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Objective:To predict the therapeutic effect by 3D CT simulating osteotomy and to study the outcome of Bernese triple osteotomy for developmental dysplasia of the hip (DDH) in elder children (≥ 8 years).Methods:19 involved hips in12 elder Children with DDH treated with Bernese triple osteotomy from July 2014 to June 2017 were analyzed retrospectively. There were 7 involved hips in 5 boys and 12 involved hips in 7 girls with an average age of 11.14±1.98 years (8-13.33 years) at operation. 4 children were involved in left side, 1 child in right side and 7 children in both sides. 8 hips were classified in type I and 11 hips in type II as Tonnis classification. 6 hips were acetabular dysplasia with Reimers's indexes between 0.20 and 0.33 and 13 hips were subluxation with Reimers's indexes between 0.33 and 1. All the children were detected with DDH for the first time with no basic diseases and there was no previous treatment adopted. A simulating osteotomy by 3D CT of pelvis-femurs was given to each of the children pre-operation and Bernese triple osteotomy with varus derotation osteotomy in proximal femoral was applied simultaneously. The changes of Sharp angles, center edge angles, Reimers's indexes and lengths of sacrospinous ligaments were compared and P<0.05 was considered as statistical significance in the differences. Radiological results and the improvements of limbs' functions were evaluated at the latest follow-up. Results:12 children with 19 involved hips were followed up successfully with an average period of 2 years and 11months (1 year 4 months-4 years). Sharp angles were improved from 55°±3° to 36°±3°, CEAs were improved from -8°±14° to 22°±3°, Reimers's indexes were improved from 0.50±0.17 to 0.14±0.03 and lengths of sacrospinous ligaments decreased from 48.40±10.00 mm to 41.60±10.47 mm with statistical significance in the differences (all P<0.05). Disrupted Shenton lines in 12 hips pre-operation turned to be continuous post-operation. 12 hips as excellent, 4 hips as good and 3 hips as moderate with the excellent-good rate of 84% were seen as modified Severin classification. 12 hips as excellent, 6 hips as good and 1 hip as moderate with the excellent-good rate of 95% were seen as modified McKay classification. Nonunions of ischia were seen in 2 hips and limbs lengths discrepancies <2 cm were seen in 2 children. No avascular necrosis, infection, break of screw or injury of vessel and nerve was seen in all children. Conclusion:More precise indication, more meticulous operation and more intuitive outcome could be actualized assisted with 3D CT. The short-term effect of Bernese triple osteotomy for DDH in elder children is really significant and should be popularized in clinical.
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Objective To study the diffusion tensor imaging (DTI)features in acute cervical spinal cord injury (CSCI)and evaluate its clinical value.Methods Eight patients with acute CSCI (within 72 hours after onset)were performed conventional MRI and fast DTI scans (112 seconds)and diffusion tensor tractography (DTT)at 3.0T Siemens Trio Tim system.Meanwhile,the fractional anisotropy (FA) values and apparent diffusion coefficient (ADC)values were calculated separately in the site of lesions,the upper and lower sections to the lesions.Then the data were analyzed by paired-samples t test analysis with SPSS 13.0 software.Results Cervical spinal cord injury occurred likely in the sites of C5-C6 (account for 4/8)and C4-C5 (account for 3/8).All MRI and DTI images were satisfied for clinical diagnosis.The FA value and ADC value of injury lesions were markedly lower than that of the normal cord.Accordingly,the injury lesions on FA map and ADC map presented low signals.There were no significant differences of FA values and ADC values between the upper and lower sections to the lesions.DTT could help in displaying the disruption of spinal fiber tract in lancination case and distortion fibers in closed cervical spinal cord injury.Conclusion Fast DTI sequence at 3.0 Tesla may obtain the qualified spinal cord images.By calculation of FA values and ADC values in CSCI patients,DTI may play an important role in detecting the changes of anisotropy and water diffusion caused by myelin sheath injury and cytotoxic edema and vasogenic edema respectively.
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Objective:To introduce a method and theory about how implementation vein image projection epidermis and conduct the clinical testing.Methods: Base on existing electronic components construct circuit. The construct circuit was made of industrial personal computer, mini-projector, camera and so on. The image is captured by camera transfer to industrial personal computer. Choosing suitable image process algorithms modify image. Processed image that storage in industrial personal computer transfer to mini-projector, vascular vein lines is produced from mini-projector.Results: Through this way that vascular vein projector method get image basic agreement vascular trend, meet the clinical needs.Conclusion: Vein image projection methods meet clinical need can be used to study other field.
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Objective To assess the effect of bladder neck sling in combination with pelvic floor suspension for management of urinary incontinence due to neurogenic sphincter incompetence in children. Methods From March 1998 to October 2000,23 patients (age:5 14 years) with neurogenic urinary incontinence resulting from congenital myelodysplasia underwent bladder neck sling with pyramidalis muscle in combination with pelvic floor suspension with iliopsoas,of whom 14 patients underwent bladder augmentation concomitantly with the procedure. Results All patients were followed up for 5 to 32 months (mean 18 months).Thirteen cases achieved continence,7 cases were improved,and 3 failed to gain effect.The overall effective rate was 87%.Pre operatively,the maximum bladder volume were (151.5?72.8)ml,leak point pressure were (32.3?6.5)cm H 2O(1 cm H 2O=0.098 kPa),maximum urethral pressure were ( 38.4 ? 13.7 )cm H 2O,maximum closing pressure were (22.8?13.2)cm H 2O and functional urethral length were (3.9?1.8)cm respectively.Post operatively,they were (211.6?63.3)ml,(49.8?16.4)cm H 2O,( 50.8 ?12.3)cm H 2O,(32.9?12.5)cm H 2O,(5.6?2.0)cm correspondingly.The differences were significant ( P