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Objective To investigate the clinical effect of old thoracolumbar vertebral fracturekyphosis with spinal stenosis by pedicle of vertebral archosteotomy and internal fixation.Methods Twenty patients with old thoracolumbar fracture with kyphosis,and associated with spinal stenosis,were treated by using transpedicular osteotomy and internal fixation treatment in the First People's Hospital of Shangqiu from June 2012 to May 2014.Radiographical assessments including localized kyphosis,thoracic kyphosis,lumber lordosis,sacral tilt angle,sagittal vertical axis,bony fusion and the relative height of the ifiterbody fusion vertebra.Visual analogue scale(VAS),and ASIA were evaluated before and after surgery,and the operative duration,blood loss were recorded.Results The operation carried out in 120-200 min,800-1600 ml of bleeding statistics through operation process.Localized kyphosis was reduced from an average of (42.6±4.2) ° to (8.2± 1.6) °,the difference was statistically significant (P =0.012).All patients were followed up for 10.0 -26.0 months,average (18.0±6.2) months.The average VAS score was 6.88±0.82 before operation and 2.10 ±0.84 at final follow-up,the difference was statistically significant(P=0.023).The bone healed well,no false joints.Neurological function improved from C to D in 2 patients,from C to E in 4 patients,and from D to E in 14 patients.Conclusion Old thoracolumbar vertebral fracture kyphosis with spinal stenosis by transpedicularosteotomy and internal fixation in the treatment of simple operation,definite effect,less complications and can effectively improve the prognosis.
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Objective To investigate the clinical effect of high developmental dislocation of the hip in patients with total hip replacement operation to take biology.Methods Thirty-six cases of high developmental dislocation of the hip by patients as the object of study from January 2011 to February 2014 in the First People' s Hospital of Shangqiu, all patients underwent cementless total hip joint replacement operation, 6 months to 2 years after surgery, observed the clinical effect of all patients before and after treatemnt.Results The operation time was 1.20-3.0 h,the average operation time was (2.13±1.01) h,amount of bleeding during the operation of 300.00-700.00 ml,the average amount of bleeding was (342.43±34.23) ml;follow up of 6 months to 2 years, all patients had no prosthesis loosening and dislocation of the hip;all patients after treatment, Harris score (81.56± 14.34) points, better than that before treatment, the difference was statistically significant ((54.34 ± ±9.78) points,P=0.009);The excellent and good rate of all the patients after the treatment (97.22％) .Conclusion The clinical effect of high developmental dislocation of the hip by total hip replacement operation in patients taking biological type significantly, has the advantages of simple operation, effectively relieve pain, improve the life quality of patients and other advantages, the ideal treatment method can be used as high developmental dislocation of hip.
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Objective To analyze the clinical effects of vertebral pedicle bone graft after posterior pedicle screw fixation in the treatment of thoracolumbar fractures .Methods 80 cases with thoracolumbar fractures were ran-domly divided into the study group ( 40 cases ) and control group ( 40 cases ) .The study group used simple pedicle screw fixation , posterior reduction , and the control group adopted conventional inter vertebral internal fixation .The operation time,hemorrhage were compared between the two groups .The clinical effects of posterior transpedicular in-strumentation of bone graft and vertebral pedicle screw in fractured vertebra in the treatment of thoracolumbar fractures were analyzed.Results The operation time of study group was (110.0 ±14.9)min,which was longer than that of the control group[(91.0 ±13.7)min](t=5.93,P0.05).At the end of the follow-up after the operation,the anterior vertebral height,Cobbangle,VAS scores in the study group were (91.3 ±1.7)%,(11.2 ±1.9)°,(2.5 ±0.2)%,which were better than (86.6 ±2.3)%,(14.5 ±1.1)°,(3.5 ±0.9)% in the control group (t =5.25,3.24,6.17,all P <0.05). Conclusion Vertebral pedicle bone graft posterior pedicle screw fixation in the treatment of thoracolumbar fractures can effectively correct the kyphosis ,reconstruct vertebral height ,increase the stability of the vertebral body ,reduce and prevent postoperative vertebral height lost ,loosening and fracture fixation complications .
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Objective To compare the effects of proximal femoral nail antirotation ( PFNA) and dynamic hip screw ( DHS) in the treatment of elderly patients with intertrochanteric femur fracture .Methods According to the digital table ,92 elderly patients with intertrochanteric femur fracture were randomly divided into the PFNA group ( n=46) and the DHS group(n=46).The PFNA group was treated with PFNA and the DHS group was treated with DHS . The clinical effect was compared between the two groups .Results The operation time ,postoperative ambulation time , hospitalization time,blood loss and postoperative wound drainage of PFNA group were (58.3 ±19.7) min,(7.4 ± 4.1)d,(16.1 ±6.2)d,(97.6 ±34.7)mL,(64.7 ±12.4)mL,respectively,which were better than those of DHS group[(81.3 ±20.4)min,(11.4 ±3.8)d,(19.7 ±5.8)d,(206.3 ±35.4)mL,(75.2 ±12.8)mL](t=5.500, 4.853,2.875,14.872,3.996,all P0.05).Conclusion PFNA has shorter operation time,and earlier postoperative ambulation time,good recovery of hip function .It also has smaller surgical trauma ,but not increase the incidence of postoperative complications in elderly patients with intertrochanteric femur fracture ,it's worthy of promotion .
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Objective To summarize the keypoints of clinical diagnosis of chondroblastoma and the experience on the treatment Methods The clinical materials of 16 cases(11 males,aged from 12 to 26 years)from June 1992 to February 2003 of pathologically diagnosed chondroblastoma were analyzed retrospectively. The tumor located at distal femur in 6 cases,great trochanter in 1 case,proximal tibia in 6 cases,proximal humerus in 2 cases, talus in 1 case. The main symptoms were swelling and painful joint. All the 16 cases were treated with curettage and autologous bone graft from iliac crest. Results Twelve cases were followed up for 6 months to 5 years .averaging 3. S years. All the bone graft healed well. One case., recurred 2 years after the initial curettage and was treated with curettage again. No recurrence occurred at the last follow-up 6 months after the second curettage. The function of the involved joints was nearly normal in all cases except for one case with slight limitation of knee flexion. Conclusions Mastering the image and clinical characteristics of chondroblastoma can avoid misdiagnosis and mistreatment Curettage can control the tumor satisfactorily. Postoperative rehabilitation can improve the function of the involved limb.