthening and reconstruction methods are constantly being innovated and improved.

{"title":"[Lenthening and reconstruction progress of achondroplastic short arm deformity].","authors":"Baofeng Guo, Sihe Qin","doi":"10.7507/1002-1892.202410047","DOIUrl":"10.7507/1002-1892.202410047","url":null,"abstract":"<p><strong>Objective: </strong>To describe the characteristics of short arm deformity in patients with achondroplasia, and summarize the progress of its lenthening and reconstruction, so as to provide reference for clinical diagnosis and treatment.</p><p><strong>Methods: </strong>The literature on the lenthening of upper limb with achondroplastic short arm deformity at home and abroad in recent years was reviewed, and the characteristics, extension methods, postoperative management, effectiveness evaluation, and related complications of short arm deformity were summarized.</p><p><strong>Results: </strong>Achondroplastic short arm deformity affect the patient's daily perineal hygiene activities. Although the upper limb is proportionately shortened, the humerus is mainly short limb deformity. Bilateral humeral lengthening is a common treatment method, and the traditional lengthening tools are mainly external fixation, guided by Ilizarov distraction osteogenesis concept; intramedullary lengthening is the latest treatment method. Lengthening percentage and healing index are commonly used for clinical evaluation indexes, and complications such as nerve injury may occur during upper limb lengthening.</p><p><strong>Conclusion: </strong>In addition to appearance improvement, achondroplastic short arm lengthening is of great significance in achieving self-management of individual perineal hygiene. Lenthening and reconstruction methods are constantly being innovated and improved.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 1","pages":"118-122"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Relationship between knee meniscus and posterior tibial slope in healthy adults and patients with anteromedial osteoarthritis in Heilongjiang province].
Q3 Medicine Pub Date : 2025-01-15 DOI: 10.7507/1002-1892.202410045
Shuxin Guo, Shikun Guan, Rui Huan, Ning Liu
<p><strong>Objective: </strong>To measure and analyze the relationships among the posterior tibial slope (PTS), meniscal slope (MS), and meniscus posterior horn thickness (MPHT) of the medial and lateral tibial plateau in healthy people and patients with anteromedial osteoarthritis (AMOA) in Heilongjiang province, so as to provide reference basis for appropriate tibial osteotomy and prosthesis placement angles in knee joint surgeries.</p><p><strong>Methods: </strong>A retrospective collection of imaging data from knee joint MRI examinations conducted prior to AMOA for various reasons was performed. A total of 103 healthy individuals (healthy group) and 30 AMOA patients (AMOA group) were included. There was no significant difference in the gender composition ratio, side, and body mass index between the two groups ( <i>P</i>>0.05); however, the comparison of ages between the two groups showed a significant difference ( <i>P</i><0.05). The collected DICOM format image data was imported into the RadiAnt DICOM Viewer software and measured the medial PTS (MPTS), lateral PTS (LPTS), medial MS (MMS), lateral MS (LMS), medial MPHT (MMPHT), and lateral MPHT (LMPHT) with standard methods. The differences of the above indexes between the two groups and between different genders and sides in the two groups were compared, and Pearson correlation analysis was carried out. At the same time, the measured data of healthy group were compared with the relevant literature reported in the past.</p><p><strong>Results: </strong>Compared to the healthy group, the AMOA group exhibited significantly smaller MPTS and LPTS, as well as significantly greater MMPHT and LMPHT, with significant differences ( <i>P</i><0.05). However, there was no significant difference in the MMS and LMS between the two groups ( <i>P</i>>0.05). The differences in various indicators between genders and sides within the two groups were not significant ( <i>P</i>>0.05). The correlation analysis and regression curves indicated that both MPTS and LPTS in the two groups were positively correlated with their respective ipsilateral MS and MPHT ( <i>P</i><0.05); as PTS increased, the rate of increase in MS and MPHT tend to plateau. Compared to previous related studies, the MPTS and LPTS measured in healthy group were comparable to those of the Turkish population, exhibiting smaller values than those reported in other studies, while MMS and LMS were relatively larger, and MMPHT and LMPHT were smaller.</p><p><strong>Conclusion: </strong>In healthy people and AMOA patients in Heilongjiang province, PTS has great individual differences, but there is no significant individual difference in MS. MPHT can play a certain role in retroversion compensation, and its thickness increase may be used as one of the indicators to predict the progression of AMOA. The above factors should be taken into account when UKA is performed, and the posterior tilt angle of tibial osteotomy should be set reasonably after preoperative e
{"title":"[Relationship between knee meniscus and posterior tibial slope in healthy adults and patients with anteromedial osteoarthritis in Heilongjiang province].","authors":"Shuxin Guo, Shikun Guan, Rui Huan, Ning Liu","doi":"10.7507/1002-1892.202410045","DOIUrl":"10.7507/1002-1892.202410045","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To measure and analyze the relationships among the posterior tibial slope (PTS), meniscal slope (MS), and meniscus posterior horn thickness (MPHT) of the medial and lateral tibial plateau in healthy people and patients with anteromedial osteoarthritis (AMOA) in Heilongjiang province, so as to provide reference basis for appropriate tibial osteotomy and prosthesis placement angles in knee joint surgeries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective collection of imaging data from knee joint MRI examinations conducted prior to AMOA for various reasons was performed. A total of 103 healthy individuals (healthy group) and 30 AMOA patients (AMOA group) were included. There was no significant difference in the gender composition ratio, side, and body mass index between the two groups ( &lt;i&gt;P&lt;/i&gt;&gt;0.05); however, the comparison of ages between the two groups showed a significant difference ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). The collected DICOM format image data was imported into the RadiAnt DICOM Viewer software and measured the medial PTS (MPTS), lateral PTS (LPTS), medial MS (MMS), lateral MS (LMS), medial MPHT (MMPHT), and lateral MPHT (LMPHT) with standard methods. The differences of the above indexes between the two groups and between different genders and sides in the two groups were compared, and Pearson correlation analysis was carried out. At the same time, the measured data of healthy group were compared with the relevant literature reported in the past.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared to the healthy group, the AMOA group exhibited significantly smaller MPTS and LPTS, as well as significantly greater MMPHT and LMPHT, with significant differences ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). However, there was no significant difference in the MMS and LMS between the two groups ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). The differences in various indicators between genders and sides within the two groups were not significant ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). The correlation analysis and regression curves indicated that both MPTS and LPTS in the two groups were positively correlated with their respective ipsilateral MS and MPHT ( &lt;i&gt;P&lt;/i&gt;&lt;0.05); as PTS increased, the rate of increase in MS and MPHT tend to plateau. Compared to previous related studies, the MPTS and LPTS measured in healthy group were comparable to those of the Turkish population, exhibiting smaller values than those reported in other studies, while MMS and LMS were relatively larger, and MMPHT and LMPHT were smaller.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In healthy people and AMOA patients in Heilongjiang province, PTS has great individual differences, but there is no significant individual difference in MS. MPHT can play a certain role in retroversion compensation, and its thickness increase may be used as one of the indicators to predict the progression of AMOA. The above factors should be taken into account when UKA is performed, and the posterior tilt angle of tibial osteotomy should be set reasonably after preoperative e","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 1","pages":"32-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Application of delayed replantation of degloving skin preserved at 4 in treatment of limb degloving injuries].
Q3 Medicine Pub Date : 2025-01-15 DOI: 10.7507/1002-1892.202411057
Qianqian Xu, Jihai Xu, Yijun Shen, Chenxi Zhang, Hangchong Shen, Tianxiang Huang, Chenlin Lu, Xin Wang

Objective: To investigate the effectiveness of delayed replantation of degloving skin preserved at 4℃ in treatment of limb degloving injuries.

Methods: Between October 2020 and October 2023, 12 patients with limb degloving injuries were admitted. All patients had severe associated injuries or poor wound conditions that prevented primary replantation. There were 7 males and 5 females; age ranged from 29 to 46 years, with an average of 39.2 years. The causes of injury included machine entanglement in 6 cases, traffic accidents in 5 cases, and sharp instrument cuts in 1 case. Time from injury to hospital admission was 0.5-3.0 hours, with an average of 1.3 hours. Injury sites included upper limbs in 7 cases and lower limbs in 5 cases. The range of degloving skin was from 5 cm×4 cm to 15 cm×8 cm, and all degloving skins were intact. The degloving skin was preserved at 4℃. After the patient's vital signs became stable and the wound conditions improved, it was trimmed into medium-thickness skin grafts for replantation. The degloving skin was preserved for 3 to 7 days. At 4 weeks after replantation, the viability of the degloving skin grafts was assessed, including color, elasticity, and sensation of pain. The Vancouver Scar Scale (VSS) was used to assess the scars of the skin grafts during follow-up.

Results: At 4 weeks after replantation, 8 cases of skin grafts completely survived and the color was similar with normal skin, with a survival rate of 66.67%. The elasticity of skin grafts (R0 value) ranged from 0.09 to 0.85, with an average of 0.55; moderate pain was reported in 4 cases, mild pain in 3 cases, and no pain in 5 cases. All patients were followed up 12 months. Over time, the VSS scores of all 12 patients gradually decreased, with a range of 4-11 at 12 months (mean, 6.8).

Conclusion: For limb degloving injuries that cannot be replanted immediately and do not have the conditions for deep low-temperature freezing preservation, the method of preserving the degloving skin at 4℃ for delayed replantation can be chosen.

{"title":"[Application of delayed replantation of degloving skin preserved at 4 <b>℃</b> in treatment of limb degloving injuries].","authors":"Qianqian Xu, Jihai Xu, Yijun Shen, Chenxi Zhang, Hangchong Shen, Tianxiang Huang, Chenlin Lu, Xin Wang","doi":"10.7507/1002-1892.202411057","DOIUrl":"10.7507/1002-1892.202411057","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effectiveness of delayed replantation of degloving skin preserved at 4℃ in treatment of limb degloving injuries.</p><p><strong>Methods: </strong>Between October 2020 and October 2023, 12 patients with limb degloving injuries were admitted. All patients had severe associated injuries or poor wound conditions that prevented primary replantation. There were 7 males and 5 females; age ranged from 29 to 46 years, with an average of 39.2 years. The causes of injury included machine entanglement in 6 cases, traffic accidents in 5 cases, and sharp instrument cuts in 1 case. Time from injury to hospital admission was 0.5-3.0 hours, with an average of 1.3 hours. Injury sites included upper limbs in 7 cases and lower limbs in 5 cases. The range of degloving skin was from 5 cm×4 cm to 15 cm×8 cm, and all degloving skins were intact. The degloving skin was preserved at 4℃. After the patient's vital signs became stable and the wound conditions improved, it was trimmed into medium-thickness skin grafts for replantation. The degloving skin was preserved for 3 to 7 days. At 4 weeks after replantation, the viability of the degloving skin grafts was assessed, including color, elasticity, and sensation of pain. The Vancouver Scar Scale (VSS) was used to assess the scars of the skin grafts during follow-up.</p><p><strong>Results: </strong>At 4 weeks after replantation, 8 cases of skin grafts completely survived and the color was similar with normal skin, with a survival rate of 66.67%. The elasticity of skin grafts (R0 value) ranged from 0.09 to 0.85, with an average of 0.55; moderate pain was reported in 4 cases, mild pain in 3 cases, and no pain in 5 cases. All patients were followed up 12 months. Over time, the VSS scores of all 12 patients gradually decreased, with a range of 4-11 at 12 months (mean, 6.8).</p><p><strong>Conclusion: </strong>For limb degloving injuries that cannot be replanted immediately and do not have the conditions for deep low-temperature freezing preservation, the method of preserving the degloving skin at 4℃ for delayed replantation can be chosen.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 1","pages":"95-99"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Posterior lateral perforator flap in lower limb combined with free fibula for maxillary tissue defect repair].
Q3 Medicine Pub Date : 2025-01-15 DOI: 10.7507/1002-1892.202410044
Mingming Yan, Luwen Song, Zhenghao Ma, Tao Wang, Kai Hu, Xuji Wang, Jiancheng Li
<p><strong>Objective: </strong>To investigate the effectiveness of posterior lateral perforator flap in lower limb combined with free fibula for maxillary tissue defect repair.</p><p><strong>Methods: </strong>Between December 2018 and December 2023, 16 patients with the maxillary malignant tumors were admitted. There were 10 males and 6 females, with an average age of 64.3 years (range, 54-75 years). There were 7 cases of maxillary gingival cancer, 5 cases of hard palate cancer, and 4 cases of maxillary sinus cancer. According to the 2017 American Joint Committee on Cancer (AJCC) TNM stage, there were 8 cases of stage Ⅲ, 6 cases of stage Ⅳa, and 2 cases of stage Ⅳb. After resection of the lesion, the remaining maxillary defects were classified into class Ⅱa in 3 cases, class Ⅱb in 5 cases, and class Ⅲb in 8 cases according to Brown's classification. The size of soft tissue defects ranged from 4 cm×3 cm to 8 cm×6 cm. The posterior lateral perforator flap in lower limb in size of 5 cm×4 cm-9 cm×7 cm were harvested to repair soft tissue defects, and free fibula in length of 6-11 cm were used to repair bone defects. The donor sites of the lower limb were sutured directly (6 cases) or repaired with free skin grafting (10 cases). Six patients with positive lymph node pathology were treated with radiotherapy after operation. At 6 and 12 months after operation, the self-assessment was performed by the University of Washington Quality of Survival Questionnaire Form (QUW-4) in five dimensions (facial appearance, swallowing function, chewing function, speech function, and mouth opening), and swallowing function was evaluated by using the Kubota water swallowing test.</p><p><strong>Results: </strong>Postoperative pathological examination showed that all patients were squamous cell carcinoma. One patient who was treated with radiotherapy developed osteomyelitis and 1 patient developed venous crisis of skin flap. The rest of the flaps and all skin grafts survived, and the wounds healed by first intention. All patients were followed up 1-5 years (mean, 2.8 years). Two patients died of local recurrence of the tumor at the 4th and 5th years after operation, respectively. Except for the chewing function score and total score at 6 months after operation, which showed significant differences compared to preoperative scores ( <i>P</i><0.05), there was no significant difference in other QUW-4 scale scores between different time points ( <i>P</i>>0.05). The patients' swallowing function evaluated by Kubota water swallowing test reached normal in 4 cases, suspicious in 9 cases, and abnormal in 3 cases at 6 months after operation, and 10, 6, and 0 cases at 12 months after operation, respectively. The swallowing function at 12 months was significantly better than that at 6 months ( <i>Z</i>=-2.382, <i>P</i>=0.017).</p><p><strong>Conclusion: </strong>The posterior lateral perforator flap in the lower limb combined with free fibula to repair maxillary tissue defects can rep
{"title":"[Posterior lateral perforator flap in lower limb combined with free fibula for maxillary tissue defect repair].","authors":"Mingming Yan, Luwen Song, Zhenghao Ma, Tao Wang, Kai Hu, Xuji Wang, Jiancheng Li","doi":"10.7507/1002-1892.202410044","DOIUrl":"10.7507/1002-1892.202410044","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the effectiveness of posterior lateral perforator flap in lower limb combined with free fibula for maxillary tissue defect repair.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between December 2018 and December 2023, 16 patients with the maxillary malignant tumors were admitted. There were 10 males and 6 females, with an average age of 64.3 years (range, 54-75 years). There were 7 cases of maxillary gingival cancer, 5 cases of hard palate cancer, and 4 cases of maxillary sinus cancer. According to the 2017 American Joint Committee on Cancer (AJCC) TNM stage, there were 8 cases of stage Ⅲ, 6 cases of stage Ⅳa, and 2 cases of stage Ⅳb. After resection of the lesion, the remaining maxillary defects were classified into class Ⅱa in 3 cases, class Ⅱb in 5 cases, and class Ⅲb in 8 cases according to Brown's classification. The size of soft tissue defects ranged from 4 cm×3 cm to 8 cm×6 cm. The posterior lateral perforator flap in lower limb in size of 5 cm×4 cm-9 cm×7 cm were harvested to repair soft tissue defects, and free fibula in length of 6-11 cm were used to repair bone defects. The donor sites of the lower limb were sutured directly (6 cases) or repaired with free skin grafting (10 cases). Six patients with positive lymph node pathology were treated with radiotherapy after operation. At 6 and 12 months after operation, the self-assessment was performed by the University of Washington Quality of Survival Questionnaire Form (QUW-4) in five dimensions (facial appearance, swallowing function, chewing function, speech function, and mouth opening), and swallowing function was evaluated by using the Kubota water swallowing test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Postoperative pathological examination showed that all patients were squamous cell carcinoma. One patient who was treated with radiotherapy developed osteomyelitis and 1 patient developed venous crisis of skin flap. The rest of the flaps and all skin grafts survived, and the wounds healed by first intention. All patients were followed up 1-5 years (mean, 2.8 years). Two patients died of local recurrence of the tumor at the 4th and 5th years after operation, respectively. Except for the chewing function score and total score at 6 months after operation, which showed significant differences compared to preoperative scores ( &lt;i&gt;P&lt;/i&gt;&lt;0.05), there was no significant difference in other QUW-4 scale scores between different time points ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). The patients' swallowing function evaluated by Kubota water swallowing test reached normal in 4 cases, suspicious in 9 cases, and abnormal in 3 cases at 6 months after operation, and 10, 6, and 0 cases at 12 months after operation, respectively. The swallowing function at 12 months was significantly better than that at 6 months ( &lt;i&gt;Z&lt;/i&gt;=-2.382, &lt;i&gt;P&lt;/i&gt;=0.017).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The posterior lateral perforator flap in the lower limb combined with free fibula to repair maxillary tissue defects can rep","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 1","pages":"88-94"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Short-term effectiveness of Gamma 3 U-Blade system for osteoporotic intertrochanteric fractures in the elderly].
Q3 Medicine Pub Date : 2025-01-15 DOI: 10.7507/1002-1892.202407041
Wenbin Fan, Liu Shi, Tian Xie, Cheng Zhang, Xiangxu Chen, Hui Chen, Yunfeng Rui

Objective: To compare the short-term effectiveness between Gamma 3 intramedullary nails and Gamma 3 U-Blade system in the treatment of osteoporotic intertrochanteric fractures in the elderly.

Methods: A retrospective analysis was conducted on the clinical data of 124 elderly patients with osteoporotic intertrochanteric fractures, who were admitted between February 2020 and February 2023 and met the selection criteria. The fractures were fixed with Gamma 3 intramedullary nails in 65 patients (control group) and Gamma 3 U-Blade systems in 59 patients (UB group). The differences between the two groups were not significant in age, gender, body mass index, American Society of Anesthesiologists (ASA) classification, bone mineral density, time from injury to operation, fracture classification, and affected side ( P>0.05). The operation time, intraoperative blood loss, hospital stay, and fracture healing time were recorded; the tip-apex distance, fracture reduction quality, and lag screw position were evaluated on X-ray films at immediate after operation; the lag screw sliding distance and change value of neck-shaft angle were measured on X-ray films at last follow-up. Harris hip score at 1 year after operation and the occurrence of internal fixation-related complications were compared between the two groups.

Results: The operation time, intraoperative blood loss, and hospital stay in the UB group increased compared to the control group, but the differences were not significant ( P>0.05). All patients in both groups were followed up 12-24 months (mean, 17.1 months). At 12 months after operation, there was no significant difference in the Harris hip score between the two groups ( P<0.05). Radiological examination showed that there was no significant difference between the two groups ( P>0.05) in terms of tip-apex distance, fracture reduction quality, and lag screw position. Fractures healed in both groups, and there was no significant difference in healing time ( P>0.05). At last follow-up, the change value of neck-shaft angle and lag screw sliding distance in the UB group were significantly lower than those in the control group ( P<0.05). During follow-up, no related complications occurred in the UB group, while 6 cases (9.2%) in the control group experienced complications, and the difference in the incidence was significant ( P<0.05).

Conclusion: For the osteoporotic intertrochanteric fractures in the elderly, the Gamma 3 U-Blade system fixation can achieve good short-term effectiveness, with better imaging results compared to Gamma 3 intramedullary nails fixation.

{"title":"[Short-term effectiveness of Gamma 3 U-Blade system for osteoporotic intertrochanteric fractures in the elderly].","authors":"Wenbin Fan, Liu Shi, Tian Xie, Cheng Zhang, Xiangxu Chen, Hui Chen, Yunfeng Rui","doi":"10.7507/1002-1892.202407041","DOIUrl":"10.7507/1002-1892.202407041","url":null,"abstract":"<p><strong>Objective: </strong>To compare the short-term effectiveness between Gamma 3 intramedullary nails and Gamma 3 U-Blade system in the treatment of osteoporotic intertrochanteric fractures in the elderly.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 124 elderly patients with osteoporotic intertrochanteric fractures, who were admitted between February 2020 and February 2023 and met the selection criteria. The fractures were fixed with Gamma 3 intramedullary nails in 65 patients (control group) and Gamma 3 U-Blade systems in 59 patients (UB group). The differences between the two groups were not significant in age, gender, body mass index, American Society of Anesthesiologists (ASA) classification, bone mineral density, time from injury to operation, fracture classification, and affected side ( <i>P</i>>0.05). The operation time, intraoperative blood loss, hospital stay, and fracture healing time were recorded; the tip-apex distance, fracture reduction quality, and lag screw position were evaluated on X-ray films at immediate after operation; the lag screw sliding distance and change value of neck-shaft angle were measured on X-ray films at last follow-up. Harris hip score at 1 year after operation and the occurrence of internal fixation-related complications were compared between the two groups.</p><p><strong>Results: </strong>The operation time, intraoperative blood loss, and hospital stay in the UB group increased compared to the control group, but the differences were not significant ( <i>P</i>>0.05). All patients in both groups were followed up 12-24 months (mean, 17.1 months). At 12 months after operation, there was no significant difference in the Harris hip score between the two groups ( <i>P</i><0.05). Radiological examination showed that there was no significant difference between the two groups ( <i>P</i>>0.05) in terms of tip-apex distance, fracture reduction quality, and lag screw position. Fractures healed in both groups, and there was no significant difference in healing time ( <i>P</i>>0.05). At last follow-up, the change value of neck-shaft angle and lag screw sliding distance in the UB group were significantly lower than those in the control group ( <i>P</i><0.05). During follow-up, no related complications occurred in the UB group, while 6 cases (9.2%) in the control group experienced complications, and the difference in the incidence was significant ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>For the osteoporotic intertrochanteric fractures in the elderly, the Gamma 3 U-Blade system fixation can achieve good short-term effectiveness, with better imaging results compared to Gamma 3 intramedullary nails fixation.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 1","pages":"47-52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[TiRobot-assisted minimally invasive treatment of coracoid process fractures of scapula].
Q3 Medicine Pub Date : 2025-01-15 DOI: 10.7507/1002-1892.202409072
Yonghong Dai, Qingyu Li, Yanhui Zeng, Zhengjie Wu, Chunpeng Zhao, Junqiang Wang
<p><strong>Objective: </strong>To explore effectiveness of TiRobot-assisted screw implantation in the treatment of coracoid process fractures of the scapula.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data from 24 patients with coracoid process fractures of the scapula admitted between September 2019 and January 2024 and met selection criteria. Among them, 12 patients underwent TiRobot-assisted screw implantation (robot group) and 12 underwent manual screw implantation (control group) during internal fixation. There was no significant difference ( <i>P</i>>0.05) in baseline data such as gender, age, body mass index, disease duration, cause of injury, coracoid process fracture classification, and proportion of patients with associated injuries between the two groups. The incision length, operation time, intraoperative blood loss, hospital stay, accuracy of screw placement, coracoid process fracture healing time, and complications were recorded and compared, as well as pain visual analogue scale (VAS) score, and Constant-Murley score at last follow-up.</p><p><strong>Results: </strong>The intraoperative blood loss and incision length in the robot group were significantly lower than those in the control group ( <i>P</i><0.05); however, there was no significant difference in operation time and hospital stay between the two groups ( <i>P</i>>0.05). All patients were followed up 8-27 months (mean, 17.5 months), and the difference in follow-up time between the two groups was not significant ( <i>P</i>>0.05). At last follow-up, the VAS score for shoulder pain in the robot group was signifncatly lower compared to the control group, and the Constant-Murley score was significantly higher ( <i>P</i><0.05). In the robot group, 16 screws were implanted intraoperatively, while 13 screws were implanted in the control group. Radiographic re-evaluation showed that the excellent and good rate of screw implantation was higher in the robot group (93.8%, 15/16) than in the control group (61.5%, 8/13), but the difference in the precision of screw implantation between the two groups was not significant ( <i>P</i>>0.05). Four patients in the robot group and 1 in the control group achieved double screws fixation; however, the difference in achieving double screws fixation between the two groups was not significant ( <i>P</i>>0.05). All fractures healed in both groups with 1 case of malunion in the control group. There was no significant difference in healing time between the two groups ( <i>P</i>>0.05). During follow-up, 1 patient in the control group experienced screw loosening and displacement. There was no significant difference in the incidence of screw loosening and fracture malunion between the two groups ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Compared with manual screw implantation, TiRobot-assisted minimally invasive treatment of coracoid process fractures of the scapula can reduce intraoperative blood loss,
{"title":"[TiRobot-assisted minimally invasive treatment of coracoid process fractures of scapula].","authors":"Yonghong Dai, Qingyu Li, Yanhui Zeng, Zhengjie Wu, Chunpeng Zhao, Junqiang Wang","doi":"10.7507/1002-1892.202409072","DOIUrl":"10.7507/1002-1892.202409072","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore effectiveness of TiRobot-assisted screw implantation in the treatment of coracoid process fractures of the scapula.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on the clinical data from 24 patients with coracoid process fractures of the scapula admitted between September 2019 and January 2024 and met selection criteria. Among them, 12 patients underwent TiRobot-assisted screw implantation (robot group) and 12 underwent manual screw implantation (control group) during internal fixation. There was no significant difference ( &lt;i&gt;P&lt;/i&gt;&gt;0.05) in baseline data such as gender, age, body mass index, disease duration, cause of injury, coracoid process fracture classification, and proportion of patients with associated injuries between the two groups. The incision length, operation time, intraoperative blood loss, hospital stay, accuracy of screw placement, coracoid process fracture healing time, and complications were recorded and compared, as well as pain visual analogue scale (VAS) score, and Constant-Murley score at last follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The intraoperative blood loss and incision length in the robot group were significantly lower than those in the control group ( &lt;i&gt;P&lt;/i&gt;&lt;0.05); however, there was no significant difference in operation time and hospital stay between the two groups ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). All patients were followed up 8-27 months (mean, 17.5 months), and the difference in follow-up time between the two groups was not significant ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). At last follow-up, the VAS score for shoulder pain in the robot group was signifncatly lower compared to the control group, and the Constant-Murley score was significantly higher ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). In the robot group, 16 screws were implanted intraoperatively, while 13 screws were implanted in the control group. Radiographic re-evaluation showed that the excellent and good rate of screw implantation was higher in the robot group (93.8%, 15/16) than in the control group (61.5%, 8/13), but the difference in the precision of screw implantation between the two groups was not significant ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). Four patients in the robot group and 1 in the control group achieved double screws fixation; however, the difference in achieving double screws fixation between the two groups was not significant ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). All fractures healed in both groups with 1 case of malunion in the control group. There was no significant difference in healing time between the two groups ( &lt;i&gt;P&lt;/i&gt;&gt;0.05). During follow-up, 1 patient in the control group experienced screw loosening and displacement. There was no significant difference in the incidence of screw loosening and fracture malunion between the two groups ( &lt;i&gt;P&lt;/i&gt;&gt;0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Compared with manual screw implantation, TiRobot-assisted minimally invasive treatment of coracoid process fractures of the scapula can reduce intraoperative blood loss,","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 1","pages":"40-46"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Treatment of irreducible intertrochanteric femoral fractures in elderly by novel bone hook combined with finger-guided technique].
Q3 Medicine Pub Date : 2025-01-15 DOI: 10.7507/1002-1892.202410006
Zenghui Zhang, Tichao Han, Wei Li, Yangyang Zhou, Junjun Liu, Nannan Li, Tiantian Ren

Objective: To investigate the feasibility and effectiveness of the novel bone hook combined with finger-guided technique in the treatment of irreducible intertrochanteric femoral fractures in elderly.

Methods: Between January 2021 and August 2023, 23 elderly patients with irreducible intertrochanteric femoral fractures were treated with the novel bone hook combined with finger-guided technique. There were 10 males and 13 females; the age ranged from 68 to 93 years (mean, 76.2 years). The time from injury to operation ranged from 36 to 76 hours (mean, 51.2 hours). According to the classification standard proposed by TONG Dake et alin 2021, there were 10 cases of typeⅠA, 1 case of typeⅠB, 6 cases of type ⅡA, 4 cases of type ⅡB, and 2 cases of type ⅡC. The operation time, intraoperative blood loss, intraoperative fluoroscopy frequences, and quality of fracture reduction were recorded. The fracture healing time and occurrence of postoperative complications were observed during follow-up. At last follow-up, the Harris scoring system was used to evaluate the hip joint function.

Results: The operation time was 42-95 minutes (mean, 52.1 minutes). The intraoperative blood loss was 40-420 mL (mean, 126.5 mL). Intraoperative fluoroscopy was performed 14-34 times (mean, 20.7 times). According to the criteria proposed by Chang et al, the quality of fracture reduction was rated as good in 20 cases and acceptable in 3 cases. All patients were followed up 6-20 months (mean, 10.2 months). X-ray film showed that all fractures healed with the healing time of 3.0-5.5 months (mean, 4.0 months). At last follow-up, the Harris score of the hip joint ranged from 82 to 97 points (mean, 90.4 points). Among them, 14 cases were rated as excellent and 9 cases as good. No complication such as coxa vara, cutting of the cephalomedullary nail, nail withdrawal, or nail breakage occurred during follow-up.

Conclusion: The treatment of elderly patients with irreducible intertrochanteric femoral fractures by using the novel bone hook combined with finger-guided technique can achieve high-quality fracture reduction and fixation, and has a good effectiveness.

{"title":"[Treatment of irreducible intertrochanteric femoral fractures in elderly by novel bone hook combined with finger-guided technique].","authors":"Zenghui Zhang, Tichao Han, Wei Li, Yangyang Zhou, Junjun Liu, Nannan Li, Tiantian Ren","doi":"10.7507/1002-1892.202410006","DOIUrl":"10.7507/1002-1892.202410006","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the feasibility and effectiveness of the novel bone hook combined with finger-guided technique in the treatment of irreducible intertrochanteric femoral fractures in elderly.</p><p><strong>Methods: </strong>Between January 2021 and August 2023, 23 elderly patients with irreducible intertrochanteric femoral fractures were treated with the novel bone hook combined with finger-guided technique. There were 10 males and 13 females; the age ranged from 68 to 93 years (mean, 76.2 years). The time from injury to operation ranged from 36 to 76 hours (mean, 51.2 hours). According to the classification standard proposed by TONG Dake <i>et al</i>in 2021, there were 10 cases of typeⅠA, 1 case of typeⅠB, 6 cases of type ⅡA, 4 cases of type ⅡB, and 2 cases of type ⅡC. The operation time, intraoperative blood loss, intraoperative fluoroscopy frequences, and quality of fracture reduction were recorded. The fracture healing time and occurrence of postoperative complications were observed during follow-up. At last follow-up, the Harris scoring system was used to evaluate the hip joint function.</p><p><strong>Results: </strong>The operation time was 42-95 minutes (mean, 52.1 minutes). The intraoperative blood loss was 40-420 mL (mean, 126.5 mL). Intraoperative fluoroscopy was performed 14-34 times (mean, 20.7 times). According to the criteria proposed by Chang <i>et al</i>, the quality of fracture reduction was rated as good in 20 cases and acceptable in 3 cases. All patients were followed up 6-20 months (mean, 10.2 months). X-ray film showed that all fractures healed with the healing time of 3.0-5.5 months (mean, 4.0 months). At last follow-up, the Harris score of the hip joint ranged from 82 to 97 points (mean, 90.4 points). Among them, 14 cases were rated as excellent and 9 cases as good. No complication such as coxa vara, cutting of the cephalomedullary nail, nail withdrawal, or nail breakage occurred during follow-up.</p><p><strong>Conclusion: </strong>The treatment of elderly patients with irreducible intertrochanteric femoral fractures by using the novel bone hook combined with finger-guided technique can achieve high-quality fracture reduction and fixation, and has a good effectiveness.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 1","pages":"53-58"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Wrist arthroscopic Wafer surgery combined with triangular fibrocartilage complex insertion point reconstruction in treatment of Palmer type C combined with type B ulnar impingement syndrome].
Q3 Medicine Pub Date : 2025-01-15 DOI: 10.7507/1002-1892.202410090
Yong Li, Mingming Ma, Xiaojun Ruan, Yongbin Fu

Objective: To investigate the effectivess of arthroscopic Wafer surgery combined with triangular fibrocartilage complex (TFCC) insertion point reconstruction in the treatment of Palmer type ⅡC combined with typeⅠB ulnar impingement syndrome.

Methods: The clinical data of 14 patients with Parlmer type ⅡC combined with type ⅠB ulnar impingement syndrome who met the selection criteria between July 2021 and April 2024 were retrospectively analyzed. There were 7 males and 7 females with an average age of 43 years ranging from 16 to 59 years. The causes of injury were fall in 8 cases and sprain in 6 cases. The time from injury to operation ranged from 1 to 6 months, with an average of 2.3 months. Distal radioulnar joint instability was found in all cases. Arthroscopic Wafer surgery combined with TFCC insertion point reconstruction was used. The effectiveness was evaluated by comparing the wrist flexion-dorsiflexion range of motion, wrist ulnar deviation-radial deflection range of motion, forearm pronation-supination range of motion, visual analogue scale (VAS) score, and modified Mayo wrist score before and after operation.

Results: All patients were followed up 6-12 months, with an average of 9.1 months. The positive variation of ulna was (3.2±0.7) mm before operation, and the negative variation of ulna was (2.2±0.6) mm after operation. There was a significant difference in ulna variation between pre- and post-operation ( t=23.851, P<0.001). The pain symptoms and forearm rotation function of the patients after operation significantly improved. At last follow-up, the wrist flexion-dorsiflexion range of motion, wrist ulnar deviation-radial deflection range of motion, forearm pronation-supination range of motion, VAS score, and modified Mayo wrist score significantly improved when compared with those before operation ( P<0.05).

Conclusion: Arthroscopic Wafer surgery combined with TFCC insertion point reconstruction can effectively relieve wrist pain, enhance the stability of the distal radioulnar joint, and restore the function of the wrist in patients with Palmer type ⅡC combined with type ⅠB ulnar impingement syndrome.

{"title":"[Wrist arthroscopic Wafer surgery combined with triangular fibrocartilage complex insertion point reconstruction in treatment of Palmer type <b>Ⅱ</b>C combined with type <b>Ⅰ</b>B ulnar impingement syndrome].","authors":"Yong Li, Mingming Ma, Xiaojun Ruan, Yongbin Fu","doi":"10.7507/1002-1892.202410090","DOIUrl":"10.7507/1002-1892.202410090","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effectivess of arthroscopic Wafer surgery combined with triangular fibrocartilage complex (TFCC) insertion point reconstruction in the treatment of Palmer type ⅡC combined with typeⅠB ulnar impingement syndrome.</p><p><strong>Methods: </strong>The clinical data of 14 patients with Parlmer type ⅡC combined with type ⅠB ulnar impingement syndrome who met the selection criteria between July 2021 and April 2024 were retrospectively analyzed. There were 7 males and 7 females with an average age of 43 years ranging from 16 to 59 years. The causes of injury were fall in 8 cases and sprain in 6 cases. The time from injury to operation ranged from 1 to 6 months, with an average of 2.3 months. Distal radioulnar joint instability was found in all cases. Arthroscopic Wafer surgery combined with TFCC insertion point reconstruction was used. The effectiveness was evaluated by comparing the wrist flexion-dorsiflexion range of motion, wrist ulnar deviation-radial deflection range of motion, forearm pronation-supination range of motion, visual analogue scale (VAS) score, and modified Mayo wrist score before and after operation.</p><p><strong>Results: </strong>All patients were followed up 6-12 months, with an average of 9.1 months. The positive variation of ulna was (3.2±0.7) mm before operation, and the negative variation of ulna was (2.2±0.6) mm after operation. There was a significant difference in ulna variation between pre- and post-operation ( <i>t</i>=23.851, <i>P</i><0.001). The pain symptoms and forearm rotation function of the patients after operation significantly improved. At last follow-up, the wrist flexion-dorsiflexion range of motion, wrist ulnar deviation-radial deflection range of motion, forearm pronation-supination range of motion, VAS score, and modified Mayo wrist score significantly improved when compared with those before operation ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>Arthroscopic Wafer surgery combined with TFCC insertion point reconstruction can effectively relieve wrist pain, enhance the stability of the distal radioulnar joint, and restore the function of the wrist in patients with Palmer type ⅡC combined with type ⅠB ulnar impingement syndrome.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 1","pages":"59-63"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Short-term effectiveness of uni-portal non-coaxial spinal endoscopic surgery via crossing midline approach in treatment of free lumbar disc herniation].
Q3 Medicine Pub Date : 2025-01-15 DOI: 10.7507/1002-1892.202409030
Zhongfeng Li, Yandong Liu, Lipeng Wen, Bo Chen, Ying Yang, Yurong Wang, Randong Peng, En Song

Objective: To investigate the short-term effectiveness of uni-portal non-coaxial spinal endoscopic surgery (UNSES) via crossing midline approach (CMA) in the treatment of free lumbar disc herniation (FLDH).

Methods: Between March 2024 and June 2024, 16 patients with FLDH were admitted and treated with UNSES via CMA. There were 9 males and 7 females with an average age of 55.1 years (range, 47-62 years). The disease duration was 8-30 months (mean, 15.6 months). The pathological segments was L 3, 4 in 4 cases, L 4, 5 in 5 cases, and L 5, S 1 in 7 cases. The preoperative pain visual analogue scale (VAS) score was 6.9±0.9 and the Oswestry disability index (ODI) was 57.22%±4.16%. The operation time, intraoperative bleeding volume, postoperative hospital stay, and incidence of complications were recorded. The spinal pain and functional status were evaluated by VAS score and ODI, and effectiveness was evaluated according to the modified MacNab criteria. CT and MRI were used to evaluate the effect of nerve decompression.

Results: All 16 patients underwent operation successfully without any complications. The operation time was 63-81 minutes (mean, 71.0 minutes). The intraoperative bleeding volume was 47.3-59.0 mL (mean, 55.0 mL). The length of hospital stay after operation was 3-4 days (mean, 3.5 days). All patients were followed up 1-3 months, with 15 cases followed up for 2 months and 14 cases for 3 months. The VAS score and ODI gradually decreased over time after operation, and there were significant differences between different time points ( P<0.05). At 3 months after operation, the effectiveness was rated as excellent in 12 cases and good in 2 cases according to the modified MacNab criteria, with an excellent and good rate of 100%. CT and MRI during follow-up showed a significant increase in the diameter and cross-sectional area of the spinal canal, indicating effective decompression of the canal.

Conclusion: When using UNSES to treat FLDH, choosing CMA for nerve decompression has the advantages of wide decompression range, large operating space, and freedom of operation. It can maximize the preservation of the articular process, avoid fracture and breakage of the isthmus, clearly display the exiting and traversing nerve root, and achieve good short-term effectiveness.

{"title":"[Short-term effectiveness of uni-portal non-coaxial spinal endoscopic surgery via crossing midline approach in treatment of free lumbar disc herniation].","authors":"Zhongfeng Li, Yandong Liu, Lipeng Wen, Bo Chen, Ying Yang, Yurong Wang, Randong Peng, En Song","doi":"10.7507/1002-1892.202409030","DOIUrl":"10.7507/1002-1892.202409030","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the short-term effectiveness of uni-portal non-coaxial spinal endoscopic surgery (UNSES) via crossing midline approach (CMA) in the treatment of free lumbar disc herniation (FLDH).</p><p><strong>Methods: </strong>Between March 2024 and June 2024, 16 patients with FLDH were admitted and treated with UNSES via CMA. There were 9 males and 7 females with an average age of 55.1 years (range, 47-62 years). The disease duration was 8-30 months (mean, 15.6 months). The pathological segments was L <sub>3, 4</sub> in 4 cases, L <sub>4, 5</sub> in 5 cases, and L <sub>5</sub>, S <sub>1</sub> in 7 cases. The preoperative pain visual analogue scale (VAS) score was 6.9±0.9 and the Oswestry disability index (ODI) was 57.22%±4.16%. The operation time, intraoperative bleeding volume, postoperative hospital stay, and incidence of complications were recorded. The spinal pain and functional status were evaluated by VAS score and ODI, and effectiveness was evaluated according to the modified MacNab criteria. CT and MRI were used to evaluate the effect of nerve decompression.</p><p><strong>Results: </strong>All 16 patients underwent operation successfully without any complications. The operation time was 63-81 minutes (mean, 71.0 minutes). The intraoperative bleeding volume was 47.3-59.0 mL (mean, 55.0 mL). The length of hospital stay after operation was 3-4 days (mean, 3.5 days). All patients were followed up 1-3 months, with 15 cases followed up for 2 months and 14 cases for 3 months. The VAS score and ODI gradually decreased over time after operation, and there were significant differences between different time points ( <i>P</i><0.05). At 3 months after operation, the effectiveness was rated as excellent in 12 cases and good in 2 cases according to the modified MacNab criteria, with an excellent and good rate of 100%. CT and MRI during follow-up showed a significant increase in the diameter and cross-sectional area of the spinal canal, indicating effective decompression of the canal.</p><p><strong>Conclusion: </strong>When using UNSES to treat FLDH, choosing CMA for nerve decompression has the advantages of wide decompression range, large operating space, and freedom of operation. It can maximize the preservation of the articular process, avoid fracture and breakage of the isthmus, clearly display the exiting and traversing nerve root, and achieve good short-term effectiveness.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 1","pages":"83-87"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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中国修复重建外科杂志
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