ABSTRACT
Objective: TO evaluate the effect of custom-made artificial total knee prosthesis replacement on pathological fracture of distal femur caused by giant cell tumor of bone. Methods." A total of 12 knees of 12 patients with pathological fracture of distal femur caused by giant cell tumor of bone were treated with cus-tom-made artificial total knee prosthesis replacement. There were 5 males and 7 females aged from 23 to 40 years (34.2 years on average). Results: All patients tolerated surgery very well. The surgical duration was 120～ 180 rain and the intraoperative bleeding was 500 ～ 900mL. The drainage tube was taken out in 5 days after surgery. The postoperative drainage volume was 300 ～ 700mL. There were no postoperative complica-tions. The postoperative X-ray examination showed that all of the prosthesises were in the right position. Lo-cal pain disappeared in all patients after surgery. The pathological examination identified all the patients with giant cell tumor of bone. All patients were followed up for 18 ～ 30 months (24 months on average). No recur-rence was observed after surgery. No infection or implant loosening occurred during the follow up. According to the Enneking assessment system of function after limb salvage surgery, the mean Enneking scale was 23.8 points (ranged from 15 to 28 points) at the last follow-up visit. Conclusion: Custom-made artificial total knee prosthesis replacement can achieve a high satisfactory rate in clearance of lesion and restoring function of the knee in patients with pathological fracture of distal femur caused by giant cell tumor of bone, improving patients' quality of life.
ABSTRACT
[Objective]To assess the efficacy of autograft fusion and anterior spinal stabilization as an alternative treatment for tuberculosis lesion of the lower cervical spine. [Methods]Thirty patients with tuberculosis of the lower cervical spine underwent anterior decompression and fusion.There were 22 male and 8 female with the age from 24 to 58 years(mean age,37 years).The involved area included 2 vertebral bodies in 21 patients,3 vertebral bodies in 9 patients.Combined chemotherapy was delivered to each patient for at least three weeks preoperatively.There were 5 patients with Frankel Grade B,5 with Grade C,13 with Grade D and 7 with Grade E.The mean kyphosis angle were 12?.[Results]The patiets stood surgery well.The operation time was 70～100 min and the bleeding during operation was 50～150ml.There was no postoperative complication.All patients were followed up for 24～36 months.At the last follow-up visit,5 cases with Frankel Grade B improved to Grade D,3 cases with Grade C improved to Grade D,2 cases with Grade C improved to Grade E,13 cases with Grade D improved to Grade E.There was no breakage of nails or failure of the internal fixation during the follow up.Stable bone union was observed in all cases and the average time required for fusion were 6.5 months.[Conclusion]Anterior debridement and autograft with internal fixation is a safe and effective method for treatment of the lower cervical tuberculosis.
ABSTRACT
Objective To discuss the teaching effects of PBL teaching mode applied in clinical practice of bone surgery.Methods Through clinical practice of bone surgery with the PBL teaching mode and the traditional one,a contrast between two teaching modes was made,and the teaching results were investigated base on the questionair.Results The PBL teaching mode is superior to the traditional one.Conclusion The PBL teaching mode has an obvious advantage in the teaching of clinical practice of bone surgery and can improve the teaching quality.