ABSTRACT
Objective To report a new surgical approach (modified anconeus flap approach) in which the anconeus and part of triceps are reflected in the treatment of distal intercondylar humerus fracture (AO type C).Methods To design the modified anconeus flap approach,the anatomy of the distal tendon of the triceps brachii and the anconeus was studied using 15 cadaveric adult specimens (30 sides).The new surgical approach was compared with the triceps-reflecting anconeus pedicle (TRAP) approach in terms of the area of exposure at the distal humeral articular surface.Furthermore,the new surgical approach was applied in 16 patients who had been treated for intercondylar humerus fracture (AO type C) from May 2005 to May 2013.The clinical outcomes were evaluated using the Mayo elbow performance score (MEPS) and Broberg-Morrey scoring systems.Results The blood supply and innervation of the anconeus was interrupted minimally during incision along the radical edge of triceps tendon.The area of exposure at the distal humeral articular surface provided by the part triceps and anconeus reflecting approach and the medial humerus approach was 42.66％ ± 0.03％ at the elbow flexion from 0° to 50°.This was significantly smnaller than that provided by the TRAP approach (46.11％ ±0.03％) (P ＜0.05).Of the 16 patients,15 obtained complete follow-ups from 6 months to 4 years(average,16.5 months).The mean MEPS at the last follow-up was 90.5 points (range,from 82 to 93 points),with 10 excellent and 4 good cases and one poor case.The Broberg & Morrey score system showed 11 patients with no articular cartilage degeneration (level-0),3 patients with level-1 degeneration,and 2 patients with level-2 degeneration.Conclusion The modified anconeus flap approach proposed in the present study provides clear surgical vision and needs no olecranon osteotomy or olecranon dissection or ablation of the major triceps brachii tendon for intercondylar humerus fractures,thereby leading to early active motion and satisfactory clinical outcomes.
ABSTRACT
Objective To understand the cogniton,attitude and behavior of the psychological counseling in college students,and the results should be helpful to mental health promotion programs.Methods 585 college students were recruited by a cluster sampling.A self-designed questionnaire about the psychological consultation was finished by the subjects.All the data were entered a database with Epi Data V3.1 software.Statistical analysis of the data was done on the SPSS software (V13.0).Chi-square test was used to compare the constituent ratio difference among different groups.Results 64.10% students considered the function of counseling was to help person better understand themselves;63.72% of students agreed with that it is very necessary to carry out psychological counseling in college.When they encountered some confusion which beyond their ability to solve,they will at first resort to their friends,parents other than counseling Center in campus.32.58% of students didn’t know the counseling center in their college.Only 8.38% of students ever went to the counseling center.Conclusions Although the majority of students hold positive attitudes and cognition about psychological counseling.However,their behavior was negative.It is contradictory between their cognition and behavior.It is very necessary to explore the deeper reasons and carry out some targeted health education in college students.