ABSTRACT
AIM: To investigate the clinical effect of small incision lenticule extraction (SMILE) for super high myopia.METHODS: Totally 64 cases (128 eyes) patients with super high myopia, were randomly divided into observation group and control group, 32 cases (64 eyes) in each group.The two groups were separately treated with SMILE or femtosecond laser LASIK (FS-LASIK).We calculated the effectiveness index and safety index by contrastive observation of clinical effects in all patients included uncorrected visual acuity, best corrected visual acuity and postoperative spherical equivalent at preoperative and postoperative 1d, 1wk, 1, 3 and 6mo.RESULTS: The safety index: the observation group and the control group at 6mo after operation were respectively 1.10±0.10 and 1.08±0.12, the difference between the two groups was not statistically significant (P>0.05).The validity index: the observation group and the control group at 6mo after operation were respectively 1.08±0.12 and 1.06±0.14 and there was no significant difference between the two groups (P>0.05).Postoperative spherical equivalent at 6mo in the observation group was 0.09±0.36D, that in the control group was 0.36±0.46D.After 6mo, the count of spherical equivalent refraction within ±0.50D were 58 eyes (90.1%) in observation group and 49 eyes (76.6%) in the control group, within±1.0D were 64 eyes (100%) and 60 eyes(93.8%).CONCLUSION: SMILE is safe and effective in the treatment for super high myopia.The postoperative visual acuity and diopter can be stabilized earlier by comparing with FS-LASIK.
ABSTRACT
<p><b>OBJECTIVE</b>To compare clinical outcomes of external and posterior malleolar fractures associated with compressive articular surface through posteriorlateral incision and posteriormedial incision.</p><p><b>METHODS</b>From January 2012 to January 2015, 52 patients with external and posterior malleolar fractures associated with compressive articular surface were treated by interfix. Among them, 24 patients were treated through posteriourlateral incision, including 16 males and 8 females, aged from 20 to 65 years old with an average of(35.2±6.4);28 patients were treated through posteromedi and posterior lateral incision, including 18 males and 10 females, aged from 22 to 62 years old with an average of(36.4±4.8). Operation time, blood loss, length of incision, times of X-ray exposure and complications between two groups were recorded and compared, AOFAS scores were applied for evaluate clinical outcomes.</p><p><b>RESULTS</b>All patients were followed up, group A were followed up from 13 to 55 months with an average of (27.5±2.5) months;group B were followed up from 12 to 54 months with an average of (28.5±2.4) months. All fractures were obtained good reduction, and the healing time ranged from 10 to 16 weeks with an average of 12 weeks. Two patients in group B occurred incision infection, and 1 patient occurred screw loosening; while no incision infection occurred in group A, and 1 patient occurred screw loosening. There were statistical significance in operation time, blood loss, times of X-ray exposure and complications between two group;while no significant difference in ankle AOFAS score between two groups.</p><p><b>CONCLUSIONS</b>Compared with reduction through achilles tendon, reduction for external and posterior malleolar fractures combined with compressive articular surface through tibiafibular fractures region has advantages of less blood loss, shorter operation time, less times of X-ray exposure, good recovery of ankle joint function, especially in treating external and posterior malleolar combined with compressive articular surface which could not obtained good reduction through normal pathway.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of a new type sternoclavicular hook plate fixation in treating unstable sternoclavicular joint dislocation and fracture.</p><p><b>METHODS</b>From June 2011 to December 2013, 32 patients with sternoclavicular joint dislocation and fracture were treated with a new type sternoclavicular hook plate fixation, including 24 males and 8 females with an average age of 42 years ranging from 25 to 76 years;12 patients were anterior dislocation, 5 pations were posterior dislocation, 10 patients were internal extremity of clavicle fracture and 5 patients were sternoclavicular joint dislocation combined with fracture. The anterior fracture dislocation of the sternoclavicular joint adopted standard sternoclavicular joint hook plate, and the posterior dislocation was at the distal end of the hook of the steel plate, that is, the front part of the handle of the breast was added with a nut and a gasket to prevent the re-dislocation after operation. The results were evaluated according to Rockwood score.</p><p><b>RESULTS</b>No complication happened in all patients. X-ray and CT showed that the dislocation and fracture of the sternoclavicular joint was well reduced and the plate was on right position. All patients were followed up for 6 to 24 months with an average of 10 months. At 6 to 3 months after operation, the fracture was healing without re-dislocation of the sternoclavicular joint, the medial end of the clavicle anatomical structure were restored, functional satisfaction, in which 9 patients with the swelling around sternoclavicular joint, but no pain and other symptoms. The total Rockwood score was 12.78±1.43; the results were excellent in 24 cases, good in 8 cases.</p><p><b>CONCLUSIONS</b>The use of the new type of locking hook plate for the treatment of unstable fracture of the sternoclavicular joint, internal fixation is reliable, high security, easy to operate, to provide a reliable method for the treatment of such trauma.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the fenestration operation for treatment of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome.</p><p><b>METHODS</b>From July 2005 to February 2007, 52 cases of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome were treated by two methods. Among them, 24 cases were treated by fenestration operation for articular facet reduction, bone grafing, anatomical reconstruction of the acetabular parastyle with internal fixation, included 17 males and 7 females with an average age of (35.2 +/- 6.4) years old; the other 28 cases were treated only anatomical reconstruction of the acetabular parastyle with internal fixation, included 19 males and 9 females with an average age of (36.4 +/- 4.8) years old. All the patients were evaluated with modified d'Aubigne-Postel clinical evaluation standard.</p><p><b>RESULTS</b>All patients gained bone healing. There were only 1 patient occurenced femoral nerve injury and recovered 2 months later. There were no other complications. All patients were followed up from 12 to 51 months (averaged in 31.5 months). According to modified d'Aubigne-Postel clinical evaluation standard, there were statistic difference between the two groups of patients in pain, walking, range of motion and total score. In fenestration operation group, the results were excellent in 13 patients, good in 9, fair in 1, poor in 1; in parastyle reduction group,the results were excellent in 9 patients, good in 11, fair in 6, poor in 2 (u=0.613, P<0.05).</p><p><b>CONCLUSION</b>Fenestration operation for treatment of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome is a feasible method for the recovery of hip joint function.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Acetabulum , Wounds and Injuries , General Surgery , Fractures, Compression , General Surgery , Joints , Wounds and Injuries , General Surgery , Treatment Outcome , Weight-BearingABSTRACT
<p><b>OBJECTIVE</b>To explore the traumatic mechanism and the effectiveness of conservative and operative therapy for intra-articular fracture of calcaneus.</p><p><b>METHODS</b>Forty-eight patients (52 feet) with intra-articular fractures were divided into two groups named as conservative group and operative group. There were 30 patients in the conservative group, including 26 males and 4 females, ranging in age from 2 to 73 years, with an average of (49.2 +/- 8.5) years. The patients in conservative group were treated with manual reduction, external fixation and functional exercise at early time. Among 18 patients in the operative group, 14 patients were male and 4 patients were female, ranging in age from 26 to 66 years,with an average of (50.1 +/- 19.3) years. The patients in the operative group were treated with open reduction and internal fixation. The height and width of calcaneus, Böhler and Gissane angles were measured before and after treatment. The assessment in the function of ankle joints was scored according to AOFAS scoring system.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 8 to 18 months,with a mean of 12 months. The time of weight-bearing ranged from 3 to 6 months, averaged 4 months. The fractures were fused completely on average of 12 months. The height and width of calcaneus, Böhler and Gissane angles had no statistically significance between two groups. According to AOFAS criteria,in the conservative group, 18 patients reached an excellent result, 6 good, 5 poor and 1 bad; in operative group, 4 patients reached an excellent result, 7 good, 6 poor and 1 bad. The therapeutic effect of conservative group was better than that of operative group.</p><p><b>CONCLUSION</b>Operative therapy in intra-articular fracture of calcaneus with steel plate can directly perceive the restoration (or roughly restoration sometimes) of the anatomical shapes of calcaneus, while conservative therapy has advantages such as restoration of the anatomical shapes of calcaneus, early functional practice, early healing, and avoiding operational complications as well.</p>