Applying the femoral neck-lesser trochanter anteversion to evaluate the proximal femoral deformity of unilateral developmental dislocation of the hip in children / 中华骨科杂志

Objective:A new measurement index, femoral neck-lesser trochanter anteversion (FN-LTA), is proposed. To explore the feasibility and advantage of applying the FN-LTA to evaluate the proximal femoral deformity of unilateral developmental dislocation of the hip in children, so as to solve the current clinical problems.Methods:The imaging data of 90 patients with unilateral DDH admitted to our department from February 2016 to April 2017 were retrospectively analyzed, There were 13 males and 77 females. The age ranged from 0.6 to 11 years, with an average of 2.6±2.3 years. Femoral neck anteversion (FNA) and FN-LTA were measured at the affected and healthy sides. Analyze the correlation between FN-LTA and FNA, analyze the influence of gender, age, side, dislocation degree and other factors on FN-LTA, compare the difference between the affected side and the healthy side of FNA, FN-LTA, and analyze the influence of dislocation degree on this difference, compare the diagnostic efficacy and intra group consistency of FNA and FN-LTA. The possible advantages of FN-LTA in clinical application were preliminarily analyzed.Results:There was a positive correlation between FN-LTA and FNA in both healthy and affected sides (healthy side r=0.217, P=0.040, affected side r=0.298, P=0.004). FNA and FN-LTA in the affected side of DDH children were both larger than the healthy side, FNA affected side 38.86°±11.70°, healthy side 35.44°±11.16°; FN-LTA affected side 72.19°±9.17°, healthy side 61.17°±10.30°. The difference had statistical significance. FN-LTA was not affected by gender, side, degree of dislocation and other factors (gender P=0.060, side P=0.550, degree of dislocation of healthy side P=0.130, affected side P=0.705), but negatively correlated with age (healthy side r=-0.261, P=0.013, affected side r=-0.287, P=0.006). The diagnostic efficiency of FN-LTA is better, AUC FNA=0.561, AUC FN-LTA=0.736 ( P<0.05). FN-LTA and FNA had excellent intra group and inter group consistency. Inter group ICCFNA=0.956, ICCFN-LTA=0.973; intra group ICCFNA1=0.937, ICCFNA2=0.893, ICCFN-LTA1=0.887, ICCFN-LTA2=0.874. With the increase of dislocation degree, the difference between FNA and FN-LTA decreased. This decreasing trend was statistically significant in FNA ( P=0.030) but not in FN-LTA ( P=0.180). Conclusion:FN-LTA is a reliable method with a higher degree of differentiation for the assessment of anteverted deformity in DDH children' proximal end of femur, the measured data are more capable of guiding the rotation of osteotomy.

Reconstruction of medial patella femoral ligament(MPFL)for the treatment of recurrent dislocation of the patella in Children / 中国矫形外科杂志

[Objective]To introduce the effect of treatment of recurrent dislocation of the patella with reconstruction of MPFL in children.[Method]Forteen knees of 11 cases of children recurrent patellar dislocation were treated by reconstruction of MPFL,the patients were followed for 3 years at least.The rate of recurrence,the subjective symptoms and the function of the injured leg were evaluated.[Result]There was no recurrence at the last follow up.The IKOC subjective knee scores were(39.4?4.7)and(91.3?6.1)(P

Observation of the response with drug therapy by arterio of thigh for treatment of osteosarcoma of leg bones in 13 patients / 肿瘤研究与临床

Objective To observe the value of drug therapy by the arterio of thigh in the treatment of osteosarcoma of the leg bones. Methods 13 cases of patients with osteosarcoma of the leg bones were treaded with DDP, ADM and VCR by the arterio of thigh, IFO by phlebo. Results The response rates(PP+CR) to osteosarcoma lesions were 69.2 %. Conclusion The comdination regimen with drug therapy by the arterio of thigh is simple and safe and effective for osteosarcoma of the leg bones, which is worth spreading and applying.