Transpedicular osteotomy and internal fixation in the treatment of old thoracolumbar vertebral fracture with kyphosis clinical study with spinal stenosis / 中国综合临床

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.

High developmental dislocation of the hip in patients with non bone cement (biological) and curative effect of total hip replacement operation method / 中国综合临床

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.

Surgical strategy of osteoarthritis secondary to acetabular dysplasia by total hip arthroplasty / 中国医师进修杂志

Objective To investigate the experiences of total hip replacement in the treatment of different types of osteoarthritis secondary to acetabular dysplasia, and evaluate its effect. Methods From January 1999 to December 2006, 37 hips in 35 cases with osteoarthritis secondary to acetabular dysplasia undergoing total hip replacement were included in this study. Preoperative Harris score was 30-64 points, with an average score of 45 points. Undergoing total hip replacement with complete release, of soft tissue, original acetabular, and no femoral osteotomy. Crowe Ⅰ , Ⅱ-type acetabular dysplasia chose conventional cementless press-fit prosthesis;Crowe Ⅲ,Ⅳ-type,chose the appropriate trumpet,Zweymüller system cementless acetabular biconical spiral surface and thin and straight SL rectangular hip stems. Results The duration of follow-up ranged from 12 to 60 months (average 24 months). No case appeared dislocation, periprosthetic fractures, femoral nerve and sciatic nerve injury and other complications, no clinical and X-ray findings of prosthesis loosening occurred. Postoperative Harris score was 60-95 points, and average was 85 points. Conclusion Adequate preoperative preparation, intraoperative complete release, is the key of the treatment and restoration of limb length.