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Objective@#To introduce a combined operation for treating chronical peroneal tendon dislocation and to evalu-ate the clinical outcomes of patients.@*Methods@#Data of 12 ankles in 12 patients (male 9, female 3) with chronical peroneal ten-don dislocation who underwent the fibular groove deepening procedure with transposition of the peroneal longus muscle from June 2006 to August 2013 were retrospectively analyzed. The mean age was 24.6±4.3 years (range, 18-34 years), and there were 3 cas-es on left side, 9 on right side. The mechanism of peroneal tendon injury consisted of sports injuries in 8 and sprains in 4. There were 8 cases of flat fibula sulcus and 4 cases of convex. All patients met the inclusion criteria of a painful snapping or popping sen-sation or palpable clicking and positive provocation maneuver and without fracture and were treated with peroneal sulcus deepen-ing and peroneal longus tendon transposition. The duration of preoperative popping and pain symptoms ranged from 12 to 23 weeks, with an average of 16.9±4.0 weeks. All cases were treated conservatively 3-4 weeks before operation and were not effec-tive. The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, visual anologue scale (VAS).@*Results@#Twelve patients were followed up with an average period of 37.3±7.0 (range, 25-50) months. The mean VAS scale score of all patients reduced from 5.6±0.9 to 0.5±0.7 at the latest follow-up. The mean AOFAS scale score improved from 61.4±5.6 to 92.6±4.2 at the latest follow-up. The difference between preoperative and postoperative was statis-tically significant. (t=16.250,-18.475; P=0.000). According to the evaluation of symptom and function scoring system, 10 cases were excellent and 2 cases were good, with an excellent rate of 100%. The mean postoperative return-sport time was 26.42±3.06 weeks (range, 23-32 weeks). All patients healed primarily and no infection, skin necrosis and residual redislocation occurred. The osteotomy healed completely without displacement, which was confirmed by imaging examination in three months postoperation. No patients had intractable pain after surgery, and they were able to perform daily activities at 3 months and physical exercise at 6 months after surgery. No slip occurred in all patients at the latest follow-up.@*Conclusion@#The fibular groove deepening procedure with transposition of the peroneal longus muscle can effectively treat chronical peroneal tendon dislocation and obtain good medi-um-term results.
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Objective To introduce a combined operation for treating chronical peroneal tendon dislocation and to evaluate the clinical outcomes of patients.Methods Data of 12 ankles in 12 patients (male 9,female 3) with chronical peroneal tendon dislocation who underwent the fibular groove deepening procedure with transposition of the peroneal longus muscle from June 2006 to August 2013 were retrospectively analyzed.The mean age was 24.6±4.3 years (range,18-34 years),and there were 3 cases on left side,9 on right side.The mechanism of peroneal tendon injury consisted of sports injuries in 8 and sprains in 4.There were 8 cases of flat fibula sulcus and 4 cases of convex.All patients met the inclusion criteria of a painful snapping or popping sensation or palpable clicking and positive provocation maneuver and without fracture and were treated with peroneal sulcus deepening and peroneal longus tendon transposition.The duration of preoperative popping and pain symptoms ranged from 12 to 23 weeks,with an average of 16.9±4.0 weeks.All cases were treated conservatively 3-4 weeks before operation and were not effective.The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale,visual anologue scale (VAS).Results Twelve patients were followed up with an average period of 37.3± 7.0 (range,25-50)months.The mean VAS scale score of all patients reduced from 5.6±0.9 to 0.5±0.7 at the latest follow-up.The mean AOFAS scale score improved from 61.4±5.6 to 92.6±4.2 at the latest follow-up.The difference between preoperative and postoperative was statistically significant.(t=16.250,-18.475;P=0.000).According to the evaluation of symptom and function scoring system,10 cases were excellent and 2 cases were good,with an excellent rate of 100％.The mean postoperative return-sport time was 26.42±3.06 weeks (range,23-32 weeks).All patients healed primarily and no infection,skin necrosis and residual redislocation occurred.The osteotomy healed completely without displacement,which was confirmed by imaging examination in three months postoperation.No patients had intractable pain after surgery,and they were able to perform daily activities at 3 months and physical exercise at 6 months after surgery.No slip occurred in all patients at the latest follow-up.Conclusion The fibular groove deepening procedure with transposition of the peroneal longus muscle can effectively treat chronical peroneal tendon dislocation and obtain good medium-term results.
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Objective@#To observe the quantity of Treg cells and Th17 cells in spleen of adult primary immune thrombocytopenic purpura (ITP) patients.@*Methods@#43 ITP cases with splenectomy treatment were enrolled from December 2008 to June 2016 at Union Hospital of Fujian Medical University, including 20 males and 23 females with a median age of 36 (18-76) years. The controls were thirty patients who underwent splenectomy because of pancreatic diseases or splenic impairment, including 21 males and 9 females with a median age of 47 (21-69) years. The quantity and ratio of Treg cells and Th17 cells were examined by immunohistochemistry between ITP patients and controls.@*Results@#①The quantity of Treg cells in ITP were less than controls[ (11.3±4.7) /mm2 vs (59.0±15.0) /mm2, t=-22.894, P<0.001], but Th17 cells were more than controls[ (235.2±69.4) /mm2 vs (181.1±23.7) /mm2, t=13.768, P<0.001]. So the ratio of Treg/Th17 in ITP was lower than controls (0.048±0.027 vs 0.328±0.086, t=19.522, P<0.001) . ② The quantity of Treg cells in cases without response after splenectomy were less than cases with response[ (9.5±5.0) /mm2 vs (11.6±4.7) /mm2, t=2.723, P=0.010], and there is no statistical differences between the two groups about the quantity of Th17 cells and the ratio of Treg/Th17 cells[ (232.3±80.8) /mm2 vs (239.6±66.9) /mm2, t=1.108, P=0.277; 0.040±0.024 vs 0.053±0.027, t=0.540, P=0.592].@*Conclusions@#There is a significant difference about the quantity of Treg cells and Th17 cells in spleen between ITP patients and healthy controls, and they are relevant to the response after splenectomy.
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Objective To discuss the clinical effect of hallux valgus deformity treated with minimally invasive the first metatarsal distal osteotomy. Methods The data of 375 cases (626 feet) treated with minimally invasive the first metatarsal distal osteotomy was retrospectively analyzed. Hallux valgus angle was21°-65°(mean37.61°±9.25°), intermetatarsal (IM) anglewas7° -21° (mean 13.03°± 3.73°). The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score was (46.5 ± 9.4) pints. Results The patients were followed up 12-30 months [mean (18.5 ± 6.8) months]postoperation, hallux valgus angle was 7.18°±4.55°,intennetatarsal angle was 5.07°± 1.70°,with a mean angle decreasing 30.54° and 12.33°.The AOFAS score was (84.8±7.6) points (P <0.01). Conclusion According to the hallux valgus angle,intermetatarsal angle and the length of the first metatarsal,decide the place and method of osteotomy, the hallux valgus can be corrected in three-dimensional and get an excellent effect.
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Objective To test the Footscan system for guiding the postoperative rehabilitation of calcaneus fractures.Methods Sixty patients with unilateral calcaneus fracture were divided randomly into a rehabilitation group and a control group.Patients in both groups began a routine of functional rehabilitation training 24 h after a reduction and fixation operation.The patients in the rehabilitation group received individualized rehabilitation protocols based on regular dynamic evaluation of their plantar pressure using the Footscan system.Those in the control group were administered routine rehabilitation training without the personal modifications.At the 2nd and 7th month postoperation,the dynamic plantar pressure of both groups was evaluated and the functioning of their feet Was scored.Results At the 2nd month post-operation,there was no significant difference between the two groups in terms of subtalar ioint range of motion,the lateral deviation of pressure center,the time of heel touch with the ground,the maximum pressure at the lateral aspect of the calcaneus and impulsive force during walking.The functional evaluation scores were also not significantly different.At the 7th month post-operation,all the indices in both groups had improved significantly over the 2nd month,bulthe improvement in the rehabilitation group Was greater(except the time of heel touch with the ground).Conclusion The Footscan system can be a valuable tool for evaluating patients with calcaneus fracture and serve as a reference for planning rehabilitation interventions for such patients.
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Objective To evaluate the effects of post-operation rehabilitation treatment of patients with calcaneus fracture by dynamic plantar pressure analysis,and assess the value of the Footscan system.Methods Sixty-two patients with unilateral calcaneus fracture were randomly divided into a rehabilitation group and a control group.The patients in the rehabilitation group were given early,systemic standard rehabilitation treatment,while those in the control group took functional exercise following the doctors'advice.At 3 months and 6 months after operation,the plantar pressure distribution of the patients in both groups was analyzed with the Footscan system,respectively.Results After 3 months of treatment.there was statistically significant difference between the injured and the uninjured sides in both groups,with regard to the contact time,average plantar pressure and pressure-time integrals at different phases of gait.However,there was no significant difference between the injured and the uninjured sides after 6 months in rehabilitation group.But in control group,there was still statistically significant difference between the two sides with regard to the above parameters.Conclusion Early rehabilitation treatment could significantly improve the function outcome of patients with calcaneus fracture.Footscan System can objectively evaluate the recovery of the calcaneous fracture.
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[Objective]To study the imageologic characteristic of pelvic arterial anastomosis and the method of ultraselection arterial embolism for pelvic fracture with hemorrhage.[Method]From 1999.1-2005.6,60 patients were undergone pelvic arteriography.The patient ages ranged from 21 to 52 years of age(mean,34.5),and 42 were male,18 were female.Measure the types and number of pelvic arterial anastomosis.[Result]The types and number of pelvic arterial anastomosis were observed by pelvic arteriography as follows: the lumbar artery with iliolumbal artery 100%;the iliolumbal artery with deep iliac circumflex artery 83.33%;the obturator artery with inferior epigastric artery(or external iliac artery) 36.67%;the lateral sacral artery with coccygeal artery 100%;the inferior gluteal artery with internal pudendal artery 26.67%;the inferior gluteal artery with deep femoral artery 56.67%;the superior gluteal artery with inferior gluteal artery 61.67%.[Conclusion]For pelvic fracture whith hemorrahge,the best treatment of the pelvic arterial disruption is embolization of injured arteries and their anastomosis.
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[Objective]To evaluate the clinical value of surgical treatment of multiple thoracolumbar spinal fractures by pedicle screw/rod Instrumentation system.[Method]Ninteen cases of male 14 and femal 5 of multiple injuries involving thoracic and lumbar spine were surgically treated through anterior approach by open reduction,selective vertebral canal decompression,internal fixation with pedicle screw/Rod spine instrumentation,and followed by anterior lateral bone graft fusion according to complex classification system 19 cases,Ba.m1T_(11) 1 cases,Ba.m.p2T_(11) 2 cases,Ba.m1T_(12) 1 cases,Ba.m.p2T_(12) 1cases,Ba.m.p3T_(12) 1cases,Ba.m1_L 4 cases,Ba.m.p2L_1 3cases,Fa.m.p3(T_(12),L_1) 2cases,Sa.m.p3L_2 1cases,Ba.m.p1L_2 1 cases.[Result]All cases were followed up form 6 to 15 months averageing 10.5 months.No implant failure and late kyphosis deformity was observed.The average vertebra height was improved from preoperative 48.14% to postoperative 92.14%.The postoperative neurological function in two cases of complete spina lcord injuries and 11 incomplete spina lcord injuries were improved according to JOA criterion.Astable bone fusion according to radiological criteria was achieved in call cases postoperatively,and progressive compression did not occur.[Conclusion]Pedicle screw/rod instrumentation system can achieve effective reduction for the fractured vertebrae and simultaneously restore spine stability on the basis of adequate vertebral canal decompression.Posterior spine instrumentation is an ideal choice for surgical treatment of thoracolumbar unstable fractures with or without spinal cord dysfunction.
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[Objective]To discuss the causes and preventive measures about complications of iliac crest bone graft harvesting.[Method]From Jan.1990 to Jan.2005,828 patients with iliac crest bone graft harvesting were reviewed retrospectively,their complications were taken statistical analysis.[Result]Fifteen patients were found with superficial infections;10 deep infections;20 patients with superficial seromas and 10 patients with minor hematomas;4 deep hematomas;30 nerve injuries;3 vascular injuries,all 3 cases occurred secondary to harvesting of posterior iliac crest bone grafts;1 donor defect hernias,and 2 iliac wing fractures.[Conclusion]The causes of complications are incorrectly harvesting and rude operation.The preventive measures are that operators should know the anatomic characteristic of ilium and microinvasion.