Pub Date : 2019-06-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2019.03.018
J. Rui, Yali Xu, Xin Zhao, Ji-feng Li, J. Lao, Y. Gu
Objective To verify the safety of a new surgical model by assessing the lung function of phrenic nerve and intercostal nerve via side-to-side with nerve autograft to the neurorrhaphy site of the musculocutaneous nerve in rats. Methods Fifty four SD rats were randomly divided into three groups. Group A was the negative control group, in which the musculocutaneous nerve was transected and directly sutured. The other two groups were the phrenic nerve (group B) and intercostal nerve (group C): after the musculocutaneous nerve was transected and the side-to-side neurorrhaphy was conducted. Sural nerve was used to connect the musculocutaneous nerve neurorrhaphy site and the donor nerve as phrenic nerve or intercostal nerve. Lung function test was conducted at 1, 2 and 3 months postoperatively. Results No significant difference was detected from each parameter including breathing frequency (F), minute ventilation (MV), inspirationand expiration time (Ti and Te), peak inspiratory and expiratory flow (PIF and PEF) and 50% expiratory flow (EF50) of lung function test among group A, B and C at 1, 2 and 3 months postoperatively. Conclusion Side-to-side neurorrhaphy has no obvious damage to pulmonary function. This new method is safe and has great advantages in clinical application. Key words: Rats; Respiratory function tests; Phrenic nerve; Intercostal nerve; Side-to-side neurorrhaphy
{"title":"Effects of side-to-side neurorrhaphy of phrenic nerve or intercostal nerve on pulmonary function in rats","authors":"J. Rui, Yali Xu, Xin Zhao, Ji-feng Li, J. Lao, Y. Gu","doi":"10.3760/CMA.J.ISSN.1005-054X.2019.03.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2019.03.018","url":null,"abstract":"Objective \u0000To verify the safety of a new surgical model by assessing the lung function of phrenic nerve and intercostal nerve via side-to-side with nerve autograft to the neurorrhaphy site of the musculocutaneous nerve in rats. \u0000 \u0000 \u0000Methods \u0000Fifty four SD rats were randomly divided into three groups. Group A was the negative control group, in which the musculocutaneous nerve was transected and directly sutured. The other two groups were the phrenic nerve (group B) and intercostal nerve (group C): after the musculocutaneous nerve was transected and the side-to-side neurorrhaphy was conducted. Sural nerve was used to connect the musculocutaneous nerve neurorrhaphy site and the donor nerve as phrenic nerve or intercostal nerve. Lung function test was conducted at 1, 2 and 3 months postoperatively. \u0000 \u0000 \u0000Results \u0000No significant difference was detected from each parameter including breathing frequency (F), minute ventilation (MV), inspirationand expiration time (Ti and Te), peak inspiratory and expiratory flow (PIF and PEF) and 50% expiratory flow (EF50) of lung function test among group A, B and C at 1, 2 and 3 months postoperatively. \u0000 \u0000 \u0000Conclusion \u0000Side-to-side neurorrhaphy has no obvious damage to pulmonary function. This new method is safe and has great advantages in clinical application. \u0000 \u0000 \u0000Key words: \u0000Rats; Respiratory function tests; Phrenic nerve; Intercostal nerve; Side-to-side neurorrhaphy","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"35 1","pages":"212-215"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47469267","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 : 2019-06-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2019.03.015
B. Mao, Lei Li, Wencong Wang, Zhixi Hu, Yongli He, Qiang Wang, Ju-yu Tang
Objective To explore the clinical efficacy of self-prepared Kirschner wire retractor reduction and internal fixation through ulnar dorsal approach in the treatment of Bennett fractures. Methods From July 2014 to February 2018, 13 patients with Bennett fractures were treated. The first carpometacarpal ulnar dorsal approach was designed to expose the fracture and articular surface. The reduction was performed using self-prepared Kirschner wire retractor, and then the fracture was fixed with Kirschner wires. Early functional exercise was performed after the operation, and Kirschner wire was removed after 4 to 6 weeks. Results All the patients were follow-up for 6 to 24 months postoperatively with an average of 14.6 months. All the incisions achieved primary healing. Bone healing was achieved in all the patients, and the pre-traumatic activity was restored 10 weeks after the operation. The VAS score ranged from 0 to 3 with an average of 1.46. The function of affected finger was evaluated by total active motion (TAM) assessment and the results were rated as excellent in 11 cases and good in 2 cases. One patient had redness and swelling in the needle track, while the other patients had no complications such as infection of the needle track, irritation of surrounding soft tissue, loosening of Kirschner needle and re-dislocation of joint. Conclusion The method of reduction and fixation of Bennett fractures through ulnar dorsal approach using self-prepared Kirschner wire retractor proves to be simple and reliable, which is worthy of clinical application. Key words: Fractures,bone; Treatment outcome; Internal fixator; Reduction
{"title":"Application of self-prepared Kirschner wire retractor reduction and internal fixation through ulnar dorsal approach for the treatment of Bennett fractures","authors":"B. Mao, Lei Li, Wencong Wang, Zhixi Hu, Yongli He, Qiang Wang, Ju-yu Tang","doi":"10.3760/CMA.J.ISSN.1005-054X.2019.03.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2019.03.015","url":null,"abstract":"Objective \u0000To explore the clinical efficacy of self-prepared Kirschner wire retractor reduction and internal fixation through ulnar dorsal approach in the treatment of Bennett fractures. \u0000 \u0000 \u0000Methods \u0000From July 2014 to February 2018, 13 patients with Bennett fractures were treated. The first carpometacarpal ulnar dorsal approach was designed to expose the fracture and articular surface. The reduction was performed using self-prepared Kirschner wire retractor, and then the fracture was fixed with Kirschner wires. Early functional exercise was performed after the operation, and Kirschner wire was removed after 4 to 6 weeks. \u0000 \u0000 \u0000Results \u0000All the patients were follow-up for 6 to 24 months postoperatively with an average of 14.6 months. All the incisions achieved primary healing. Bone healing was achieved in all the patients, and the pre-traumatic activity was restored 10 weeks after the operation. The VAS score ranged from 0 to 3 with an average of 1.46. The function of affected finger was evaluated by total active motion (TAM) assessment and the results were rated as excellent in 11 cases and good in 2 cases. One patient had redness and swelling in the needle track, while the other patients had no complications such as infection of the needle track, irritation of surrounding soft tissue, loosening of Kirschner needle and re-dislocation of joint. \u0000 \u0000 \u0000Conclusion \u0000The method of reduction and fixation of Bennett fractures through ulnar dorsal approach using self-prepared Kirschner wire retractor proves to be simple and reliable, which is worthy of clinical application. \u0000 \u0000 \u0000Key words: \u0000Fractures,bone; Treatment outcome; Internal fixator; Reduction","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"35 1","pages":"203-205"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42855736","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 : 2019-06-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2019.03.008
Zheng-bing Zhou, Ju-yu Tang, Panfeng Wu, Fang Yu, Ding Pan, Lei Zeng, Yongbing Xiao, X. Pang, Li-ming Qing, Rui Liu
Objective To explore the feasibility and clinical efficacy of combined transplantation of bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery for the reconstruction of large area tissue defects of upper limbs. Methods From January 2014 to June 2018, 22 patients with large area skin and soft tissue defects of upper extremities were treated with bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery. The donor site was closed directly. The wound involved upper arm, forearm, hand and elbow stump. The area of defect ranged from 16 cm×13 cm to 40 cm×15 cm. Results Twenty-one cases (95.45%) of the combined flaps survived completely. One case had partial necrosis of the distal part of the flap, which was healed by second-stage skin grafting. The donor sites of the flaps were closed directly and achieved primary healing without complications. The follow-up period ranged from 3 to 38 months with an average of 20 months. All the cases had good wound healing and limb functional recovery. Conclusion The combined transplantation of bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery is an effective method for repairing large skin and soft tissue defects of upper extremities. The operation is simple, the perforator vessel is reliable and the flaps can be cut in large area with less damage to donor site. Key words: Upper extremity; Surgical flaps; Descending branch of lateral circumflex femoral artery; Upper extremity reconstruction
{"title":"Combined transplantation of bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery for the reconstruction of large area tissue defects of upper limbs","authors":"Zheng-bing Zhou, Ju-yu Tang, Panfeng Wu, Fang Yu, Ding Pan, Lei Zeng, Yongbing Xiao, X. Pang, Li-ming Qing, Rui Liu","doi":"10.3760/CMA.J.ISSN.1005-054X.2019.03.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2019.03.008","url":null,"abstract":"Objective \u0000To explore the feasibility and clinical efficacy of combined transplantation of bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery for the reconstruction of large area tissue defects of upper limbs. \u0000 \u0000 \u0000Methods \u0000From January 2014 to June 2018, 22 patients with large area skin and soft tissue defects of upper extremities were treated with bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery. The donor site was closed directly. The wound involved upper arm, forearm, hand and elbow stump. The area of defect ranged from 16 cm×13 cm to 40 cm×15 cm. \u0000 \u0000 \u0000Results \u0000Twenty-one cases (95.45%) of the combined flaps survived completely. One case had partial necrosis of the distal part of the flap, which was healed by second-stage skin grafting. The donor sites of the flaps were closed directly and achieved primary healing without complications. The follow-up period ranged from 3 to 38 months with an average of 20 months. All the cases had good wound healing and limb functional recovery. \u0000 \u0000 \u0000Conclusion \u0000The combined transplantation of bilateral perforator flaps based on the descending branch of lateral circumflex femoral artery is an effective method for repairing large skin and soft tissue defects of upper extremities. The operation is simple, the perforator vessel is reliable and the flaps can be cut in large area with less damage to donor site. \u0000 \u0000 \u0000Key words: \u0000Upper extremity; Surgical flaps; Descending branch of lateral circumflex femoral artery; Upper extremity reconstruction","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"35 1","pages":"183-185"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41455625","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 : 2019-06-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2019.03.002
Weiyang Gao, Jian Ding, An-yuan Wang, Long Wang, Zongwei Zhou
Objective To summarize retrospectively the manifestation types of nail deformities after Bilhaut-Cloquet (BC) procedure for polydactyly deformityand its influence on aesthetic evaluation. Methods From January 2005 to December 2015, 84 patients (88 thumbs) were treated with BC. According to the Wassel classification, 3 case was typeⅠ, 20 were type Ⅱ, 12 were type Ⅲ, 33 were type Ⅳ, 6 were type Ⅵ, 10 were type Ⅶ. The shape, width, flatness, semilunar and fold shape of reconstructed nails were observed and classified after the operation. The aesthetic effect of the reconstructed nails was evaluated by the modified Wang-Gao score. Results The follow-up period ranged from 6 to 128 months, with an average of 34.4 months. Among them, abnormal flatness of the reconstructed nails occurred in 51 thumbs (57.95%), nail semilunar deformity in 27 fingers (30.68%), nail fold deformity in 22 fingers (25.00%), abnormal nail width in 16 fingers (18.18%) and abnormal nail shape in 7 fingers (7.95%). According to the modified Wang-Gao score, the score was 2 to 12 points with an average of 9.18 points. Among them, the results were rated as excellent in 58 fingers, good in 23 fingers, fair 5 fingers and poor in 2 fingers, with the excellent and good rate being 92.05%. Conclusion The application of BC procedure for correction of polydactyly deformity has a definite effect on the improvement of finger volume and nail width. The deformities may occur in all the nail structural units requiring reconstruction, and manifestations are diverse, mainly mild deformities. More than three structural unit deformities are the main cause of dissatisfaction of patients or their families, but the incidence is not high. Therefore, BC procedure is still an option for dysplastic polydactyly deformity. Key words: Hand deformities,congenital; Treatment outcome; Bilhaut-Clouquet procedure; Nail deformity
{"title":"Types and aesthetic evaluation of nail deformities after Bilhaut-Clouquet procedure in the treatment of polydactyly deformity","authors":"Weiyang Gao, Jian Ding, An-yuan Wang, Long Wang, Zongwei Zhou","doi":"10.3760/CMA.J.ISSN.1005-054X.2019.03.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2019.03.002","url":null,"abstract":"Objective \u0000To summarize retrospectively the manifestation types of nail deformities after Bilhaut-Cloquet (BC) procedure for polydactyly deformityand its influence on aesthetic evaluation. \u0000 \u0000 \u0000Methods \u0000From January 2005 to December 2015, 84 patients (88 thumbs) were treated with BC. According to the Wassel classification, 3 case was typeⅠ, 20 were type Ⅱ, 12 were type Ⅲ, 33 were type Ⅳ, 6 were type Ⅵ, 10 were type Ⅶ. The shape, width, flatness, semilunar and fold shape of reconstructed nails were observed and classified after the operation. The aesthetic effect of the reconstructed nails was evaluated by the modified Wang-Gao score. \u0000 \u0000 \u0000Results \u0000The follow-up period ranged from 6 to 128 months, with an average of 34.4 months. Among them, abnormal flatness of the reconstructed nails occurred in 51 thumbs (57.95%), nail semilunar deformity in 27 fingers (30.68%), nail fold deformity in 22 fingers (25.00%), abnormal nail width in 16 fingers (18.18%) and abnormal nail shape in 7 fingers (7.95%). According to the modified Wang-Gao score, the score was 2 to 12 points with an average of 9.18 points. Among them, the results were rated as excellent in 58 fingers, good in 23 fingers, fair 5 fingers and poor in 2 fingers, with the excellent and good rate being 92.05%. \u0000 \u0000 \u0000Conclusion \u0000The application of BC procedure for correction of polydactyly deformity has a definite effect on the improvement of finger volume and nail width. The deformities may occur in all the nail structural units requiring reconstruction, and manifestations are diverse, mainly mild deformities. More than three structural unit deformities are the main cause of dissatisfaction of patients or their families, but the incidence is not high. Therefore, BC procedure is still an option for dysplastic polydactyly deformity. \u0000 \u0000 \u0000Key words: \u0000Hand deformities,congenital; Treatment outcome; Bilhaut-Clouquet procedure; Nail deformity","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"35 1","pages":"163-167"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69848589","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 : 2019-06-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2019.03.019
Chengli Li, Yongwei Pan
Objective To provide anatomical data for avoiding the injury of the recurrent branch of median nerve (RBMN) through the proximal operative incision of the carpal thenar region. Methods Thirty adult upper limb specimens (16 formaldehyde fixed specimens and 14 fresh frozen specimens) were dissected. The origin of the RBMN, the angle between the RBMN and the longitudinal axis of the median nerve main trunk, the location of the first bifurcation point of the RBMN, the distribution of the superficial branch and the deep branch of the RBMN were measured, and the relationship between the RBMN and the proximal, middle and distal regions of the thenar was observed. Results The origin of the trunk of the RBMN located in the proximal and middle third of the thenar area account for 46.7% and 52.3%, respectively. After the RBMN originated from the main trunk of the median nerve, it moved towards the radial side at an average angle of 48.6° (range, 20° to 70°). The first bifurcation point of RBMN located in the proximal and middle third of the thenar area account for 56.7% and 43.3%, respectively. 96.7% deep branch and 56.7% superficial branch were located in the proximal third of the thenar area. Conclusion The RBMN and its terminal branches were mostly located in the proximal third of the thenar area, and any operation in this area should pay attention to avoiding injury. Key words: Median nerve; Anatomy; Recurrent branch; Clinical significance
{"title":"Anatomy study and clinical significance about the spatial distribution of the recurrent branch of median nerve","authors":"Chengli Li, Yongwei Pan","doi":"10.3760/CMA.J.ISSN.1005-054X.2019.03.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2019.03.019","url":null,"abstract":"Objective \u0000To provide anatomical data for avoiding the injury of the recurrent branch of median nerve (RBMN) through the proximal operative incision of the carpal thenar region. \u0000 \u0000 \u0000Methods \u0000Thirty adult upper limb specimens (16 formaldehyde fixed specimens and 14 fresh frozen specimens) were dissected. The origin of the RBMN, the angle between the RBMN and the longitudinal axis of the median nerve main trunk, the location of the first bifurcation point of the RBMN, the distribution of the superficial branch and the deep branch of the RBMN were measured, and the relationship between the RBMN and the proximal, middle and distal regions of the thenar was observed. \u0000 \u0000 \u0000Results \u0000The origin of the trunk of the RBMN located in the proximal and middle third of the thenar area account for 46.7% and 52.3%, respectively. After the RBMN originated from the main trunk of the median nerve, it moved towards the radial side at an average angle of 48.6° (range, 20° to 70°). The first bifurcation point of RBMN located in the proximal and middle third of the thenar area account for 56.7% and 43.3%, respectively. 96.7% deep branch and 56.7% superficial branch were located in the proximal third of the thenar area. \u0000 \u0000 \u0000Conclusion \u0000The RBMN and its terminal branches were mostly located in the proximal third of the thenar area, and any operation in this area should pay attention to avoiding injury. \u0000 \u0000 \u0000Key words: \u0000Median nerve; Anatomy; Recurrent branch; Clinical significance","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"35 1","pages":"216-219"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49588505","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 : 2019-06-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2019.03.003
Peng Lu, W. Tian, Jun-hui Zhao, Yang Guo, Yong Yang, Kun Liu, Yaobin Yin, Liying Sun, Wenyao Zhong
Objective To explore the classification and treatment efficacy of hand deformities of arthrogryposis multiplex congenita. Methods From January 2010 to January 2018, 72 patients (144 thumbs, 556 other fingers) with hand deformities of arthrogryposis multiplex congenita were treated. The patients were divided into 6 groups according to their different pathological and anatomical characteristics and treated accordingly. Results Postoperatively, 60 patients (93 thumbs, 296 other fingers) were follow-up for 1 to 83 months, with an average of 16.2 months. The overall excellent and good rate of the clinical efficacy of the affected fingers was 87.4% (340/389), of which 76.3% (71/93) was for the thumbs and 90.9% (269/296) for the other fingers. All skin grafts survived and 1 finger recurred. Conclusion All the patients in this group have satisfactory finger movement and high safety after treatment. Therefore, according to the classification method described in this paper, the patients with hand deformities of arthrogryposis multiplex congenita can be treated accordingly, which can achieve good results. Key words: Hand deformities,congenital; Treatment outcome; Arthrogryposis multiplex congenita
{"title":"Classification and treatment of hand deformities of arthrogryposis multiplex congenita: a clinical analysis","authors":"Peng Lu, W. Tian, Jun-hui Zhao, Yang Guo, Yong Yang, Kun Liu, Yaobin Yin, Liying Sun, Wenyao Zhong","doi":"10.3760/CMA.J.ISSN.1005-054X.2019.03.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2019.03.003","url":null,"abstract":"Objective \u0000To explore the classification and treatment efficacy of hand deformities of arthrogryposis multiplex congenita. \u0000 \u0000 \u0000Methods \u0000From January 2010 to January 2018, 72 patients (144 thumbs, 556 other fingers) with hand deformities of arthrogryposis multiplex congenita were treated. The patients were divided into 6 groups according to their different pathological and anatomical characteristics and treated accordingly. \u0000 \u0000 \u0000Results \u0000Postoperatively, 60 patients (93 thumbs, 296 other fingers) were follow-up for 1 to 83 months, with an average of 16.2 months. The overall excellent and good rate of the clinical efficacy of the affected fingers was 87.4% (340/389), of which 76.3% (71/93) was for the thumbs and 90.9% (269/296) for the other fingers. All skin grafts survived and 1 finger recurred. \u0000 \u0000 \u0000Conclusion \u0000All the patients in this group have satisfactory finger movement and high safety after treatment. Therefore, according to the classification method described in this paper, the patients with hand deformities of arthrogryposis multiplex congenita can be treated accordingly, which can achieve good results. \u0000 \u0000 \u0000Key words: \u0000Hand deformities,congenital; Treatment outcome; Arthrogryposis multiplex congenita","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"35 1","pages":"168-172"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45742697","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 : 2019-06-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2019.03.006
Xiaofei Yu, Yadong Yu, X. Shao, Li Wang, Y. Bai
Objective To explore the clinical features and surgical treatment of congenital proximal radioulnar synostosis. Methods From May 2014 to May 2017, 9 cases of congenital proximal radioulnar synostosis were treated in our hospital. By preoperative X-ray examination, forearm shape, forearm rotation function, elbow flexion and extension function, the fusion and development of radial head, ulna and radius were observed and classified. The operations including fusion site osteotomy, ulna osteotomy, radius osteotomy, interosseous membrane release and circular ligament reconstruction were performed. Results Nine patients performed operation on 14 sides were follow-up for 3 to 38 months with an average of 17 months. No re-synostosis occurred, and the shape and rotation function of the forearm were improved. The elbow function was evaluated by Mayo score, and the results were excellent in 7 sides, good in 5 sides and fair in 2 sides. Conclusion Congenital proximal radioulnar synostosis seriously affects the quality of life of children, and the fusion site osteotomy combined with ulna and radius osteotomy can achieve good treatment outcomes. Key words: Congenital abnormalities; Surgical procedures, operative; Proximal radioulnar synostosis; Osteotomy
{"title":"Application of fusion site osteotomy combined with ulna and radius osteotomy for the treatment of congenital proximal radioulnar synostosis","authors":"Xiaofei Yu, Yadong Yu, X. Shao, Li Wang, Y. Bai","doi":"10.3760/CMA.J.ISSN.1005-054X.2019.03.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2019.03.006","url":null,"abstract":"Objective \u0000To explore the clinical features and surgical treatment of congenital proximal radioulnar synostosis. \u0000 \u0000 \u0000Methods \u0000From May 2014 to May 2017, 9 cases of congenital proximal radioulnar synostosis were treated in our hospital. By preoperative X-ray examination, forearm shape, forearm rotation function, elbow flexion and extension function, the fusion and development of radial head, ulna and radius were observed and classified. The operations including fusion site osteotomy, ulna osteotomy, radius osteotomy, interosseous membrane release and circular ligament reconstruction were performed. \u0000 \u0000 \u0000Results \u0000Nine patients performed operation on 14 sides were follow-up for 3 to 38 months with an average of 17 months. No re-synostosis occurred, and the shape and rotation function of the forearm were improved. The elbow function was evaluated by Mayo score, and the results were excellent in 7 sides, good in 5 sides and fair in 2 sides. \u0000 \u0000 \u0000Conclusion \u0000Congenital proximal radioulnar synostosis seriously affects the quality of life of children, and the fusion site osteotomy combined with ulna and radius osteotomy can achieve good treatment outcomes. \u0000 \u0000 \u0000Key words: \u0000Congenital abnormalities; Surgical procedures, operative; Proximal radioulnar synostosis; Osteotomy","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"35 1","pages":"176-179"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49216404","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 : 2019-04-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2019.02.008
Chao Liang, Rui Zhao, Cheng-wu Zang, Hang Zhang, Hang Xian, Liangliang Huang, Jinghui Huang, R. Cong
Objective To investigate the clinical efficacy of collagen array microtubule nerve scaffolds for repair of finger nerve defects. Methods From July 2017 to March 2018, 5 patients with 6 side digital nerve defects were repaired with collagen array microtubule nerve scaffolds developed by our group. The length of defects ranged from 18 to 28 mm, with an average of 21.7 mm. Results All the patients were follow-up for 6 to 14 months, with an average of 9 months. All the wounds achieved primary healing without any adverse events, such as infection, allergy, liver and kidney damage. The sensory function of the repaired digital nerves was improved, and the static two-point discrimination of 3 distal finger pulp was 4, 7 and 8 mm, respectively. According to BMRC sensory assessment criteria (1954), the result was S4 in 1 case (1 finger), S3+ in 2 cases (2 fingers), and S2 in 2 cases (3 fingers). Conclusion Preliminary study shows that there is no adverse reaction and the function of digital nerve recovers well after collagen array microtubule nerve scaffolds bridging digital nerve defects. Key words: Collagen; Treatment outcome; Digital nerve; Defects; Nerve scaffold
{"title":"Preliminary clinical study on repair of digital nerve defect with collagen array microtubule nerve scaffold","authors":"Chao Liang, Rui Zhao, Cheng-wu Zang, Hang Zhang, Hang Xian, Liangliang Huang, Jinghui Huang, R. Cong","doi":"10.3760/CMA.J.ISSN.1005-054X.2019.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2019.02.008","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy of collagen array microtubule nerve scaffolds for repair of finger nerve defects. \u0000 \u0000 \u0000Methods \u0000From July 2017 to March 2018, 5 patients with 6 side digital nerve defects were repaired with collagen array microtubule nerve scaffolds developed by our group. The length of defects ranged from 18 to 28 mm, with an average of 21.7 mm. \u0000 \u0000 \u0000Results \u0000All the patients were follow-up for 6 to 14 months, with an average of 9 months. All the wounds achieved primary healing without any adverse events, such as infection, allergy, liver and kidney damage. The sensory function of the repaired digital nerves was improved, and the static two-point discrimination of 3 distal finger pulp was 4, 7 and 8 mm, respectively. According to BMRC sensory assessment criteria (1954), the result was S4 in 1 case (1 finger), S3+ in 2 cases (2 fingers), and S2 in 2 cases (3 fingers). \u0000 \u0000 \u0000Conclusion \u0000Preliminary study shows that there is no adverse reaction and the function of digital nerve recovers well after collagen array microtubule nerve scaffolds bridging digital nerve defects. \u0000 \u0000 \u0000Key words: \u0000Collagen; Treatment outcome; Digital nerve; Defects; Nerve scaffold","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"35 1","pages":"103-106"},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48759923","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 : 2019-04-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2019.02.001
Qin Shao, Xujia Wang, Yue Zhang, Shen Yang, Jianrui Li
Objective To investigate the method and clinical efficacy of long proximal humeral internal locking system (PHILOS) fixation in the treatment of complex middle-proximal humeral shaft fractures. Methods From January 2012 to April 2017, 9 cases of complex middle-proximal humeral shaft fractures were treated with long PHILOS fixation. According to AO/OTA classification, 1 case was type B2, 2 cases were type B3 and 6 cases were type C3. Constant-Murley shoulder scoring system was used to evaluate the function and calculate the percentage of the score, percentage of affected side score to healthy side score. Results Postoperatively all the 9 patients were follow-up for 12 to 48 months with an average of 20 months. All the fractures healed without wound infection and vascular and nerve injuries. According to Constant-Murley shoulder score, the average score of the affected side at the last follow-up was 82.3, ranging from 64 to 95. The percentage of scores ranged from 71% to 97%, with an average of 85.1%. The results were rated as excellent or good in 7 cases and fair in 2 cases. Conclusion Long PHILOS fixation is an effective method for treatment of complex middle-proximal humeral shaft fractures. The effective treatment of combined injuries, correct choice of operative timing, good techniques of fracture reduction and fixation are the keys to successful treatment. Key words: Humeral fractures; Treatment outcome; Fracture fixation,internal; Locking plate
{"title":"Application of long proximal humeral internal locking system fixation for treatment of complex middle-proximal humeral shaft fractures","authors":"Qin Shao, Xujia Wang, Yue Zhang, Shen Yang, Jianrui Li","doi":"10.3760/CMA.J.ISSN.1005-054X.2019.02.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2019.02.001","url":null,"abstract":"Objective \u0000To investigate the method and clinical efficacy of long proximal humeral internal locking system (PHILOS) fixation in the treatment of complex middle-proximal humeral shaft fractures. \u0000 \u0000 \u0000Methods \u0000From January 2012 to April 2017, 9 cases of complex middle-proximal humeral shaft fractures were treated with long PHILOS fixation. According to AO/OTA classification, 1 case was type B2, 2 cases were type B3 and 6 cases were type C3. Constant-Murley shoulder scoring system was used to evaluate the function and calculate the percentage of the score, percentage of affected side score to healthy side score. \u0000 \u0000 \u0000Results \u0000Postoperatively all the 9 patients were follow-up for 12 to 48 months with an average of 20 months. All the fractures healed without wound infection and vascular and nerve injuries. According to Constant-Murley shoulder score, the average score of the affected side at the last follow-up was 82.3, ranging from 64 to 95. The percentage of scores ranged from 71% to 97%, with an average of 85.1%. The results were rated as excellent or good in 7 cases and fair in 2 cases. \u0000 \u0000 \u0000Conclusion \u0000Long PHILOS fixation is an effective method for treatment of complex middle-proximal humeral shaft fractures. The effective treatment of combined injuries, correct choice of operative timing, good techniques of fracture reduction and fixation are the keys to successful treatment. \u0000 \u0000 \u0000Key words: \u0000Humeral fractures; Treatment outcome; Fracture fixation,internal; Locking plate","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"35 1","pages":"81-83"},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43628842","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 : 2019-04-10DOI: 10.3760/CMA.J.ISSN.1005-054X.2019.02.002
Liu Changqing, Qin Shao, Chen-song Yang, Jianrui Li, Yue Zhang, Ai Changqing
Objective To analyze and compare the clinical efficacy of lag screws in the fixation of oblique midshaft clavicle fracture. Methods From January 2013 to August 2017, 78 cases of oblique midshaft clavicle fracture were treated. There were 37 cases in group A treated with lag screws combined with locking plate and 41 cases in group B treated with locking plate. The intraoperative conditions, blood loss, intraoperative fluoroscopy time, fracture healing time, clinical efficacy and complications of the two groups were compared and analyzed. Results There was no significant difference in blood loss and bone healing time between the two groups (P>0.05). There was no significant difference in DASH score and Constant-Murley score at 6 and 12 months after the operation between the two groups (P>0.05). The time of operation and fluoroscopy were significantly different (P 0.05). Conclusion The patients performed oblique midshaft clavicle fracture fixation without lag screws can still achieve good clinical results in terms of healing time and functional recovery after the operation. Key words: Clavicle; Fractures,bone; Lag screw; Oblique fracture
{"title":"Analysis of the clinical efficacy of lag screw in the fixation of oblique midshaft clavicle fracture","authors":"Liu Changqing, Qin Shao, Chen-song Yang, Jianrui Li, Yue Zhang, Ai Changqing","doi":"10.3760/CMA.J.ISSN.1005-054X.2019.02.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-054X.2019.02.002","url":null,"abstract":"Objective \u0000To analyze and compare the clinical efficacy of lag screws in the fixation of oblique midshaft clavicle fracture. \u0000 \u0000 \u0000Methods \u0000From January 2013 to August 2017, 78 cases of oblique midshaft clavicle fracture were treated. There were 37 cases in group A treated with lag screws combined with locking plate and 41 cases in group B treated with locking plate. The intraoperative conditions, blood loss, intraoperative fluoroscopy time, fracture healing time, clinical efficacy and complications of the two groups were compared and analyzed. \u0000 \u0000 \u0000Results \u0000There was no significant difference in blood loss and bone healing time between the two groups (P>0.05). There was no significant difference in DASH score and Constant-Murley score at 6 and 12 months after the operation between the two groups (P>0.05). The time of operation and fluoroscopy were significantly different (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000The patients performed oblique midshaft clavicle fracture fixation without lag screws can still achieve good clinical results in terms of healing time and functional recovery after the operation. \u0000 \u0000 \u0000Key words: \u0000Clavicle; Fractures,bone; Lag screw; Oblique fracture","PeriodicalId":67383,"journal":{"name":"中华手外科杂志","volume":"35 1","pages":"84-86"},"PeriodicalIF":0.0,"publicationDate":"2019-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44969202","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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