Review of the results of different operative procedures for old acromioclavicular dislocation / 中华骨科杂志

Objective To compare the results of different operative methods for old acromioclavicular dislocation. Methods Forty three patients with old acromioclavicular dislocation were treated with three different operative methods: 1)open reduction plus Kirschner wire fixation (9 cases); 2)open reduction plus reconstruction of acromioclavicular ligament (14 cases) and 3)open reduction plus modified Dewar s operation (20 cases). After surgery, the subjective symptoms of the arm, muscular contraction power, function of the shoulder joint and space of acromioclavicular joint in 43 cases were followed up for an average 4.8 years. Results The excellent results following three operative methods were seen in 33％ , 50％ and 74％ respectively. There was no significant difference between Kirschner wire fixation and reconstruction of acromioclavicular ligament (P > 0.05). Modified Dewar's operation was better compared with Kirschner wire fixation and reconstruction of acromioclavicular ligament (P< 0.05). Conclusion A satisfactory surgical procedure for treatment of old acromioclavicular dislocation should accomplish the following points: removal of scar tissue and intra articular cartilaginous fragments, reconstruction of joint stability and effective internal fixation until complete healing of the ligament structures.

An experimental research and follow-up study of the management of pelvic obliquity due to leg length inequality / 中华骨科杂志

Objective To study the method of surgical correction for pelvic obliquity secondary to leg length inequality. Methods Pelvic equilibrium operation is designed to correct the fixed pelvic obliquity, equilibrate the two lower limbs by bilateral iliac osteotomies with transfer of a block of iliac bone from the normal ilium into the abnormal ilium of the contralateral side. This procedure also corrects the associated acetabular dysplasia. Results In this series of 32 patients, none was lost to follow-up. Thirty-two patients, 19 males and 13 females, whose ages ranged from 14 to 34 years with a mean of 22 years, underwent surgery; twenty-four cases had fixed pelvic obliquity and acetabular dysplasia secondary to a short limb following anterior poliomyelitis. The deformities in seven cases were due to severe tuberculous infection in childhood which had resulted in a fixed adducted ankylosed hip. The pelvic equilibrium was caused by trauma in one case. During the review, the minimum time from surgery was 2 years and 6 months, and the maximum 13 years and 6 months with a mean of 6 years and 8 months. The results were excellent. Preoperatively, 29 patients walked on crutches, and postoperatively, 25 patients could walk unaided, one with a stick and three on single crutch. In this paper, we also presented the associated experiment research of pelvic equilibrium operation. Conclusion Pelvic equilibrium operation has been proved to be a new effective surgical correction method of pelvic obliquity secondary to leg length inequality.