Pub Date : 2020-04-10DOI: 10.3760/CMA.J.CN311653-20190702-00188
Shan-Shan Tao, Xiao-yun Pan, Chen Liu, Jingyi Mi
Objective To explore the expression of hyperphosphorylated Tau protein in the retrograde degeneration of spinal central neurons after cervical 7 nerve transection, so as to provide a new idea for the protection of retrograde degeneration of central neurons after peripheral nerve injury. Methods Thirty-six adult female Sprague-Dawley rats were randomly divided into three groups (sham operation group, transection group, transection+drug intervention group). The rats in transection group and transection+drug intervention group were treated with bilateral cervical 7 nerve cutting to make models, and the rats in transection+drug intervention group were treated with 1 mmol/kg lithium chloride intraperitoneally every day. After 2 and 4 weeks, the spinal cords of cervical 7 of the rats were taken, and the apoptosis of neurons was analyzed by HE staining and flow cytometry. The expression of Tau protein and related protein was analyzed by Western blot. Results HE staining and flow cytometry showed that the apoptotic degree of the transection group at 2 weeks was less than that at 4 weeks. The resutls of Western blot showed that as time went on, the amount of total Tau protein decreased due to the transection of cervical 7 nerve, and the proportion of phosphorylated Tau protein increased. The difference was statistically significant. After lithium chloride administration, the degree of apoptosis and the proportion of phosphorylated Tau protein decreased significantly. Conclusion The mechanism of Tau protein hyperphosphorylation lies in the process of retrograde degeneration of spinal cord central neurons after cervical 7 transection, and lithium chloride can reduce the degree of retrograde degeneration. Key words: Tau proteins; Brachial plexus; Neuron retrograde degeneration; Hyperphosphorylation
{"title":"Expression of hyperphosphorylated Tau protein in retrograde degeneration of neurons","authors":"Shan-Shan Tao, Xiao-yun Pan, Chen Liu, Jingyi Mi","doi":"10.3760/CMA.J.CN311653-20190702-00188","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311653-20190702-00188","url":null,"abstract":"Objective \u0000To explore the expression of hyperphosphorylated Tau protein in the retrograde degeneration of spinal central neurons after cervical 7 nerve transection, so as to provide a new idea for the protection of retrograde degeneration of central neurons after peripheral nerve injury. \u0000 \u0000 \u0000Methods \u0000Thirty-six adult female Sprague-Dawley rats were randomly divided into three groups (sham operation group, transection group, transection+drug intervention group). The rats in transection group and transection+drug intervention group were treated with bilateral cervical 7 nerve cutting to make models, and the rats in transection+drug intervention group were treated with 1 mmol/kg lithium chloride intraperitoneally every day. After 2 and 4 weeks, the spinal cords of cervical 7 of the rats were taken, and the apoptosis of neurons was analyzed by HE staining and flow cytometry. The expression of Tau protein and related protein was analyzed by Western blot. \u0000 \u0000 \u0000Results \u0000HE staining and flow cytometry showed that the apoptotic degree of the transection group at 2 weeks was less than that at 4 weeks. The resutls of Western blot showed that as time went on, the amount of total Tau protein decreased due to the transection of cervical 7 nerve, and the proportion of phosphorylated Tau protein increased. The difference was statistically significant. After lithium chloride administration, the degree of apoptosis and the proportion of phosphorylated Tau protein decreased significantly. \u0000 \u0000 \u0000Conclusion \u0000The mechanism of Tau protein hyperphosphorylation lies in the process of retrograde degeneration of spinal cord central neurons after cervical 7 transection, and lithium chloride can reduce the degree of retrograde degeneration. \u0000 \u0000 \u0000Key words: \u0000Tau proteins; Brachial plexus; Neuron retrograde degeneration; Hyperphosphorylation","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"36 1","pages":"126-130"},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48886390","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 : 2020-04-10DOI: 10.3760/CMA.J.CN311653-20190724-00207
S. Gu, R. Xie, Yinjun Huang
Objective To evaluate the clinical efficacy of trans-articular plate combined with Kirschner wire for treatment of the fifth carpometacarpal joint fracture and dislocation. Methods From July 2016 to June 2018, 10 cases of the fifth carpometacarpal joint fracture and dislocation were treated with trans-articular plate combined with Kirschner wire. The pain, range of motion, function and grip strength of the wrist were followed up after operation, and the effect was evaluated by Cooney wrist function score. Results The postoperative follow-up period ranged from 10 to 33 months, with an average of 20.3 months. There were no complications such as fracture of internal fixation, nonunion and malunion of fracture. At the last follow-up, the flexion and extension range of the affected wrist was (116.2±11.9)° which was 89.6% of that of the healthy side; the grip strength of the affected side was (85.2±19.6) lb which was 91.1% of that of the healthy side. There were 7 cases without pain and 3 cases with occasional pain. All patients returned to normal work. According to Cooney's wrist function score, 2 cases were excellent and 8 cases were good. Conclusion The clinical efficacy of trans-articular plate combined with Kirschner wire for treatment of the fifth carpometacarpal joint fracture and dislocation is satisfactory and worthy of clinical application. Key words: Fractures,bone; Treatment outcome; Kirschner wire; Carpometacarpal joint
{"title":"Clinical efficacy analysis of trans-articular plate combined with Kirschner wire for treatment of the fifth carpometacarpal joint fracture and dislocation","authors":"S. Gu, R. Xie, Yinjun Huang","doi":"10.3760/CMA.J.CN311653-20190724-00207","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311653-20190724-00207","url":null,"abstract":"Objective \u0000To evaluate the clinical efficacy of trans-articular plate combined with Kirschner wire for treatment of the fifth carpometacarpal joint fracture and dislocation. \u0000 \u0000 \u0000Methods \u0000From July 2016 to June 2018, 10 cases of the fifth carpometacarpal joint fracture and dislocation were treated with trans-articular plate combined with Kirschner wire. The pain, range of motion, function and grip strength of the wrist were followed up after operation, and the effect was evaluated by Cooney wrist function score. \u0000 \u0000 \u0000Results \u0000The postoperative follow-up period ranged from 10 to 33 months, with an average of 20.3 months. There were no complications such as fracture of internal fixation, nonunion and malunion of fracture. At the last follow-up, the flexion and extension range of the affected wrist was (116.2±11.9)° which was 89.6% of that of the healthy side; the grip strength of the affected side was (85.2±19.6) lb which was 91.1% of that of the healthy side. There were 7 cases without pain and 3 cases with occasional pain. All patients returned to normal work. According to Cooney's wrist function score, 2 cases were excellent and 8 cases were good. \u0000 \u0000 \u0000Conclusion \u0000The clinical efficacy of trans-articular plate combined with Kirschner wire for treatment of the fifth carpometacarpal joint fracture and dislocation is satisfactory and worthy of clinical application. \u0000 \u0000 \u0000Key words: \u0000Fractures,bone; Treatment outcome; Kirschner wire; Carpometacarpal joint","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"36 1","pages":"111-113"},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44287916","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 : 2020-04-10DOI: 10.3760/CMA.J.CN311653-20190830-06169
Guheng Wang, Shuang Li, Yalan Chen, S. Xing, Jian-wei Hou, T. Mao, Jun Tan, Ai-dong Deng, R. Xie
Objective To compare the clinical efficacy of reconstruction of trapezium ligament, conoid ligament and acromioclavicular ligament with allogeneic tendon and Endoboutton reduction and fixation in the treatment of acromioclavicular joint dislocation. Methods From February 2010 to August 2016, 16 patients with acromioclavicular joint dislocation were treated, including 8 patients who used allogeneic tendons to reconstruct trapezoid ligament, conoid ligament and the upper and lower parts of acromioclavicular ligament, and 8 patients who used Endobouton technique to reconstruct coracoclavicular ligament. The follow-up of patients' overall satisfaction, observation of shoulder shape, measurement of shoulder joint activity, X-ray evaluation of acromioclavicular joint reduction and maintenance were conducted. The Constant-Murley score and DASH score were used to evaluate the functional recovery of shoulder and upper extremity, and the visual analog scale (VAS) was used to obtain the pain of patients. The follow-up results of the two methods were compared. Results The follow-up period ranged from 34 to 60 months with an average of 48.8 months. All the patients were satisfied with the treatment results and the shape of shoulder joint was normal. In the allogeneic tendon group, the Constant-Murley score was 94.5±5.2, the DASH score was 2.1±2.6, and the VAS score was 0.4±1.1; in the Endobutton group, the Constant-Murley score was 92.8±3.7, the DASH score was 2.2±2.0, and the VAS score was 0.3±0.7. There were no significant differences between the two groups (P>0.05). Conclusion The technique of allogeneic tendon reconstruction and Endoboutton in the treatment of acromioclavicular joint dislocation can achieve satisfactory results, and the allogeneic tendon is more close to the biomechanical requirements, which is an effective method. Key words: Acromioclavicular joint; Dislocations; Allogeneic tendon; Ligament reconstruction; Endobutton technique
{"title":"A retrospective comparative study in the treatment of acromioclavicular joint dislocation: ligaments reconstruction with allogenic tendon versus Endobutton technique","authors":"Guheng Wang, Shuang Li, Yalan Chen, S. Xing, Jian-wei Hou, T. Mao, Jun Tan, Ai-dong Deng, R. Xie","doi":"10.3760/CMA.J.CN311653-20190830-06169","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311653-20190830-06169","url":null,"abstract":"Objective \u0000To compare the clinical efficacy of reconstruction of trapezium ligament, conoid ligament and acromioclavicular ligament with allogeneic tendon and Endoboutton reduction and fixation in the treatment of acromioclavicular joint dislocation. \u0000 \u0000 \u0000Methods \u0000From February 2010 to August 2016, 16 patients with acromioclavicular joint dislocation were treated, including 8 patients who used allogeneic tendons to reconstruct trapezoid ligament, conoid ligament and the upper and lower parts of acromioclavicular ligament, and 8 patients who used Endobouton technique to reconstruct coracoclavicular ligament. The follow-up of patients' overall satisfaction, observation of shoulder shape, measurement of shoulder joint activity, X-ray evaluation of acromioclavicular joint reduction and maintenance were conducted. The Constant-Murley score and DASH score were used to evaluate the functional recovery of shoulder and upper extremity, and the visual analog scale (VAS) was used to obtain the pain of patients. The follow-up results of the two methods were compared. \u0000 \u0000 \u0000Results \u0000The follow-up period ranged from 34 to 60 months with an average of 48.8 months. All the patients were satisfied with the treatment results and the shape of shoulder joint was normal. In the allogeneic tendon group, the Constant-Murley score was 94.5±5.2, the DASH score was 2.1±2.6, and the VAS score was 0.4±1.1; in the Endobutton group, the Constant-Murley score was 92.8±3.7, the DASH score was 2.2±2.0, and the VAS score was 0.3±0.7. There were no significant differences between the two groups (P>0.05). \u0000 \u0000 \u0000Conclusion \u0000The technique of allogeneic tendon reconstruction and Endoboutton in the treatment of acromioclavicular joint dislocation can achieve satisfactory results, and the allogeneic tendon is more close to the biomechanical requirements, which is an effective method. \u0000 \u0000 \u0000Key words: \u0000Acromioclavicular joint; Dislocations; Allogeneic tendon; Ligament reconstruction; Endobutton technique","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"36 1","pages":"99-102"},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47583449","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 : 2020-02-28DOI: 10.3760/CMA.J.CN311653-20200226-00000
Qishun Huang, Xia Wu, Kun Wang, Xiaobin Cong, Jia Tian, Fang-xing Ai, P. Zhou, W. Lei, G. Guo, Zhengyu Liu, Xiaofan Yang, Gongchi Li, Yutian Liu, Xiaocheng Lu, Wei Ji, Tao Li, Huaiyuan Zheng, Yan-hua Chen, Jin Li, Jing-hua Chen, Yu-xiong Weng, Zhenbing Chen
To explore how to make the hand injury patients get timely and effective treatment under the background of COVID-19 epidemic situation, and effectively prevent the spread of the epidemic situation. Through the training of relevant knowledge for medical staff, hand trauma patients were classified according to the contact history of the epidemic situation and clinical symptoms, and the corresponding treatment plan was taken. Since the outbreak of the epidemic, hand trauma patients were treated in time and effectively, no case of infection of medical staff occurred, and no epidemic spread. Combined with the emergency management regulations of infection prevention and control in the epidemic period, this paper puts forward suggestions for the treatment of hand injury in the COVID-19 epidemic period, aiming to provide a reference for hand surgeons in dealing with hand injury in the epidemic period. Key words: Hand injuries; Pneumonia; COVID-19; Infection control
{"title":"Management strategy of acute hand injury in epidemic period of COVID-19","authors":"Qishun Huang, Xia Wu, Kun Wang, Xiaobin Cong, Jia Tian, Fang-xing Ai, P. Zhou, W. Lei, G. Guo, Zhengyu Liu, Xiaofan Yang, Gongchi Li, Yutian Liu, Xiaocheng Lu, Wei Ji, Tao Li, Huaiyuan Zheng, Yan-hua Chen, Jin Li, Jing-hua Chen, Yu-xiong Weng, Zhenbing Chen","doi":"10.3760/CMA.J.CN311653-20200226-00000","DOIUrl":"https://doi.org/10.3760/CMA.J.CN311653-20200226-00000","url":null,"abstract":"To explore how to make the hand injury patients get timely and effective treatment under the background of COVID-19 epidemic situation, and effectively prevent the spread of the epidemic situation. Through the training of relevant knowledge for medical staff, hand trauma patients were classified according to the contact history of the epidemic situation and clinical symptoms, and the corresponding treatment plan was taken. Since the outbreak of the epidemic, hand trauma patients were treated in time and effectively, no case of infection of medical staff occurred, and no epidemic spread. Combined with the emergency management regulations of infection prevention and control in the epidemic period, this paper puts forward suggestions for the treatment of hand injury in the COVID-19 epidemic period, aiming to provide a reference for hand surgeons in dealing with hand injury in the epidemic period. \u0000 \u0000 \u0000Key words: \u0000Hand injuries; Pneumonia; COVID-19; Infection control","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"131 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41265131","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 : 2020-02-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2020.01.017
F. Zhao, Bowen Zhang, Jian Gao, Yonglu Huang, F. Gong, Xiaoliang Li, Yi Ding, Han-qi Zhang, Lipeng Zhang, Kai-Ling Peng
Objective To investigate the surgical method and clinical efficacy of vascularized anterior subcutaneous transposition of the ulnar nerve with inferior ulnar collateral artery for treatment of severe cubital tunnel syndrome through minimal incision in the medial elbow. Methods From June 2015 to June 2017, 22 patients with severe cubital tunnel syndrome were admitted and divided into two groups according to different surgical methods: the vascularized anterior subcutaneous transposition of the ulnar nerve and the vascularized anterior subcutaneous transposition of the ulnar nerve through minimal incision in elbow. The conduction velocity of ulnar nerve through elbow joint, the two-point discrimination of the distal pulp of the little finger and the length of incision were compared between the two groups. Results All the 22 patients were follow-up for 8 to 15 months, with an average of 12.2 months. The excellent and good rate was 82.29% in the vascularized anterior subcutaneous transposition of the ulnar nerve group and 80.91% in the group with minimal incision in elbow. There was no significant difference between the two groups in the changes of ulnar nerve conduction velocity before and after the operation and in the recovery of two-point discrimination of the distal pulp of the little finger. After using the minimal incision in elbow, the average conventional incision of 13.4 cm was reduced to 4.7 cm. Conclusion The vascularized anterior subcutaneous transposition of the ulnar nerve operation ensures the blood supply of the local ulnar nerve of the elbow. It is a kind of operation method for the treatment of severe cubital tunnel syndrome. On this basis, the selection of the minimal incision on the medial side of the elbow can also achieve the clinical efficacy of the conventional incision length. The minimal incision can recover more quickly and the appearance of operation area is better. Key words: Cubital tunnel syndrome; Treatment outcome; Severe; Inferior ulnar collateral artery
{"title":"Vascularized anterior subcutaneous transposition of the ulnar nerve with inferior ulnar collateral artery for treatment of severe cubital tunnel syndrome through minimal incision in elbow","authors":"F. Zhao, Bowen Zhang, Jian Gao, Yonglu Huang, F. Gong, Xiaoliang Li, Yi Ding, Han-qi Zhang, Lipeng Zhang, Kai-Ling Peng","doi":"10.3760/CMA.J.ISSN.1005-054X.2020.01.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2020.01.017","url":null,"abstract":"Objective \u0000To investigate the surgical method and clinical efficacy of vascularized anterior subcutaneous transposition of the ulnar nerve with inferior ulnar collateral artery for treatment of severe cubital tunnel syndrome through minimal incision in the medial elbow. \u0000 \u0000 \u0000Methods \u0000From June 2015 to June 2017, 22 patients with severe cubital tunnel syndrome were admitted and divided into two groups according to different surgical methods: the vascularized anterior subcutaneous transposition of the ulnar nerve and the vascularized anterior subcutaneous transposition of the ulnar nerve through minimal incision in elbow. The conduction velocity of ulnar nerve through elbow joint, the two-point discrimination of the distal pulp of the little finger and the length of incision were compared between the two groups. \u0000 \u0000 \u0000Results \u0000All the 22 patients were follow-up for 8 to 15 months, with an average of 12.2 months. The excellent and good rate was 82.29% in the vascularized anterior subcutaneous transposition of the ulnar nerve group and 80.91% in the group with minimal incision in elbow. There was no significant difference between the two groups in the changes of ulnar nerve conduction velocity before and after the operation and in the recovery of two-point discrimination of the distal pulp of the little finger. After using the minimal incision in elbow, the average conventional incision of 13.4 cm was reduced to 4.7 cm. \u0000 \u0000 \u0000Conclusion \u0000The vascularized anterior subcutaneous transposition of the ulnar nerve operation ensures the blood supply of the local ulnar nerve of the elbow. It is a kind of operation method for the treatment of severe cubital tunnel syndrome. On this basis, the selection of the minimal incision on the medial side of the elbow can also achieve the clinical efficacy of the conventional incision length. The minimal incision can recover more quickly and the appearance of operation area is better. \u0000 \u0000 \u0000Key words: \u0000Cubital tunnel syndrome; Treatment outcome; Severe; Inferior ulnar collateral artery","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"36 1","pages":"55-57"},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45615280","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 : 2020-02-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2020.01.011
Y. Duan, J. Ju, Guangliang Zhang, Xin-yi Liu, You Li, Guodong Jiang
Objective To explore the surgical method and clinical efficacy of two free flaps pedicled with the tibial proper toe artery of the second toe for repair of the defects of two fingertips. Methods From November 2014 to September 2018, five patients with the defects of two fingertips were treated with one pedicle double flaps of the tibial side of the second toe in emergency. The proper artery of the tibial side of the second toe was used as the vascular pedicle. The blood circulation of the two flaps and the injured finger was reconstructed. The donor site was replanted with full thickness skin graft of the medial leg. Results All the 10 finger flaps survived uneventfully. The donor and recipient wounds achieved primary healing without vascular crisis. The postoperative follow-up ranged from 6 to 24 months with an average of 12 months. The appearance, sensation and function of the free flaps recovered well. No second operation was needed to thin the flaps. There were no obvious scar hyperplasia and contracture in the donor site, no abrasion resistance and pain. Conclusion The application of two free flaps from the tibial side of the second toe to repair fingertip defect of two fingers can cover the defect wound, ensure the appearance, sensation and function of the finger, reduce the number of donor sites and damage. It is an ideal repair method. Key words: Finger injuries; Surgical flaps; The second toe; One pedicle and double flaps
{"title":"The repair of the defects of two fingertips with free tibial pedicle double flaps of the second toe","authors":"Y. Duan, J. Ju, Guangliang Zhang, Xin-yi Liu, You Li, Guodong Jiang","doi":"10.3760/CMA.J.ISSN.1005-054X.2020.01.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2020.01.011","url":null,"abstract":"Objective \u0000To explore the surgical method and clinical efficacy of two free flaps pedicled with the tibial proper toe artery of the second toe for repair of the defects of two fingertips. \u0000 \u0000 \u0000Methods \u0000From November 2014 to September 2018, five patients with the defects of two fingertips were treated with one pedicle double flaps of the tibial side of the second toe in emergency. The proper artery of the tibial side of the second toe was used as the vascular pedicle. The blood circulation of the two flaps and the injured finger was reconstructed. The donor site was replanted with full thickness skin graft of the medial leg. \u0000 \u0000 \u0000Results \u0000All the 10 finger flaps survived uneventfully. The donor and recipient wounds achieved primary healing without vascular crisis. The postoperative follow-up ranged from 6 to 24 months with an average of 12 months. The appearance, sensation and function of the free flaps recovered well. No second operation was needed to thin the flaps. There were no obvious scar hyperplasia and contracture in the donor site, no abrasion resistance and pain. \u0000 \u0000 \u0000Conclusion \u0000The application of two free flaps from the tibial side of the second toe to repair fingertip defect of two fingers can cover the defect wound, ensure the appearance, sensation and function of the finger, reduce the number of donor sites and damage. It is an ideal repair method. \u0000 \u0000 \u0000Key words: \u0000Finger injuries; Surgical flaps; The second toe; One pedicle and double flaps","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"36 1","pages":"38-40"},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48472594","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 : 2020-02-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2020.01.003
Liu Jianrui, Tuoheti Aihemaiti, L. Fang, Chen-song Yang, Yunfei Cao, Zhi Zhang, Guixin Sun
Objective To explore the clinical advantages of minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of proximal humerus fractures of Neer typeⅢ andⅣ. Methods From May 2015 to May 2018, 78 cases of proximal humerus fractures of Neer type Ⅲ and Ⅳ were treated with MIPPO and open reduction and internal fixation (ORIF). There were 36 cases in MIPPO group, 20 males and 16 females, including 21 cases of Part Ⅲ fractures and 15 cases of Part Ⅳ fractures; and 42 cases in ORIF group, 24 males and 18 females, including 26 cases of Part Ⅲ fractures and 16 cases of Part Ⅳ fractures. The length of incision, the amount of bleeding, the time of operation, the time of fracture healing, the UCLA score of shoulder joint before and 3, 6 months after operation, the Constant-Murley score of shoulder joint function at 3, 6, 12 months after operation, the classification of joint function at the last follow-up, the axillary nerve injury and other complications were compared. The shoulder joint function of MIPPO group was evaluated after fracture healing. Results All the 78 patients were follow-up for (17.3±2.8) months. The incision length, fracture healing time and intraoperative bleeding in MIPPO group were significantly shorter than those in ORIF group. The UCLA scores of shoulder joint in MIPPO group were 29.04±1.63 and 30.95±1.69 at 3 and 6 months after operation, which were higher than those in ORIF group 22.11±2.33 and 25.96±2.01. The shoulder function Constant-Murley scores of MIPPO group were 55.64±2.83 and 75.01±5.71 at 3 and 6 months after operation, which were higher than those of ORIF group 45.03±6.32 and 64.61±6.77. However, there was no significant difference between the two groups in the shoulder function Constant-Murley score and the last shoulder function grade at 12 months after operation. After fracture healing, the shoulder function of MIPPO group was further evaluated: the average flexion angle was 170.5 ° (ranged, 161° to 180°), the average external rotation angle was 71° (ranged, 63.5° to 83.5°), the average internal rotation angle was 73.6 ° (ranged, 68° to 79°) and the recovery of mobility was good. The complication rate of MIPPO group was 5.56%, which was better than that of ORIF group 11.90% (P<0.05). Conclusion Both MIPPO and ORIF can treat proximal humerus fractures of Neer type Ⅲ and Ⅳ. The former is superior to the latter in incision length, bleeding volume, fracture healing time, shoulder joint function recovery at 3 and 6 months after operation, complications and other aspects, which is worth clinical promotion. Key words: Humeral fractures; Fracture fixation,internal; Axillary nerve injury; Minimal invasive
{"title":"Advantages of percutaneous minimally invasive plate internal fixation in the treatment of complex proximal humeral fractures","authors":"Liu Jianrui, Tuoheti Aihemaiti, L. Fang, Chen-song Yang, Yunfei Cao, Zhi Zhang, Guixin Sun","doi":"10.3760/CMA.J.ISSN.1005-054X.2020.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2020.01.003","url":null,"abstract":"Objective To explore the clinical advantages of minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of proximal humerus fractures of Neer typeⅢ andⅣ. Methods From May 2015 to May 2018, 78 cases of proximal humerus fractures of Neer type Ⅲ and Ⅳ were treated with MIPPO and open reduction and internal fixation (ORIF). There were 36 cases in MIPPO group, 20 males and 16 females, including 21 cases of Part Ⅲ fractures and 15 cases of Part Ⅳ fractures; and 42 cases in ORIF group, 24 males and 18 females, including 26 cases of Part Ⅲ fractures and 16 cases of Part Ⅳ fractures. The length of incision, the amount of bleeding, the time of operation, the time of fracture healing, the UCLA score of shoulder joint before and 3, 6 months after operation, the Constant-Murley score of shoulder joint function at 3, 6, 12 months after operation, the classification of joint function at the last follow-up, the axillary nerve injury and other complications were compared. The shoulder joint function of MIPPO group was evaluated after fracture healing. Results All the 78 patients were follow-up for (17.3±2.8) months. The incision length, fracture healing time and intraoperative bleeding in MIPPO group were significantly shorter than those in ORIF group. The UCLA scores of shoulder joint in MIPPO group were 29.04±1.63 and 30.95±1.69 at 3 and 6 months after operation, which were higher than those in ORIF group 22.11±2.33 and 25.96±2.01. The shoulder function Constant-Murley scores of MIPPO group were 55.64±2.83 and 75.01±5.71 at 3 and 6 months after operation, which were higher than those of ORIF group 45.03±6.32 and 64.61±6.77. However, there was no significant difference between the two groups in the shoulder function Constant-Murley score and the last shoulder function grade at 12 months after operation. After fracture healing, the shoulder function of MIPPO group was further evaluated: the average flexion angle was 170.5 ° (ranged, 161° to 180°), the average external rotation angle was 71° (ranged, 63.5° to 83.5°), the average internal rotation angle was 73.6 ° (ranged, 68° to 79°) and the recovery of mobility was good. The complication rate of MIPPO group was 5.56%, which was better than that of ORIF group 11.90% (P<0.05). Conclusion Both MIPPO and ORIF can treat proximal humerus fractures of Neer type Ⅲ and Ⅳ. The former is superior to the latter in incision length, bleeding volume, fracture healing time, shoulder joint function recovery at 3 and 6 months after operation, complications and other aspects, which is worth clinical promotion. Key words: Humeral fractures; Fracture fixation,internal; Axillary nerve injury; Minimal invasive","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"36 1","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45881613","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 report the micro-hardness of human metacarpal bones, compare and analyze the hardness values between different anatomical parts, and explore the distribution characteristics of micro-hardness of human metacarpal bones. Methods The metacarpal bones were collected from three fresh healthy frozen specimens. The soft tissue of the right metacarpal bone was dissected. These metacarpal bones were cut into 3 mm-thick slices perpendicular to the long axis with a low-speed saw in metacarpal base, shaft and head. The Vickers method was used to measure the hardness of different areas of the palmar, dorsal, medial and lateral site of bone slices, and the standard operation method with 50 g force loading for 50 s and maintenance for 12 s was used to determine the hardness. The hardness value was compared by one-way ANOVA, and P<0.05 was statistically significant. Results Totally, 45 specimens and 900 indentations at different bones and anatomic sites were involved. The overall hardness of metacarpal bone was (38.23±7.15) HV. The third metacarpal bone had the highest hardness (41.04±6.75) HV, followed by the second metacarpal bone (39.62±7.64) HV, the first metacarpal bone (37.83±6.52) HV, the fifth metacarpal bone (36.69±7.30) HV, and the fourth metacarpal bone (35.97±6.28) HV. The metacarpal shaft hardness (43.45±6.35) HV was higher than metacarpal basal (35.82±6.17) HV and metacarpal head (35.43±5.85) HV (F=16.415, P<0.01). There was no significant difference in palmar (37.58±7.35) HV, dorsal (38.93±7.08) HV, medial (38.26±7.00) HV and lateral site (38.15±7.14) HV in hardness (F=1.352, P=0.256). Conclusion The results of this study have deepened the understanding of metacarpal micro-biomechanical properties, and can guide the placement, direction and number of internal fixators in metacarpal fracture surgery, and provide data support for 3D printing of artificial metacarpophalangeal joint for the treatment of comminuted metacarpal fracture or defect. Key words: Metacarpal bones; Biomechanics; Vickers hardness; Micro-hardness
{"title":"Study on micro-hardness distribution characteristics of human metacarpal bones","authors":"B. Yin, X. Shao, Chang-ping Zhao, Jialiang Guo, Jian-chao Wang, Yingze Zhang","doi":"10.3760/CMA.J.ISSN.1005-054X.2020.01.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2020.01.020","url":null,"abstract":"Objective \u0000To report the micro-hardness of human metacarpal bones, compare and analyze the hardness values between different anatomical parts, and explore the distribution characteristics of micro-hardness of human metacarpal bones. \u0000 \u0000 \u0000Methods \u0000The metacarpal bones were collected from three fresh healthy frozen specimens. The soft tissue of the right metacarpal bone was dissected. These metacarpal bones were cut into 3 mm-thick slices perpendicular to the long axis with a low-speed saw in metacarpal base, shaft and head. The Vickers method was used to measure the hardness of different areas of the palmar, dorsal, medial and lateral site of bone slices, and the standard operation method with 50 g force loading for 50 s and maintenance for 12 s was used to determine the hardness. The hardness value was compared by one-way ANOVA, and P<0.05 was statistically significant. \u0000 \u0000 \u0000Results \u0000Totally, 45 specimens and 900 indentations at different bones and anatomic sites were involved. The overall hardness of metacarpal bone was (38.23±7.15) HV. The third metacarpal bone had the highest hardness (41.04±6.75) HV, followed by the second metacarpal bone (39.62±7.64) HV, the first metacarpal bone (37.83±6.52) HV, the fifth metacarpal bone (36.69±7.30) HV, and the fourth metacarpal bone (35.97±6.28) HV. The metacarpal shaft hardness (43.45±6.35) HV was higher than metacarpal basal (35.82±6.17) HV and metacarpal head (35.43±5.85) HV (F=16.415, P<0.01). There was no significant difference in palmar (37.58±7.35) HV, dorsal (38.93±7.08) HV, medial (38.26±7.00) HV and lateral site (38.15±7.14) HV in hardness (F=1.352, P=0.256). \u0000 \u0000 \u0000Conclusion \u0000The results of this study have deepened the understanding of metacarpal micro-biomechanical properties, and can guide the placement, direction and number of internal fixators in metacarpal fracture surgery, and provide data support for 3D printing of artificial metacarpophalangeal joint for the treatment of comminuted metacarpal fracture or defect. \u0000 \u0000 \u0000Key words: \u0000Metacarpal bones; Biomechanics; Vickers hardness; Micro-hardness","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"36 1","pages":"66-69"},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42155729","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 : 2020-02-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2020.01.018
Fanyu Pu, Mingyu Xue, L. Qiang, Jingyi Mi, Yongjun Rui
Objective To explore the clinical efficacy of arthroscopic minimally invasive technique in the treatment of traumatic pain and dysfunction of metacarpophalangeal joint in the early and middle stages. Methods From March 2016 to December 2018, nine patients with traumatic metacarpophalangeal arthritis were treated with arthroscopic minimally invasive assistance to understand the lesions of metacarpophalangeal joint, and to clean up the osteophytes, intra-articular free bodies and synovitis. After the operation, the patients were instructed to take progressive functional exercise. The joint motion degree of the affected fingers was followed up. Whether there were swelling, deformity and pain in the fingers was observed. Results The postoperative follow-up time ranged from 6 to 24 months, with an average of 15 months. All the patients did not have any symptoms such as surgical complications and pain discomfort in a short period of time. The joint flexion and extension function were improved in varying degrees. According to the measurement standard of total active motion (TAM) of finger flexion and extension function, before operation the results were good in 1 case, fair in 5 cases and poor in 3 cases; after operation the results were excellent in 6 cases, good in 2 cases and fair in 1 case. Conclusion In the early and middle stage of traumatic arthritis of metacarpophalangeal joint, the minimally invasive treatment under arthroscope has the advantages of small trauma, high accuracy and pertinence, quick postoperative recovery, which is an effective treatment method to improve hand function and reduce joint pain, and is worthy of clinical promotion. Key words: Metacarpophalangeal joint; Treatment outcome; Traumatic arthritis; Arthroscopes
{"title":"Clinical efficacy of arthroscope-assisted treatment of traumatic metacarpophalangeal arthritis","authors":"Fanyu Pu, Mingyu Xue, L. Qiang, Jingyi Mi, Yongjun Rui","doi":"10.3760/CMA.J.ISSN.1005-054X.2020.01.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2020.01.018","url":null,"abstract":"Objective \u0000To explore the clinical efficacy of arthroscopic minimally invasive technique in the treatment of traumatic pain and dysfunction of metacarpophalangeal joint in the early and middle stages. \u0000 \u0000 \u0000Methods \u0000From March 2016 to December 2018, nine patients with traumatic metacarpophalangeal arthritis were treated with arthroscopic minimally invasive assistance to understand the lesions of metacarpophalangeal joint, and to clean up the osteophytes, intra-articular free bodies and synovitis. After the operation, the patients were instructed to take progressive functional exercise. The joint motion degree of the affected fingers was followed up. Whether there were swelling, deformity and pain in the fingers was observed. \u0000 \u0000 \u0000Results \u0000The postoperative follow-up time ranged from 6 to 24 months, with an average of 15 months. All the patients did not have any symptoms such as surgical complications and pain discomfort in a short period of time. The joint flexion and extension function were improved in varying degrees. According to the measurement standard of total active motion (TAM) of finger flexion and extension function, before operation the results were good in 1 case, fair in 5 cases and poor in 3 cases; after operation the results were excellent in 6 cases, good in 2 cases and fair in 1 case. \u0000 \u0000 \u0000Conclusion \u0000In the early and middle stage of traumatic arthritis of metacarpophalangeal joint, the minimally invasive treatment under arthroscope has the advantages of small trauma, high accuracy and pertinence, quick postoperative recovery, which is an effective treatment method to improve hand function and reduce joint pain, and is worthy of clinical promotion. \u0000 \u0000 \u0000Key words: \u0000Metacarpophalangeal joint; Treatment outcome; Traumatic arthritis; Arthroscopes","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"36 1","pages":"58-60"},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43741648","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 : 2020-02-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2020.01.006
Ya-li Xu, Ye Tian, Dongdong Zhang, X. Shao
Objective To analyze the electrophysiological characteristics of the patients with hourglass-like constriction of radial nerve (RN)/posterior interosseous nerve (PIN) and explore the possible causes. Methods From January 2011 to November 2018, 18 patients with hourglass-like constriction of RN/PIN were treated in our hospital. The electrophysiological results of them were analyzed retrospectively. The extent and degree of lesion involvement were evaluated. Results The course of disease was 3 weeks to 13 months before electrophysiological examination in 18 patients. 14 patients (77.8%) suffered from complete injury and 4 patients (22.1%) suffered from incomplete injury. The coincidence rate between electrophysiological results and intraoperative findings was 94.4%. In addition to the abnormalities directly related to hourglass-like constriction, 88.9% of RN hourglass-like constriction patients and 11.1% of PIN hourglass-like constriction patients were associated with other neurological abnormalities. Among them, 8 patients with RN hourglass-like constriction were complicated with the abnormalities of median nerve (50%), ulnar nerve (50%), musculocutaneous nerve (37.5%), axillary nerve (25%), suprascapular nerve (25%), triceps brachii branch (75%), and the nerves of contralateral upper extremity (25%), contralateral phrenic nerve (12.5%) and the nerves of four extremities (12.5%). The main manifestations were abnormal insertion potential, resting spontaneous fibrillation potential, prolongation of light contraction time limit, simple phase of forced contraction and decrease of amplitude of motor evoked potential in sensory and motor nerve conduction. There was no obvious abnormality in nerve conduction velocity. Conclusion The hourglass-like constriction of RN/PIN is often associated with other neural abnormalities. The higher the location of hourglass-like constriction, the wider the range of involvement. It is different from the electrophysiological characteristics of peripheral nerve entrapment, indicating possible presence of neuralgic amyotrophy. Key words: Electrophysiology; Radial nerve; Posterior interosseous nerve; Hourglass-like constriction
{"title":"Electrophysiological analysis of the patients with hourglass-like constriction of radial nerve/posterior interosseous nerve","authors":"Ya-li Xu, Ye Tian, Dongdong Zhang, X. Shao","doi":"10.3760/CMA.J.ISSN.1005-054X.2020.01.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2020.01.006","url":null,"abstract":"Objective \u0000To analyze the electrophysiological characteristics of the patients with hourglass-like constriction of radial nerve (RN)/posterior interosseous nerve (PIN) and explore the possible causes. \u0000 \u0000 \u0000Methods \u0000From January 2011 to November 2018, 18 patients with hourglass-like constriction of RN/PIN were treated in our hospital. The electrophysiological results of them were analyzed retrospectively. The extent and degree of lesion involvement were evaluated. \u0000 \u0000 \u0000Results \u0000The course of disease was 3 weeks to 13 months before electrophysiological examination in 18 patients. 14 patients (77.8%) suffered from complete injury and 4 patients (22.1%) suffered from incomplete injury. The coincidence rate between electrophysiological results and intraoperative findings was 94.4%. In addition to the abnormalities directly related to hourglass-like constriction, 88.9% of RN hourglass-like constriction patients and 11.1% of PIN hourglass-like constriction patients were associated with other neurological abnormalities. Among them, 8 patients with RN hourglass-like constriction were complicated with the abnormalities of median nerve (50%), ulnar nerve (50%), musculocutaneous nerve (37.5%), axillary nerve (25%), suprascapular nerve (25%), triceps brachii branch (75%), and the nerves of contralateral upper extremity (25%), contralateral phrenic nerve (12.5%) and the nerves of four extremities (12.5%). The main manifestations were abnormal insertion potential, resting spontaneous fibrillation potential, prolongation of light contraction time limit, simple phase of forced contraction and decrease of amplitude of motor evoked potential in sensory and motor nerve conduction. There was no obvious abnormality in nerve conduction velocity. \u0000 \u0000 \u0000Conclusion \u0000The hourglass-like constriction of RN/PIN is often associated with other neural abnormalities. The higher the location of hourglass-like constriction, the wider the range of involvement. It is different from the electrophysiological characteristics of peripheral nerve entrapment, indicating possible presence of neuralgic amyotrophy. \u0000 \u0000 \u0000Key words: \u0000Electrophysiology; Radial nerve; Posterior interosseous nerve; Hourglass-like constriction","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"36 1","pages":"23-26"},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45992208","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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