ABSTRACT
Objective To evaluate the clinical efficacy and safety of all-inside arthroscopic repair of anterior talofibular ligament(ATFL) for chronic lateral ankle instability(CLAI).Methods From October 2016 to September 2017,19 patients with CLAI were treated with all-inside arthroscopic repair of ATFL at Department of Orthopaedic Surgery,Zhejiang Provincial People's Hospital and Department of Foot and Ankle Surgery,Guangzhou Orthopaedic Hospital.They were 12 men and 7 women,aged from 18 to 35 years(mean,27.3 years).Their defective ATFLs had no effective tension.After the fibular foot-print zone of ATFL was refreshed,an absorbable anchor was inserted accurately and its suture was threaded into the remnant of ATFL using the all-inside arthroscopic technique.The remnant of ATFL was fixated by the suture using Lasso-Loop method and anatomically repaired into the foot-print zone to restore the ligamentous tension.The American Orthopedic Foot and Ankle Surgery Society(AOFAS) ankle-hindfoot score,Karlsson ankle function score,Tegner activity score and visual analogue scale(VAS) were used to assess funtion of ankle before and after operation.Results All the 19 patients were followed up for a mean time of 15.6 months(from 12 to 22 months).Their ankle symptoms were all relieved after operation;their ankles recovered fine range of motion;their anterior drawer tests and varus stress tests were negative.Their preoperative AOFAS scores(64.6±11.4),Karlsson ankle function scores(63.5±11.4),Tegner activity scores(3.2±0.7) and VAS(5.8±1.7) were significantly improved at the final follow-up(92.3±3.2,91.2±4.4,5.7±0.6 and 1.4±1.0,respectively)(P<0.05).complications such as incision and articular infections,superficial peroneal nerve injury,sural nerve injury and iatrogenic fracture were not demonstrated in the cohort.By the final follow-up,no patient had been found who needed a secondary revision.Conclusions The all-inside arthroscopic repair of ATFL can be used effectively and safely for CLAI,because it leads to accurate anchor insertion,anatomic repair,limited invasion,and reliable restoration of ligamentous tension.To avoid complications,surgeons should familiarize themselves with arthroscopic procedures.
ABSTRACT
Objective To investigate the clinical efficacy of arthroscopic Brostr(o)m-Gould procedure for chronic lateral ankle instability (CLAI).Methods A retrospective case series study was conducted to analyze the clinical data of 36 CLAI patients admitted to Zhejiang Provincial People's Hospital,Second Affiliated Hospital of Shenzhen University,Institute of Orthopedics of Soochow University,and Guangzhou Orthopedic Hospital from August 2016 to July 2017.There were 21 males (21 ankles) and 15 females (15 ankles),aged 18-42 years [(26.5 ± 8.6)years].The duration from injury to operation ranged from 6 to 30 months [(10.8-± 1.6) months].All patients received arthroscopic Brostr(o)m-Gould procedure (anterior talofibular ligament repair,capsular constriction,subextensor ligament reinforcement).The operation time and arthroscopic intra-articular lesions and treatment were recorded,and the wound healing and complications were recorded.The visual analogue score (VAS),front drawer test and varus stress test results,American Orthopedic Foot and Ankle Surgery Society (AOFAS) ankle-hind foot score and Karlsson-Peterson ankle function score were compared before operation,6 weeks after operation and at the last follow-up.Results All 36 patients were followed up for 18-29 months [(20.5 ±6.3) months].The operation time ranged from 45 to 115 minutes [(67.2 ± 18.6) minutes].During the operation,synovitis hyperplasia of ankle joint was found in 35 patients,scar tissue around ligament in 32,talus cartilage injury in 10,osteophyte in 19 and free body in 5,all of which were treated accordingly.All incisions were healed in the first stage after operation,without joint infection,superficial sural nerve injury or thread stimulation.The ankle varus was slightly limited in two patients after operation and improved after functional rehabilitation.No revision operation was needed at the last follow-up.Front drawer test and inverted stress test results were negative (-).The VAS score was (5.9 ± 1.6) points before operation,(1.9 ± 1.0) points at 6 weeks after operation,and (1.6 ± 0.3) points at the last follow-up,with significant difference compared with that before operation (P ＜ 0.01).The AOFAS ankle-hind foot score was (67.4 ± 7.4) points before operation,(89.2 ±4 6.8) points at 6 weeks after operation,and (91.7 ±5.3)points at the last follow-up,with significant difference compared with that before operation (P ＜ 0.01).Karlsson-Peterson ankle function score was (65.3 ± 9.6)points before operation,(88.6 ± 5.3) points at 6 weeks after operation,and (90.6 ± 3.8) points at the last follow-up,with significant difference compared with that before operation (P ＜ 0.0 1).Conclusion For CLAI,the arthroscopic Brostr(o)m-Gould procedure can treat the intra-articular lesions and reliably restore the stability of the lateral ankle.At the same time,quick motion recovery can be achieved,with satisfactory shortterm curative effect.
ABSTRACT
Objective To compare and analyze the surgical and non-surgical treatment results of hypertensive cerebrat hemorrhage.Methods 29 vases of hypertensive cerebral hemorrhage patients are randomly divided into two groups:13 cases were treated by surgical treatment,and 16 cases were treated by medicine treatment.Results In surgical group,dead 3 cases,plant survival 5 eases,death disablity rate is 62%;and in non-surgical group:dead 1 case,plant survival 5 eases,death disablity rate is 44%.Conclusion There is no significant difierence between surgical and non-surgical treatment of hypertensive cerebral hemorrhage.It should be thought more to use surgical treatment on hypertensive cerebral hemorrhage.
ABSTRACT
Objective To discuss the possibility of transpedicular balloon kyphoplasty for aged osteoporotic thoracolumbar burst fractures.Methods 7 consecutive procedures were performed in 7 patients of aged osteoporotic spinal fractures.The burst fractures were confirmed by CT before the procedure.Although bony fragments were seen to protrud into the spinal canal in the cases,no patient had nerve injury preoperatively.This operation involved the percutaneous insertion of two inflatable bone tamps into a fractured vertebral body transpedicularly under fluoroscopic guidance.Inflation of the bone tamp would elevate the endplates,restoring the vertebral body height,while creating a cavity to be filled with bone cement.Preoperative and postoperative heights were measured.Results 7 patients tolerated the procedure well with immediate relief of their back pain in 24 hours.There was no leakage of cement into the epidural.The height restoration of vertebral was confirmed by x-ray after the procedure.No complications occurred.The patients were allowed to take walk after the procedure.Conclusion Transpedicular balloon kyphoplasty was a effective way to treat aged osteoporotic thoracolumbar burst fractures without obvious canal occupations and neurologic deficit,the procedure can restore height of aged osteoporotic thoracolumbar burst fractures,cement distribution and vertebral canal stenosis can be avoided.
ABSTRACT
Objective An innovation of operative procedure with biological repair of ligaments for the treatment of acromioclavicular dislocation. Methods Based on the anatomy, physiology, and biomechanics, the operation was designed for restoring the stability of a completely dislocated acromioclavicular joint. Through bone holes drilled along the direction of coracoclavicular ligament fibers, the synthetic absorbable suture was used to rebuild the coracoclavicular ligament for vertical stability of the joint, and then a double loop suture was performed to rebuild acromioclavicular ligament and the capsule for horizontal stability. This biomechanical repair was simple, rapid procedure, and of less tissue trauma. The acromioclavicular joint was steadily fixed without any metallic imbedding, nor interference with joint surface. Results With 1－ 2.5 years follow up, 11 patients recovered with good healing, normal range of shoulder joint motion, and stable fixation. There was no need for secondary procedure to remove the sutures. The curative results of all patients were A degree based on the Karlsson s evaluation. There was no any complication. Conclusion The synthetic absorbable suture could be used with satisfaction for the repair of acromioclavicular dislocation. Compared with routine fixation with metallic material, the new kind of biofixation was not only effective, but also avoided the need of a second procedure for suture removal.
ABSTRACT
Methylene blue injection has a stronger direct inactivation on VZV in vitro. When the injection was diluted from 1:16 to 1:128, which was obvious (P＜0.01 and P＜0.05). The MIC was 1:222, the IC50 was 1:135 and IC90 was 1:77. The results of microcellculture method showed when the injection was diluted from 1:16 to 1:64, it also effectively inhibited the proliferation of VZV in WISH continuous cell-lines (P＜0.01 and P＜0.05). The MIC was 1:95, the IC50 was 1:45 and the IC90 was 1:21.
ABSTRACT
IFA was used to observe the distribution and the alteration of T-lymphocyte subtypes in the peripheral blood of 20 patiens with condyloma acuminata for 31 times. The murine antibody was the first antient and the antient of rabbit against IGFITC the second. The results showed that the percentage of CD_3 cell in the patients decreased significantly(P
ABSTRACT
The goats were injected with hepatitis B virus-transfer factor (HBV-TF), which was made from the immune spleen of the same spacies goats immunized with HBsAg After that, we measured the goats cellular immunity and humoral immunity by cheching up the serum anti-HBs level and lymphocyte transformation assay by ~3H-Thymidine (~3H-TdR) incorporation assay. The experiments showed that HBV-TF has the capacity of passing the specific cellular immunity from immune animals to no immune animals. The animals receiving HBV-TF showed a typical skin delay hypersensitivity to specific antigen and augument the effect of lymphocyte transformation in the presence of HBsAg. HBV-TF can also remove the inhibition of lymphocyte transformation caused by HBsAg, Both HBV-TF and N-TF can increase the number of goats blood leucocytes. However HBV-TF and N-TF have no effect on animal's humoral immunity.
ABSTRACT
The present paper studies and analyses the prevalence of epidemic hemorrhagic fever which occured in our university, The results showed that there was direct relationship between epidemic and infection of experimental rats. This paper also discusses the relation among the rat's positive detection rate, the feeding conditions and the rat's age.