Pub Date : 2019-11-16DOI: 10.3760/CMA.J.ISSN.0253-2352.2019.22.006
Penghui Liu, Yanping Zheng, Jun Yan, Xun Guo, Peng-fei Chen, Qiang Yang
According to the literature review, using thyroid and thyroid capsule to repair cervical esophageal perforation after anterior cervical spine surgery was just mentioned, but no literature reported operative process in detail. In this study, a 51-year-old male patient was admitted to the hospital because of cervical spine injury. The patient underwent anterior cervical discectomy with the iliac bone graft and ORION plate fixation. Esophageal perforation occurred after anterior cervical spine surgery. After conservative treatment, esophageal perforation didn't heal. A repairing operation was performed to remove the plate and repair esophageal perforation using sternocleidomastoid flap. After repairing surgery 6 months, perforation didn't heal completely. A second repairing surgery was performed to repair esophageal perforation using thyroid and its capsule. After second repairing surgery, esophageal perforation healed. The present study reviewed the literature about cause, clinical manifestation, diagnosis method and treatment of esophageal perforation. Using thyroid and thyroid capsule to repair cervical esophageal perforation could offer a treatment option in repairing esophageal perforation, especially the esophageal perforation after muscle flap repair still didn't heal.
{"title":"Repair cervical esophageal perforation after anterior cervical spine surgery using thyroid and thyroid capsule: a case report and literature review","authors":"Penghui Liu, Yanping Zheng, Jun Yan, Xun Guo, Peng-fei Chen, Qiang Yang","doi":"10.3760/CMA.J.ISSN.0253-2352.2019.22.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2019.22.006","url":null,"abstract":"According to the literature review, using thyroid and thyroid capsule to repair cervical esophageal perforation after anterior cervical spine surgery was just mentioned, but no literature reported operative process in detail. In this study, a 51-year-old male patient was admitted to the hospital because of cervical spine injury. The patient underwent anterior cervical discectomy with the iliac bone graft and ORION plate fixation. Esophageal perforation occurred after anterior cervical spine surgery. After conservative treatment, esophageal perforation didn't heal. A repairing operation was performed to remove the plate and repair esophageal perforation using sternocleidomastoid flap. After repairing surgery 6 months, perforation didn't heal completely. A second repairing surgery was performed to repair esophageal perforation using thyroid and its capsule. After second repairing surgery, esophageal perforation healed. The present study reviewed the literature about cause, clinical manifestation, diagnosis method and treatment of esophageal perforation. Using thyroid and thyroid capsule to repair cervical esophageal perforation could offer a treatment option in repairing esophageal perforation, especially the esophageal perforation after muscle flap repair still didn't heal.","PeriodicalId":36405,"journal":{"name":"中华骨科杂志","volume":"39 1","pages":"1399-1404"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45699796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To analyze the mid-term clinical efficacy of extended to C1, 2 posterior single-door laminoplasty for the treatment of ossification of the posterior longitudinal ligament combined the upper cervical spine. Methods From February 2013 to December 2015, 32 patients with cervical OPLL who were extended to C1, 2 posterior open-door laminoplasty were enrolled in our hospital (complete follow-up of 25 patients). There were 19 males and 6 females, aged 48-76 years (mean 60.1±7.0 years). Cervical spinal cord function was assessed using the Japanese Orthopaedic Association (JOA) spinal cord function score, and the rate of improvement in neurological function was calculated. The quality of life of patients was assessed using the neck disability index (NDI). Axial symptoms were assessed and indexed using the visual analog scale (VAS). The C0-2 angle of the cervical spine was measured by X-ray preoperative and at the last follow-up. The cervical curvature was evaluated by the C2-7 angle, and the cervical vertebra activity was observed by the dynamic X-ray of the cervical spine. Results 25 patients were followed up for a period of 26-64 months (mean 35.9±8.1 months). At the last follow-up, the JOA score was 14.32±3.24, the NDI score was 7.61±1.23, and the VAS score was 1.42±0.78. The differences between the three scores were statistically significant compared with the preoperative scores. The neurological improvement rate at the last follow-up was 79.61%±13.23%. The preoperative C0-2 angle was 26.04°±6.28°, and the last follow-up was 24.92°±5.51°; the C2-7 angle was 19.55°±9.42° before surgery, and the C2-7 angle at last follow-up was 17.97°±8.80°. The C2-7 angle at last follow-up was slightly reduced compared with that preoperative, but the difference was not statistically significant. The preoperative cervical vertebra ROM was 35.31°±12.24°, and at the last follow-up it was 32.23°±9.65°. The ROM of cervical vertebrae at the last follow-up was slightly lower than that before surgery, but the difference was not statistically significant. Among them, the reduction of the ROM of overflexion was greater than that of the over-extension, which was the main reason for the decrease of ROM. The OPLL bone mass continued to grow at the last follow-up of 11 patients. Conclusion The extended to C1, 2 posterior single-door laminoplasty for the treatment of ossification of the posterior longitudinal ligament combined the upper cervical spine can achieve adequate spinal cord decompression, satisfactory neurological improvement, and improve the postoperative cervical curvature and activity. There was no obvious change in the curvature and activity of the cervical spine, and the axial symptoms did not increase significantly, and the clinical efficacy was positive. Key words: Ossification of posterior longitudinal ligament; Cervical vertebrae; Treatment outcome
{"title":"A mid-term clinical analysis of the treatment of ossification of the posterior longitudinal ligament with C1,2 single-door laminoplasty","authors":"Yi-Bo Zhao, Xiaofeng Zhao, Xiang-dong Lu, Zhonghua Zhang, Detai Qi, Xiao-nan Wang, Run-tian Zhou, Yuanzhang Ji","doi":"10.3760/CMA.J.ISSN.0253-2352.2019.22.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2019.22.002","url":null,"abstract":"Objective \u0000To analyze the mid-term clinical efficacy of extended to C1, 2 posterior single-door laminoplasty for the treatment of ossification of the posterior longitudinal ligament combined the upper cervical spine. \u0000 \u0000 \u0000Methods \u0000From February 2013 to December 2015, 32 patients with cervical OPLL who were extended to C1, 2 posterior open-door laminoplasty were enrolled in our hospital (complete follow-up of 25 patients). There were 19 males and 6 females, aged 48-76 years (mean 60.1±7.0 years). Cervical spinal cord function was assessed using the Japanese Orthopaedic Association (JOA) spinal cord function score, and the rate of improvement in neurological function was calculated. The quality of life of patients was assessed using the neck disability index (NDI). Axial symptoms were assessed and indexed using the visual analog scale (VAS). The C0-2 angle of the cervical spine was measured by X-ray preoperative and at the last follow-up. The cervical curvature was evaluated by the C2-7 angle, and the cervical vertebra activity was observed by the dynamic X-ray of the cervical spine. \u0000 \u0000 \u0000Results \u000025 patients were followed up for a period of 26-64 months (mean 35.9±8.1 months). At the last follow-up, the JOA score was 14.32±3.24, the NDI score was 7.61±1.23, and the VAS score was 1.42±0.78. The differences between the three scores were statistically significant compared with the preoperative scores. The neurological improvement rate at the last follow-up was 79.61%±13.23%. The preoperative C0-2 angle was 26.04°±6.28°, and the last follow-up was 24.92°±5.51°; the C2-7 angle was 19.55°±9.42° before surgery, and the C2-7 angle at last follow-up was 17.97°±8.80°. The C2-7 angle at last follow-up was slightly reduced compared with that preoperative, but the difference was not statistically significant. The preoperative cervical vertebra ROM was 35.31°±12.24°, and at the last follow-up it was 32.23°±9.65°. The ROM of cervical vertebrae at the last follow-up was slightly lower than that before surgery, but the difference was not statistically significant. Among them, the reduction of the ROM of overflexion was greater than that of the over-extension, which was the main reason for the decrease of ROM. The OPLL bone mass continued to grow at the last follow-up of 11 patients. \u0000 \u0000 \u0000Conclusion \u0000The extended to C1, 2 posterior single-door laminoplasty for the treatment of ossification of the posterior longitudinal ligament combined the upper cervical spine can achieve adequate spinal cord decompression, satisfactory neurological improvement, and improve the postoperative cervical curvature and activity. There was no obvious change in the curvature and activity of the cervical spine, and the axial symptoms did not increase significantly, and the clinical efficacy was positive. \u0000 \u0000 \u0000Key words: \u0000Ossification of posterior longitudinal ligament; Cervical vertebrae; Treatment outcome","PeriodicalId":36405,"journal":{"name":"中华骨科杂志","volume":"39 1","pages":"1365-1372"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47960063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-16DOI: 10.3760/CMA.J.ISSN.0253-2352.2019.22.008
Jia-yu Kang, Jianwei Lyu, Zhihu Zhao, Jian-xiong Ma, Xinlong Ma
Osteochondral defects caused by various factors are still difficult clinical problems. With the development of tissue engineering, the strategies and methods for repairing osteochondral defects in the past decade have made great progress, and some osteochondral tissue stratified stent products have gradually entered the clinical trial stage.. The related articles on tissue engineering for the treatment of osteochondral defects were retrieved by searching databases with key words osteochondral defects, cartilage repair and hierarchical scaffolds. This paper discussed the research status of hierarchical scaffolds in osteochondral tissue engineering during recent five years. In this work, the classification of hierarchical scaffold including monophasic scaffolds, bilayered scaffolds, multilayered scaffolds and gradient scaffolds, are summarized by comparing different experiment researches. Furthermore, the advantages and disadvantages of different types of hierarchical scaffolds were introduced through analyzing relevant studies. Monophasic scaffolds can support the adhesion and proliferation of osteoblasts and chondrocytes, but lack the inherent stratified structure features required for osteochondral regeneration.. Bilayered scaffolds consist of a chondral layer and subchondral layer which base on the biocompatibility of monophasic scaffolds. Biphasic scaffolds are significantly better than monophasic scaffolds in simulating natural cartilage, but the interface between chondral and subchondral layer is poor binding. Compared with bilayered scaffold, trilayered scaffolds are added with an intermediate layer which simulates the calcification of normal cartilage between the two layers, so as to obtain better connection of the bone and cartilage layer. Unlike hierarchical scaffolds, gradient scaffolds provide a gradient connection between the layers, which is more similar to the native osteochondral tissue. In the past five years, the development of osteochondral layered scaffolds mainly depended on the novel structure and fabrication methods of scaffolds. However, correlational clinical studies are quite few. Further high quality and large clinical studies are still required.
{"title":"Hierarchical scaffolds for osteochondral tissue engineering","authors":"Jia-yu Kang, Jianwei Lyu, Zhihu Zhao, Jian-xiong Ma, Xinlong Ma","doi":"10.3760/CMA.J.ISSN.0253-2352.2019.22.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2019.22.008","url":null,"abstract":"Osteochondral defects caused by various factors are still difficult clinical problems. With the development of tissue engineering, the strategies and methods for repairing osteochondral defects in the past decade have made great progress, and some osteochondral tissue stratified stent products have gradually entered the clinical trial stage.. The related articles on tissue engineering for the treatment of osteochondral defects were retrieved by searching databases with key words osteochondral defects, cartilage repair and hierarchical scaffolds. This paper discussed the research status of hierarchical scaffolds in osteochondral tissue engineering during recent five years. In this work, the classification of hierarchical scaffold including monophasic scaffolds, bilayered scaffolds, multilayered scaffolds and gradient scaffolds, are summarized by comparing different experiment researches. Furthermore, the advantages and disadvantages of different types of hierarchical scaffolds were introduced through analyzing relevant studies. Monophasic scaffolds can support the adhesion and proliferation of osteoblasts and chondrocytes, but lack the inherent stratified structure features required for osteochondral regeneration.. Bilayered scaffolds consist of a chondral layer and subchondral layer which base on the biocompatibility of monophasic scaffolds. Biphasic scaffolds are significantly better than monophasic scaffolds in simulating natural cartilage, but the interface between chondral and subchondral layer is poor binding. Compared with bilayered scaffold, trilayered scaffolds are added with an intermediate layer which simulates the calcification of normal cartilage between the two layers, so as to obtain better connection of the bone and cartilage layer. Unlike hierarchical scaffolds, gradient scaffolds provide a gradient connection between the layers, which is more similar to the native osteochondral tissue. In the past five years, the development of osteochondral layered scaffolds mainly depended on the novel structure and fabrication methods of scaffolds. However, correlational clinical studies are quite few. Further high quality and large clinical studies are still required.","PeriodicalId":36405,"journal":{"name":"中华骨科杂志","volume":"39 1","pages":"1413-1420"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48384811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-16DOI: 10.3760/CMA.J.ISSN.0253-2352.2019.22.003
Zheng-Hao Wang, Kainan Li, Xuejun Wang, J. Mu, Shou-hua Fan
Objective To map OTA/AO type B and type C distal radial fractures according to three-dimensional (3D) CT scan data, and to describe the morphological distribution of fracture lines. Methods A total of 468 cases of distal radius fractures admitted to the Affiliated Hospital of Chengdu University from January 2016 to March 2019 were analyzed and AO classification were performed. AO type B and type C fractures meet the inclusion criteria and then CT data were 3D reconstructed, and morphological description were performed on the fracture lines of each joint surface, including fracture shape angle, fracture area and fracture ratio. At the same time, the articular surface fracture model was superimposed on the standard model, then fracture line and fracture area distribution map were drawn to create the fracture map of intra-articular distal radial fractures. Result Intra-articular fractures of the distal radius were 209 cases, accounting for 44.7% (209/468) of the distal radius fractures, among which 67 cases of AO type B fracture. In type B fractures, average fracture height were 20.30±11.26 mm, average fracture width were 12.24±6.83 mm, average fracture area were 189.61±101.84 mm2, average angle were 57.23°±14.95°, and average area ratio of fracture (fracture zone area/joint surface area ratio) were 32.42%±10.24%. 142 cases were OA type C fracture, the average fracture height were 24.43±11.37 mm, average fracture width were 20.38±7.59 mm, average fracture area were 425.26±314.31 mm2, average angle were 51.26°±13.17°, and average area ratio of fracture were 73.81%±26.29%. According to fracture map formed by main fracture lines, five different fracture areas were identified: ① 63 cases in central area; ② 25 cases in Lister's nodule area; ③ 59 cases in scaphoid area; ④ 36 cases in lumbar fossa area; ⑤ 26 cases in lower iliac area. Main fracture lines were concentrated in the area on the dorsal side of the central area and the scaphoid area. The fracture lines of type B fracture mainly concentrated in scaphoid region, which accounted for 29.85% (20/67), and dorsal side and central area accounted for 26.87% (18/67). The fracture lines of type C fracture accounted for 27.46% (39/142) in scaphoid area and 31.69% (45/142) in central area. The fracture line of type C fracture increased in the lumbar fossa region (17.61%, 25/142) and the lower ulnar region (12.68%, 18/142) compared with type B fracture (28.69%). Compared with the type B fracture, the overall distribution of the fracture line of the type C fracture is more central. Conclusion The map of intra-articular fracture of distal radius was drawn and morphological distribution of fracture lines were quantified. Fracture-prone site and shape of fracture line were visually recognized. At the same time, description of articular surface fracture line and fracture area of type B and type C fractures of OA classification were improved, which may help with new classification and diagnosis.
{"title":"A 3D CT-based fracture map study of intra-articular distal radial fractures","authors":"Zheng-Hao Wang, Kainan Li, Xuejun Wang, J. Mu, Shou-hua Fan","doi":"10.3760/CMA.J.ISSN.0253-2352.2019.22.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2019.22.003","url":null,"abstract":"Objective \u0000To map OTA/AO type B and type C distal radial fractures according to three-dimensional (3D) CT scan data, and to describe the morphological distribution of fracture lines. \u0000 \u0000 \u0000Methods \u0000A total of 468 cases of distal radius fractures admitted to the Affiliated Hospital of Chengdu University from January 2016 to March 2019 were analyzed and AO classification were performed. AO type B and type C fractures meet the inclusion criteria and then CT data were 3D reconstructed, and morphological description were performed on the fracture lines of each joint surface, including fracture shape angle, fracture area and fracture ratio. At the same time, the articular surface fracture model was superimposed on the standard model, then fracture line and fracture area distribution map were drawn to create the fracture map of intra-articular distal radial fractures. \u0000 \u0000 \u0000Result \u0000Intra-articular fractures of the distal radius were 209 cases, accounting for 44.7% (209/468) of the distal radius fractures, among which 67 cases of AO type B fracture. In type B fractures, average fracture height were 20.30±11.26 mm, average fracture width were 12.24±6.83 mm, average fracture area were 189.61±101.84 mm2, average angle were 57.23°±14.95°, and average area ratio of fracture (fracture zone area/joint surface area ratio) were 32.42%±10.24%. 142 cases were OA type C fracture, the average fracture height were 24.43±11.37 mm, average fracture width were 20.38±7.59 mm, average fracture area were 425.26±314.31 mm2, average angle were 51.26°±13.17°, and average area ratio of fracture were 73.81%±26.29%. According to fracture map formed by main fracture lines, five different fracture areas were identified: ① 63 cases in central area; ② 25 cases in Lister's nodule area; ③ 59 cases in scaphoid area; ④ 36 cases in lumbar fossa area; ⑤ 26 cases in lower iliac area. Main fracture lines were concentrated in the area on the dorsal side of the central area and the scaphoid area. The fracture lines of type B fracture mainly concentrated in scaphoid region, which accounted for 29.85% (20/67), and dorsal side and central area accounted for 26.87% (18/67). The fracture lines of type C fracture accounted for 27.46% (39/142) in scaphoid area and 31.69% (45/142) in central area. The fracture line of type C fracture increased in the lumbar fossa region (17.61%, 25/142) and the lower ulnar region (12.68%, 18/142) compared with type B fracture (28.69%). Compared with the type B fracture, the overall distribution of the fracture line of the type C fracture is more central. \u0000 \u0000 \u0000Conclusion \u0000The map of intra-articular fracture of distal radius was drawn and morphological distribution of fracture lines were quantified. Fracture-prone site and shape of fracture line were visually recognized. At the same time, description of articular surface fracture line and fracture area of type B and type C fractures of OA classification were improved, which may help with new classification and diagnosis. ","PeriodicalId":36405,"journal":{"name":"中华骨科杂志","volume":"39 1","pages":"1373-1380"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41970281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-16DOI: 10.3760/CMA.J.ISSN.0253-2352.2019.22.001
Yang Li, B. Shi, Zhen Liu, Xu Sun, Bin Wang, Ze-zhang Zhu
Objective To investigate the efficacy and safety of Ponte osteotomy and sequential correction technique with satellite rod construction in the treatment of severe rigid thoracic scoliosis. Methods A total of 32 patients (12 male, 20 female) with severe rigid thoracic scoliosis (Cobb angle>100°) who underwent posterior Ponte osteotomy and sequential correction technique with satellite rod construction between October 2012 and October 2016 and with more than 2 years follow-up were retrospectively reviewed. Major curve Cobb angle, apex vertebral translation, trunk shift, thoracic kyphosis and lumbar lordosis were measured through standing posterior-anterior X-ray preoperatively, postoperatively and at the final follow-up. The duration of operation, blood loss and complications were recorded. SRS-22 questionnaire was used to evaluate the clinical outcomes. Results The average age was 21.3±10.8 years (range from 17 to 46 years). The mean preoperative major curve Cobb angle was 117.8°±9.8°(range from 104° to 131°) with a mean flexibility of 13.9% and the mean thoracic kyphosis was 65.5°±18.7° (range from 48° to 87°). The mean duration of operation was 267.4±42.3 min and the mean blood loss was 895.4±103.1 ml. The mean fused levels ranged from T2 to L4 with a mean 13.3±2.4 fused segments. The mean implant density was 62.1%±8.8%. Ponte osteotomy was performed in 4-9 segments which was 6.1±1.9 segments in average. The coronal main curve was corrected to 54.4°±10.9° with a mean correction rate of 53.9%±9.3% and the mean thoracic kyphosis was corrected to 35.6°±12.0°, which were both significantly improved. The average follow-up time was 34.3±8.9 months. At the last follow-up, the mean coronal main curve was 53.1°±1.9° with a mean correction loss of 1.3° and the thoracic kyphosis was 36.7°±11.4°. There were no neurological deficit or implant failure postoperatively and follow-up. Conclusion Ponte osteotomy followed by sequential correction technique with satellite rods construction was safe and effective which could achieve satisfactory correction rate and less correction loss during the longitudinal follow-up in the treatment of severe rigid thoracic scoliosis. Key words: Thoracic vertebrae; Scoliosis; Osteotomy; Orthopedic procedures
{"title":"Ponte osteotomy followed by sequential correction technique with satellite rods in severe rigid thoracic scoliosis","authors":"Yang Li, B. Shi, Zhen Liu, Xu Sun, Bin Wang, Ze-zhang Zhu","doi":"10.3760/CMA.J.ISSN.0253-2352.2019.22.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2019.22.001","url":null,"abstract":"Objective \u0000To investigate the efficacy and safety of Ponte osteotomy and sequential correction technique with satellite rod construction in the treatment of severe rigid thoracic scoliosis. \u0000 \u0000 \u0000Methods \u0000A total of 32 patients (12 male, 20 female) with severe rigid thoracic scoliosis (Cobb angle>100°) who underwent posterior Ponte osteotomy and sequential correction technique with satellite rod construction between October 2012 and October 2016 and with more than 2 years follow-up were retrospectively reviewed. Major curve Cobb angle, apex vertebral translation, trunk shift, thoracic kyphosis and lumbar lordosis were measured through standing posterior-anterior X-ray preoperatively, postoperatively and at the final follow-up. The duration of operation, blood loss and complications were recorded. SRS-22 questionnaire was used to evaluate the clinical outcomes. \u0000 \u0000 \u0000Results \u0000The average age was 21.3±10.8 years (range from 17 to 46 years). The mean preoperative major curve Cobb angle was 117.8°±9.8°(range from 104° to 131°) with a mean flexibility of 13.9% and the mean thoracic kyphosis was 65.5°±18.7° (range from 48° to 87°). The mean duration of operation was 267.4±42.3 min and the mean blood loss was 895.4±103.1 ml. The mean fused levels ranged from T2 to L4 with a mean 13.3±2.4 fused segments. The mean implant density was 62.1%±8.8%. Ponte osteotomy was performed in 4-9 segments which was 6.1±1.9 segments in average. The coronal main curve was corrected to 54.4°±10.9° with a mean correction rate of 53.9%±9.3% and the mean thoracic kyphosis was corrected to 35.6°±12.0°, which were both significantly improved. The average follow-up time was 34.3±8.9 months. At the last follow-up, the mean coronal main curve was 53.1°±1.9° with a mean correction loss of 1.3° and the thoracic kyphosis was 36.7°±11.4°. There were no neurological deficit or implant failure postoperatively and follow-up. \u0000 \u0000 \u0000Conclusion \u0000Ponte osteotomy followed by sequential correction technique with satellite rods construction was safe and effective which could achieve satisfactory correction rate and less correction loss during the longitudinal follow-up in the treatment of severe rigid thoracic scoliosis. \u0000 \u0000 \u0000Key words: \u0000Thoracic vertebrae; Scoliosis; Osteotomy; Orthopedic procedures","PeriodicalId":36405,"journal":{"name":"中华骨科杂志","volume":"39 1","pages":"1357-1364"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45379332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-16DOI: 10.3760/CMA.J.ISSN.0253-2352.2019.22.004
Yunpeng Fan, Gang Zu, Yao Pang, Z. Bian, F. He, Liulong Zhu
Objective The related literatures on supra acetabular spinal pedicle screws and a subcutaneous connecting rod (INFIX) in recent years was reviewed, and the overall prognosis was analyzed by meta analysis. Methods literatures were obtained by searching the PubMed, Google Scholar, and Wanfang Full-text Database according to the criteria of inclusion and exclusion. The two members independently screened the qualified literature, evaluated the quality of the literature and extracted the data information. The data information includes demographic and surgical information, main results and secondary results. A large number of data in the selected articles were analyzed and summarized by meta. Results A total of 20 studies were included, including 567 patients. The clinical results were evaluated by Majeed standard in 6 articles, of which 5 articles described the number of excellent and general prognosis, including 185 patients. The excellent and good prognosis rate was 91% (95%CI: 80%-103%) by meta analysis. The general prognosis rate was 9% (95%CI: 3%-14%). Among the prognostic complications, the incidence of lateral femoral cutaneous nerve damage and heterotopic ossification was higher, and the incidence of other complications was less than 5%. There were 13 articles about the complications of ectopic ossification, of which 1 did not mention the specific number of asymptomatic heterotopic ossification, and the remaining 12 included 424 cases, including 132 cases of ectopic ossification. The incidence of ectopic ossification was 26% (95%CI: 11%-40%). Among the 567 cases, obvious symptoms of lateral femoral cutaneous nerve injury were reported. The patients with lateral femoral cutaneous nerve injury accounted for 25% (95%CI: 17%-32%), and the temporary nerve damage was found in 124 cases. The incidence of temporary agitation after subgroup analysis was 21% (95%CI: 14%-28%). Five articles mentioned the manifestations of postoperative femoral nerve damage, including 10 patients, the incidence of femoral nerve damage was 3% (95%CI: -1%-6%). A total of 18 articles on surgical site-related infections were reported, including 534 patients, of which 15 were infected, with an infection rate of 3% (95%CI: 2%-4%). 19 articles clearly reported the failure of internal fixation after INIFX operation, including 32 patients who needed reoperation for different reasons. The failure of internal fixation was 3% (95%CI: 2%-4%). A total of 585 cases of fracture non-prognosis data were reported, of which 473 cases were cured and 3 cases had bone nonunion. The non-union rate of fracture was 3% (95%CI: 1%-5%). Conclusion After InFix pelvic surgery, the patient's clinical follow-up prognosis score and imaging findings showed that the postoperative recovery was good, and the new technique also avoided the inconvenience and postoperative complications caused by many traditional pelvic external fixation techniques. However, it was also found that the lateral
{"title":"Application of anterior subcutaneous Internal Pelvic Fixation in pelvic anterior ring fracture: a meta analysis","authors":"Yunpeng Fan, Gang Zu, Yao Pang, Z. Bian, F. He, Liulong Zhu","doi":"10.3760/CMA.J.ISSN.0253-2352.2019.22.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2019.22.004","url":null,"abstract":"Objective \u0000The related literatures on supra acetabular spinal pedicle screws and a subcutaneous connecting rod (INFIX) in recent years was reviewed, and the overall prognosis was analyzed by meta analysis. \u0000 \u0000 \u0000Methods \u0000literatures were obtained by searching the PubMed, Google Scholar, and Wanfang Full-text Database according to the criteria of inclusion and exclusion. The two members independently screened the qualified literature, evaluated the quality of the literature and extracted the data information. The data information includes demographic and surgical information, main results and secondary results. A large number of data in the selected articles were analyzed and summarized by meta. \u0000 \u0000 \u0000Results \u0000A total of 20 studies were included, including 567 patients. The clinical results were evaluated by Majeed standard in 6 articles, of which 5 articles described the number of excellent and general prognosis, including 185 patients. The excellent and good prognosis rate was 91% (95%CI: 80%-103%) by meta analysis. The general prognosis rate was 9% (95%CI: 3%-14%). Among the prognostic complications, the incidence of lateral femoral cutaneous nerve damage and heterotopic ossification was higher, and the incidence of other complications was less than 5%. There were 13 articles about the complications of ectopic ossification, of which 1 did not mention the specific number of asymptomatic heterotopic ossification, and the remaining 12 included 424 cases, including 132 cases of ectopic ossification. The incidence of ectopic ossification was 26% (95%CI: 11%-40%). Among the 567 cases, obvious symptoms of lateral femoral cutaneous nerve injury were reported. The patients with lateral femoral cutaneous nerve injury accounted for 25% (95%CI: 17%-32%), and the temporary nerve damage was found in 124 cases. The incidence of temporary agitation after subgroup analysis was 21% (95%CI: 14%-28%). Five articles mentioned the manifestations of postoperative femoral nerve damage, including 10 patients, the incidence of femoral nerve damage was 3% (95%CI: -1%-6%). A total of 18 articles on surgical site-related infections were reported, including 534 patients, of which 15 were infected, with an infection rate of 3% (95%CI: 2%-4%). 19 articles clearly reported the failure of internal fixation after INIFX operation, including 32 patients who needed reoperation for different reasons. The failure of internal fixation was 3% (95%CI: 2%-4%). A total of 585 cases of fracture non-prognosis data were reported, of which 473 cases were cured and 3 cases had bone nonunion. The non-union rate of fracture was 3% (95%CI: 1%-5%). \u0000 \u0000 \u0000Conclusion \u0000After InFix pelvic surgery, the patient's clinical follow-up prognosis score and imaging findings showed that the postoperative recovery was good, and the new technique also avoided the inconvenience and postoperative complications caused by many traditional pelvic external fixation techniques. However, it was also found that the lateral ","PeriodicalId":36405,"journal":{"name":"中华骨科杂志","volume":"39 1","pages":"1381-1391"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45242077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.3760/CMA.J.ISSN.0253-2352.2019.21.002
Zhao Liu, Jinli Zhang, Q. Shen, Zhong-Yu Liu, E. Li, Yuchen Zhen, Baocheng Zhao, Q. Cao, Tao Zhang, Shao-Yu Zhu
Objective To explore the clinical features and treatment strategies of tibial plateau fractures sustained with hyperextension varus. Methods Data of 11 patients of tibial plateau fractures with hyperextension varus treated from January 2008 to November 2017 were retrospectively analyzed. There were 7 males and 4 females with an average age of 41.2 years old (range, 25-67 years). Injuries were caused by falling down in 7 cases, traffic accident in 3 cases, and falling from height in 1 case, respectively. On the basis of Luo's three columns classification in tibial plateau, there were 9 cases of medial column fracture and 2 cases of medial combined with posterior column fracture. Six cases were concomitant with fibular head fracture and 2 cases with the injury of common peroneal nerve. Preoperative magnetic resonance imaging showed that there were anterior cruciate ligament injury in 3 cases, posterior cruciate ligament injury in 4 cases, medial meniscus injury in 5 cases, lateral meniscus injury in 3 cases, medial collateral ligament injury in 6 cases, iliotibial band injury in 2 cases and posterolateral complex injury of the knee joint in 9 cases, respectively. All tibial plateau fractures were treated firstly by open reduction and internal fixation via medial approach of the knee. The medial meniscuses and collateral ligaments were explored, in which of them there were 2 medial meniscuses with the marginal tear been sutured simultaneously. Then the knee joints which were still unstable after the examination of stable tests in 6 cases with posterolateral complex injuries were repaired surgically via lateral approach. Fibular head fractures were fixed with anchor nails or cannulated screws in 6 cases. The ruptured posterior cruciate ligaments in 2 cases were reconstructed with autologous tendon transplantation under endoscopy. Results All the patients were followed up for an average period of 16.2 months (range, 12-22 months). All fractures were healed in 10-20 weeks with an average time of 16.5 weeks. The range of extension of the affected knee joint in all patients was 0° and the average flexion was 135° (range, 120°-145°) one year after surgery. The average flexion of affected knee in 4 cases which were only treated with the tibial plateau fracture without the mild ligament injuries was 137° (range, 132°-145°) and the average flexion of affected knee in 7 cases who were treated with tibial plateau fracture and severe posterolateral complex included posterior cruciate ligaments completely broken with reconstruction was 132° (range, 120°-140°). According to Rasmussen radiographic evaluation, the average score of all patients was 16.3 (range, 14 to 18) and clinical outcomes were rated with excellent in 10 cases and good in 1. The excellent and good rate was 100% (11/11). The mean of the hospital for special surgery (HSS) score was 86.7 (range, 79-96) and the functional scores were excellent in 9 cases, good in 2 cases thus the excelle
{"title":"The clinical feature and treatment strategy of tibial plateau fractures sustained with hyperextension varus","authors":"Zhao Liu, Jinli Zhang, Q. Shen, Zhong-Yu Liu, E. Li, Yuchen Zhen, Baocheng Zhao, Q. Cao, Tao Zhang, Shao-Yu Zhu","doi":"10.3760/CMA.J.ISSN.0253-2352.2019.21.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2019.21.002","url":null,"abstract":"Objective \u0000To explore the clinical features and treatment strategies of tibial plateau fractures sustained with hyperextension varus. \u0000 \u0000 \u0000Methods \u0000Data of 11 patients of tibial plateau fractures with hyperextension varus treated from January 2008 to November 2017 were retrospectively analyzed. There were 7 males and 4 females with an average age of 41.2 years old (range, 25-67 years). Injuries were caused by falling down in 7 cases, traffic accident in 3 cases, and falling from height in 1 case, respectively. On the basis of Luo's three columns classification in tibial plateau, there were 9 cases of medial column fracture and 2 cases of medial combined with posterior column fracture. Six cases were concomitant with fibular head fracture and 2 cases with the injury of common peroneal nerve. Preoperative magnetic resonance imaging showed that there were anterior cruciate ligament injury in 3 cases, posterior cruciate ligament injury in 4 cases, medial meniscus injury in 5 cases, lateral meniscus injury in 3 cases, medial collateral ligament injury in 6 cases, iliotibial band injury in 2 cases and posterolateral complex injury of the knee joint in 9 cases, respectively. All tibial plateau fractures were treated firstly by open reduction and internal fixation via medial approach of the knee. The medial meniscuses and collateral ligaments were explored, in which of them there were 2 medial meniscuses with the marginal tear been sutured simultaneously. Then the knee joints which were still unstable after the examination of stable tests in 6 cases with posterolateral complex injuries were repaired surgically via lateral approach. Fibular head fractures were fixed with anchor nails or cannulated screws in 6 cases. The ruptured posterior cruciate ligaments in 2 cases were reconstructed with autologous tendon transplantation under endoscopy. \u0000 \u0000 \u0000Results \u0000All the patients were followed up for an average period of 16.2 months (range, 12-22 months). All fractures were healed in 10-20 weeks with an average time of 16.5 weeks. The range of extension of the affected knee joint in all patients was 0° and the average flexion was 135° (range, 120°-145°) one year after surgery. The average flexion of affected knee in 4 cases which were only treated with the tibial plateau fracture without the mild ligament injuries was 137° (range, 132°-145°) and the average flexion of affected knee in 7 cases who were treated with tibial plateau fracture and severe posterolateral complex included posterior cruciate ligaments completely broken with reconstruction was 132° (range, 120°-140°). According to Rasmussen radiographic evaluation, the average score of all patients was 16.3 (range, 14 to 18) and clinical outcomes were rated with excellent in 10 cases and good in 1. The excellent and good rate was 100% (11/11). The mean of the hospital for special surgery (HSS) score was 86.7 (range, 79-96) and the functional scores were excellent in 9 cases, good in 2 cases thus the excelle","PeriodicalId":36405,"journal":{"name":"中华骨科杂志","volume":"39 1","pages":"1301-1310"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42147365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.3760/CMA.J.ISSN.0253-2352.2019.21.005
M. Xiang, Xiao-chuan Hu, Yanming Lin, Youzhang Deng
Objective To explore the influence and mechanism of time effect of the controlled micromovement on fracture healing. Methods Forty-eight rabbit models of femoral fracture were prepared and fixed with unilateral two-bar external fixator. They were randomly divided into four groups: continuing immobilization group, instant micromovement group, 1-week micromovement group and 2-week micromovement group. Postoperative radiographs were taken at 1, 2, 3 and 5 weeks to observe callus growth. The maximum load, deflection and rigidity of callus at fracture end were measured 5 weeks after operation. At 1, 2 and 3 weeks after operation, the histological morphology of callus was observed, and the expression and distribution of osteocalcin (oc) in callus were detected. Results At 5 weeks after operation, the X-ray scores of fracture line in 1-week micromovement group and 2-week micromovement group were 10.384±0.744 mm, 10.412±0.482 mm, significantly higher than those in continuing immobilization group (7.518±0.536). The anteroposterior diameter and the exterior and interior diameter of the external callus in 1-week micromovement group and 2-week micromovement group were 14.3±3.2 mm, 14.0±2.8 mm and 14.6±2.1 mm, 15.2±3.1 mm, which were smaller than those in the continuing immobilization group 15.3±2.3 mm and 16.7±1.9 mm, but there was no significant difference. The bone mineral density value and proportion rate in the fracture site were 0.446±0.020 g/cm2, 0.416±0.021 g/cm2 and 1.171%±0.056%, 1.143%±0.040% in 1-week micromovement group and 2-week micromovement group, which were significantly higher than those in continuing immobilization group which were 0.376±0.022 g/cm2 and 0.912%±0.051%. The maximum load of callus in 1-week micromovement group and 2-week micromovement group was 415.6±27.2 N, 400.3±28.5 N, which was significantly higher than that in continuing immobilization group 329.2±18.4 N and instant micromovement group 272.8±22.7 N. There was no difference of the deflection of callus between groups. The rigidity of callus in 1-week micromovement group was 590.4±24.2 N/mm, which was significantly higher than that in other groups; the rigidity of callus in the 2-week micromovement group was 540.6±22.8 N/mm, which was significantly higher than those in the instant micromovement group and the continuing immobilization group (152.4±21.7 N/mm, 174.8±20.6 N/mm). Conclusion Micromovement begins from one or two weeks can significantly raise external callus formation and vagueness level of fracture line, accelerating bridging callus formation, and can significantly raise bone mineral density and rigidity of callus. It also accelerates the maturity, hypertrophy and mineralization of chondrocyte, resulting in the stimulation of the fracture healing through endochondral ossification; it seemingly can improve the amount and density of osteoclasts in callus to stimulate the maturity and mineralization of chondrocyte. The strengthening coupling of ost
目的探讨可控微动时间效应对骨折愈合的影响及机制。方法制备兔股骨骨折模型48只，采用单侧双棒外固定架固定。随机分为持续固定组、瞬间微动组、1周微动组和2周微动组。术后1、2、3、5周拍摄x线片，观察骨痂生长情况。术后5周测量骨折端骨痂的最大载荷、挠度和刚度。术后1、2、3周观察骨钙素(osteocalcin, oc)在愈伤组织中的表达及分布。结果术后5周，微活动组1周和2周骨折线x线评分分别为10.384±0.744 mm、10.412±0.482 mm，明显高于持续固定组(7.518±0.536)。1周微动组和2周微动组外愈伤组织前后径为14.3±3.2 mm, 14.0±2.8 mm, 14.6±2.1 mm, 15.2±3.1 mm，均小于持续固定组(15.3±2.3 mm和16.7±1.9 mm)，但差异无统计学意义。1周微动组和2周微动组骨折部位骨密度值和骨密度占比分别为0.446±0.020 g/cm2、0.416±0.021 g/cm2和1.171%±0.056%、1.143%±0.040%，显著高于持续固定组的0.376±0.022 g/cm2和0.912%±0.051%。1周微动组和2周微动组愈伤组织最大负荷分别为415.6±27.2 N、400.3±28.5 N，显著高于持续固定组(329.2±18.4 N)和瞬间微动组(272.8±22.7 N)，各组愈伤组织挠度无差异。微动组1周愈伤组织硬度为590.4±24.2 N/mm，显著高于其他各组;2周微动组愈伤组织硬度为540.6±22.8 N/mm，明显高于瞬间微动组和持续固定组(152.4±21.7 N/mm、174.8±20.6 N/mm)。结论1 ~ 2周开始微动可显著提高骨外愈伤组织形成和骨折线模糊程度，加速桥接愈伤组织形成，显著提高骨外愈伤组织骨密度和硬度。加速软骨细胞成熟、肥大、矿化，通过软骨内成骨刺激骨折愈合;它似乎可以提高愈伤组织中破骨细胞的数量和密度，从而刺激软骨细胞的成熟和矿化。成骨细胞与破骨细胞的耦合增强，可促进软性愈伤组织向硬性愈伤组织的转化和硬性愈伤组织的重塑。关键词:骨折;骨;骨折愈合;外固定器
{"title":"Experimental study of the time effect of controlled micromovement on the influence of the fracture healing","authors":"M. Xiang, Xiao-chuan Hu, Yanming Lin, Youzhang Deng","doi":"10.3760/CMA.J.ISSN.0253-2352.2019.21.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2019.21.005","url":null,"abstract":"Objective \u0000To explore the influence and mechanism of time effect of the controlled micromovement on fracture healing. \u0000 \u0000 \u0000Methods \u0000Forty-eight rabbit models of femoral fracture were prepared and fixed with unilateral two-bar external fixator. They were randomly divided into four groups: continuing immobilization group, instant micromovement group, 1-week micromovement group and 2-week micromovement group. Postoperative radiographs were taken at 1, 2, 3 and 5 weeks to observe callus growth. The maximum load, deflection and rigidity of callus at fracture end were measured 5 weeks after operation. At 1, 2 and 3 weeks after operation, the histological morphology of callus was observed, and the expression and distribution of osteocalcin (oc) in callus were detected. \u0000 \u0000 \u0000Results \u0000At 5 weeks after operation, the X-ray scores of fracture line in 1-week micromovement group and 2-week micromovement group were 10.384±0.744 mm, 10.412±0.482 mm, significantly higher than those in continuing immobilization group (7.518±0.536). The anteroposterior diameter and the exterior and interior diameter of the external callus in 1-week micromovement group and 2-week micromovement group were 14.3±3.2 mm, 14.0±2.8 mm and 14.6±2.1 mm, 15.2±3.1 mm, which were smaller than those in the continuing immobilization group 15.3±2.3 mm and 16.7±1.9 mm, but there was no significant difference. The bone mineral density value and proportion rate in the fracture site were 0.446±0.020 g/cm2, 0.416±0.021 g/cm2 and 1.171%±0.056%, 1.143%±0.040% in 1-week micromovement group and 2-week micromovement group, which were significantly higher than those in continuing immobilization group which were 0.376±0.022 g/cm2 and 0.912%±0.051%. The maximum load of callus in 1-week micromovement group and 2-week micromovement group was 415.6±27.2 N, 400.3±28.5 N, which was significantly higher than that in continuing immobilization group 329.2±18.4 N and instant micromovement group 272.8±22.7 N. There was no difference of the deflection of callus between groups. The rigidity of callus in 1-week micromovement group was 590.4±24.2 N/mm, which was significantly higher than that in other groups; the rigidity of callus in the 2-week micromovement group was 540.6±22.8 N/mm, which was significantly higher than those in the instant micromovement group and the continuing immobilization group (152.4±21.7 N/mm, 174.8±20.6 N/mm). \u0000 \u0000 \u0000Conclusion \u0000Micromovement begins from one or two weeks can significantly raise external callus formation and vagueness level of fracture line, accelerating bridging callus formation, and can significantly raise bone mineral density and rigidity of callus. It also accelerates the maturity, hypertrophy and mineralization of chondrocyte, resulting in the stimulation of the fracture healing through endochondral ossification; it seemingly can improve the amount and density of osteoclasts in callus to stimulate the maturity and mineralization of chondrocyte. The strengthening coupling of ost","PeriodicalId":36405,"journal":{"name":"中华骨科杂志","volume":"39 1","pages":"1333-1343"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45275602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.3760/CMA.J.ISSN.0253-2352.2019.21.006
Yaxing Li, Yi Ren, Xia Tang, Yu Chen, Shizhou Wu, W. Deng, Yun Zhu, Fuguo Huang, Hui Zhang
Due to the complex anatomical structure of ankle and the various mechanisms of ankle injury, manyeponyms and systematic classifications of ankle fracture have been developed in the past centuries. Before the emergence and constant improvement of classifications of ankle fracture, ankle fractures were most commonly named afterthe physicians who first described them. Now,these ankle fracture eponyms are still found in medical literature, textbooks and even mass media. Many special named ankle fractures can be explained by the Lauge-Hansen classification now, and they may have little practical use. However, it is still necessary to summarize and review these ankle fracture eponyms, in order to correct the wrong usage of these and to remember the sages in this field.We reviewed both common and less frequently used ankle fracture eponyms, focusing on imaging features to identify and differentiate these injuries. We also briefly reviewed the mechanism of each injury, associated complications, its diagnosis and treatment.
{"title":"The special named ankle fractures: the diagnosis and treatment","authors":"Yaxing Li, Yi Ren, Xia Tang, Yu Chen, Shizhou Wu, W. Deng, Yun Zhu, Fuguo Huang, Hui Zhang","doi":"10.3760/CMA.J.ISSN.0253-2352.2019.21.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2019.21.006","url":null,"abstract":"Due to the complex anatomical structure of ankle and the various mechanisms of ankle injury, manyeponyms and systematic classifications of ankle fracture have been developed in the past centuries. Before the emergence and constant improvement of classifications of ankle fracture, ankle fractures were most commonly named afterthe physicians who first described them. Now,these ankle fracture eponyms are still found in medical literature, textbooks and even mass media. Many special named ankle fractures can be explained by the Lauge-Hansen classification now, and they may have little practical use. However, it is still necessary to summarize and review these ankle fracture eponyms, in order to correct the wrong usage of these and to remember the sages in this field.We reviewed both common and less frequently used ankle fracture eponyms, focusing on imaging features to identify and differentiate these injuries. We also briefly reviewed the mechanism of each injury, associated complications, its diagnosis and treatment.","PeriodicalId":36405,"journal":{"name":"中华骨科杂志","volume":"39 1","pages":"1344-1356"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43037007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.3760/CMA.J.ISSN.0253-2352.2019.21.004
Chong Tang, Zheng Liu, Sijun Wu, Zhenpeng Guan, Z. Pei, Wenlong Wang
Objective To evaluate the safety and efficacy of oblique lateral interbody fusion (OLIF) in the surgical treatment of lumbar degenerative diseases. Methods All literatures of OLIF performed in lumbar degenerative diseases were searched in recognized databases including Pubmed, OVID, Embase, Cochrane Library, Science Direct, springer, CNKI, Wanfang and VIP databases. Methodological Indexfor Non-randomized Studies (MINORS) was used to evaluate the quality of the literatures. The meta-analysis was performed using Review Manager 5.3 and Stata 15.0 statistical software. Results A total of 35 literatures were included, including 22 English literatures and 13 Chinese literatures. There were 3 630 patients with 45.2% of males, aged from 14 to 89 years old (mean, 62.6 years). The average of length of stay (LOS), operation time (OT) and blood loss (BL) of OLIF procedure were 6.7 days, 117 minutes, and 128 ml, respectively. The VAS scores of low back pain of postoperative and final follow-up decreased by 4.33 and 4.70, respectively. The VAS scores of leg pain decreased by 4.57 points and 5.31, respectively. Compared with preoperative, the postoperative JOA score increased by 7.58 and the postoperative ODI were also improved by 33.89%. All the postoperative imaging data were significantly different from those before surgery. The surgical level intervertebral heightincreased 4.14 mm, and the intervertebral foramen height and intervertebral foramen area increased by 3.54 mm, 53.96 mm2, while the dura sac cross-sectional area increased by 36.61 mm2, and the overall lumbar lordosis increased by 13.78° with the local segmental lordosis increased by 4.62°. The overall incidence of complications of OLIF was 32%, with a 95% confidence interval of 25%-38%. Conclusion OLIF is a minimally invasive procedure for the treatment of lumbar degenerative diseases. OLIF has a simply procedure and short learning curve, with short LOS and operation time, less blood loss. OLIF can effectively open the narrow intervertebral space and increase the spinal canal and nerve root canal, significantly improve the symptoms, while the complication rate is low, so OLIF is worthy of widespread clinical application. Key words: Lumbar vertebrae; Spinal fusion; Meta-analysis
{"title":"The clinical value of oblique lateral interbody fusion in lumbar degenerative diseases: a meta-analysis","authors":"Chong Tang, Zheng Liu, Sijun Wu, Zhenpeng Guan, Z. Pei, Wenlong Wang","doi":"10.3760/CMA.J.ISSN.0253-2352.2019.21.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0253-2352.2019.21.004","url":null,"abstract":"Objective \u0000To evaluate the safety and efficacy of oblique lateral interbody fusion (OLIF) in the surgical treatment of lumbar degenerative diseases. \u0000 \u0000 \u0000Methods \u0000All literatures of OLIF performed in lumbar degenerative diseases were searched in recognized databases including Pubmed, OVID, Embase, Cochrane Library, Science Direct, springer, CNKI, Wanfang and VIP databases. Methodological Indexfor Non-randomized Studies (MINORS) was used to evaluate the quality of the literatures. The meta-analysis was performed using Review Manager 5.3 and Stata 15.0 statistical software. \u0000 \u0000 \u0000Results \u0000A total of 35 literatures were included, including 22 English literatures and 13 Chinese literatures. There were 3 630 patients with 45.2% of males, aged from 14 to 89 years old (mean, 62.6 years). The average of length of stay (LOS), operation time (OT) and blood loss (BL) of OLIF procedure were 6.7 days, 117 minutes, and 128 ml, respectively. The VAS scores of low back pain of postoperative and final follow-up decreased by 4.33 and 4.70, respectively. The VAS scores of leg pain decreased by 4.57 points and 5.31, respectively. Compared with preoperative, the postoperative JOA score increased by 7.58 and the postoperative ODI were also improved by 33.89%. All the postoperative imaging data were significantly different from those before surgery. The surgical level intervertebral heightincreased 4.14 mm, and the intervertebral foramen height and intervertebral foramen area increased by 3.54 mm, 53.96 mm2, while the dura sac cross-sectional area increased by 36.61 mm2, and the overall lumbar lordosis increased by 13.78° with the local segmental lordosis increased by 4.62°. The overall incidence of complications of OLIF was 32%, with a 95% confidence interval of 25%-38%. \u0000 \u0000 \u0000Conclusion \u0000OLIF is a minimally invasive procedure for the treatment of lumbar degenerative diseases. OLIF has a simply procedure and short learning curve, with short LOS and operation time, less blood loss. OLIF can effectively open the narrow intervertebral space and increase the spinal canal and nerve root canal, significantly improve the symptoms, while the complication rate is low, so OLIF is worthy of widespread clinical application. \u0000 \u0000 \u0000Key words: \u0000Lumbar vertebrae; Spinal fusion; Meta-analysis","PeriodicalId":36405,"journal":{"name":"中华骨科杂志","volume":"39 1","pages":"1320-1332"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49068964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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