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Objective To explore the application value of single-door laminoplasty via Y type nano-bone plate in treating multilevel cervical spondylotic myelopathy (MCSM) and analyze the short-term efficacy.Methods From January 2013 to December 2016,79 cases of MCSM were treated with single-door laminoplasty via Y type nano-bone plate to evaluate the improvement of post-operative neurological function by the Japanese Orthopaedic Association (JOA) evaluation system.We also measured cervical curvature of cervical X-ray and C5 sagittal diameter of the spinal canal before operation and 6 months after operation to understand the maintenance and enlargement of the spinal canal.The improvement degree of spinal cord compression was evaluated by preoperative and postoperative cervical MRI.Osseous healing on the open door side and the door shaft side was observed with the aid of three-dimensional spiral CT.Results Follow-up ranged from 6 to 36 months,with an average of (20.4±7.9)months.Preoperative JOA score was (8.6 ± 1.3) points and JOA score 6 months after operation was (14.3 ± 1.5)points (P ＜ 0.05).JOA improvement rate was (68.6 ± 15.8)％;postoperative follow-up X-ray and threedimensional spiral CT showed that the spinal canal had satisfying enlargement,the door shaft side all had osseous healing,the open door side osseous healing was not obvious,and there was no lamina collapse or reclosing.Sagittal diameter of theC spinal canal was (8.9±l.1)mm before operation and (15.1±l.1)mm 6 months after operation (P＜0.05).The spinal canal enlargement rate was (70.8±22.3)％,cervical curvature was (14.8± 7.0)°preoperatively and (15.1±6.7)°postoperatively with no significant difference (P＞0.05).Conclusion EOLP via Y type nano-bone plate is safe and efficacious in treating MCSM.It not only provides a good immediate fixation,but also provides the possibility for the open door side lateral osseous fusion.
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OBJECTIVE:TO summarize the treatment of complicated proximal humeral fracture with artificial shoulder replacement.METHODS:A computer-based online search of VIP was performed for related articles published between January 1998 and October 2009 with the key words"shoulder joint,prosthesis replacement,proximal humeral fracture".Articles with high correlation were included.and repetitive studies were excluded.The data were firstly collected,the references of each article were reviewed.RESULTS:A total of 18 articles were included The treatment of complicated proximal humeral fracture remains controversial.Early semi-shoulder ioint replacement is an appropriate method.Shoulder replacement includes humeral head replacement and total shoulder replacement.Neer and Biligani type are typical artificial humeral head.The fixation patterns of humeral head prosthesis shaft include cemented and cementless.Bone cement includes total bone cement and proximal cement fixation,and cementless includes pressure fixation and compaction bone grafting.Complications following shoulder replacement involve prosthesis instability,nodule heterotopia,heterotopic ossification,prosthesis loosening,periprosthetic fracture,infection and nerve injury.CONCLUSION:Majority of complications can be prevented by appropriate location of prosthesis,reconstruction of greater and lesser tubercle.and in combination with postoperative rehabilitation treatment.
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Objective To discuss the method for operative treatment of acetabular fractures and assess corresponding results.MethodTotally 34 cases of acetabular fractures treated operatively from February 2000 to December 2005 were reviewed. There were 22 males and 12 females, with an average age of 39 years (16 to 61).On the basis of X-ray and computed tomography,all fractures were classified according to the Letournel-Judet classification,13 cases were simple fractures and 21 complicated ones. Kocher-Langenbeck approach(23 cases),illioinguinal approach(6 cases) and anterior combined posterior approach(5 cases) were adopted for different fractures with reconstruction plates and screws.The mean operation time was 150 min.The average blood loss was 600 mL.ResultAll cases were followed up for average 31 months(12 to 64 months).According to the criteria of Matta radiographicgrade,there were 18 cases with anatomic reduction, 9 with satisfactory reduction,3 with unsatisfactory reduction and 4 with joint contour reduction.Based on the modified Merle D' Aubigne and Postel clinical grading system for joint functions,11 cases(32.4%)showed excellent results,15(44.1%)good,4(11.8%)fair and 4(11.8%)poor. The excellent and good rate for anatomic and satisfactory reduction groups were 85.2%,while unsatisfactory reduction and joint contour reduction were 42.9%(P