ABSTRACT
[Objective]To evaluate the effect of transverse arch reconstruction by modified Youngswick osteotomy on young and middle-aged hallux valgus. [Methods]From November 2005 to November 2008,25 female(36 feet) hallux valgus patients with the average age of 37.7years old(range 22 to 49 years old) were treated surgically.All feet had hypemobility of the first tarsometatarsal joint and collapse of the transverse arch of the foot.In the operation,the first metatarsal head was pushed laterally,downward and rotated downward.Modified McBride procedure was used on the correction for hallux valgus deformity.The X-ray films of all patients were obtained before operation,and 12 months after operation.The hallus valgus angle and intertatarsal angle were measured and analyzed on radiographs.The surgical outcome was evaluated combined with the Gu Xiang-jie's score.All pamameters were statistically analyzed.All cases were followed-up regularly.[Results]Twenty-one cases(28 feet) were followed-up for averaged 15.9 month.Hallax valgus angle reduced from 26.8??1.07? to 11.1??0.29?,intertatarsal angle reduced from 14.9??1.36? preoperatively to 8.3??1.19? postoperatively.The painful callus beneath the forefoot was alleviated or diminished obviously in all cases.Based on Gu Xiangjie'score,the subjective assessments were given as excellent in 16 feet,good in 7 feet,and fair in 5 feet.The good to excellent result was 82.1%.[Conclusion]For the hallux valgus with hypermobility of the first tarsometatarsal joint and transversal arch collapse,modified Youngswick surgery can recover the transverse arch,correct first metatarsal adduct abnormality,and regain the weight-bearing function of the first metatarsal head.Modified Youngswick surgery is an ideal choice for young and middle-aged hallux valgus because of less complications and reliable surgery outcomes.
ABSTRACT
[Objective]To evaluate the effects of Austin surgery for mild and moderate juvenile hallux valgus. [Method]From November 2005 to Januuary 2007,16 juvenile hallux valgus patients(28 feet)with average of 17.8 years(range,17 to 19 years)were treated with Austin surgery.The X-ray films of all patients were obtained before operation,and twelve months,fifteen months after operation.The hallus valgus angle,intermetatarsal angle,proximal articular set angle,and distal articular set angle were measured and analyzed on radiographs.The surgical outcome was evaluated combined with the Gu Xiang-jie's score.All pamameters were statistically analyzed. [Result]All the patients were completely followed up.Hallax valgus angle reduced from 26.3?1.19 to 11.7?0.40,intermetatarsal angle reduced from 14.1?0.82 to 7.2?0.85,proximal articular set angle from 12.7?0.28 to 6.4?0.54(all P
ABSTRACT
BACKGROUND: Changing the local environment of spinal injury promotes the repair and regeneration of injured nerve and recovery of partial nervous function of spinal cord. Transplantation of olfactory ensheathing cells can improve the local internal environment of injured spinal cord.OBJECTIVE: To probe into the effect and safety of transplantation of olfactory ensheathing cells on functional repair of spinal cord and nerve in patients with obsolete spinal injury DESIGN: Self-control experiment.SETTING: Wards of the Department of Surgery, Taian Rongjun Hospital of Shandong Province.PARTICIPANTS: Totally 48 patients admitted for obsolete spinal injury in the Department of Surgery, Taian Rongjun Hospital, between June 2004 and July 2005 were recruited. There were 39 males and 9 females, aged 7 to 59 years with the mean of 36 years.METHODS: ①Cell culture: Olfactory bulb of aborted fetus was digested into single olfactory ensheathing cells, which were then cultured and puri fied for 1 to 2 weeks, and finally made into single cell suspension. ②Operation and cell transplantation: Under general anesthesia, the purified single cell suspension (about 0.05-0.20 mL) of olfactory ensheathing cells was injected into the corresponding spinal injury site through multiple points with home-made syringe of 0.45 mm in diameter. Stitches were taken out at postoperative 10 to 14 days. ③Evaluation of spinal function: Injury Scoring Standard made by American Spinal Injury Association (ASIA) was used for scoring, comparison and statistical analysis at postoperative 1 day and 2 weeks to 2 months. ④Spinal function of 48 patients was observed or followed up through telephone at postoperative 3 weeks to 1 year.MAIN OUTCOME MEASURES: Changes of postoperative sensory function of the patients. Changes of postoperative motor function of the patients. Changes of postoperative automatic nervous system of the patients.RESULTS: ①All the 48 patients had improvement in spinal function, and continued improved tendency was found in the observation and follow-up through telephone at postoperative 3 weeks to 1 year. ②Scoring by ASIA for sensory function was higher after operation than before operation (touch sensation: 56.9, 51.2, P ＜ 0.01; pain sensation: 55.2, 48.3, P ＜ 0.01). Sensory function was improved obviously at the lower shift of sensory level,generally more than 2 segments. ③Scoring by ASIA for motor function was higher after operation than before operation (44.8, 40.7, P ＜ 0.01), but the improvement was slow. ④Scoring by ASIA for automatic nervous system was higher after operation than before operation (18.0, 14.5, P ＜ 0.01); diaphoresis, increased enterokinesia and other automatic nervous system improved earliest.CONCLUSION: Transplantation of olfactory ensheathing cells promotes the spinal and neurofunctional recovery of patients with malignant spinal injury, and the therapeutic method is safe.