ABSTRACT
Objective To report a new self-designed locking plate assembly suitable for treatment of displaced calcaneal fractures of Sanders types Ⅱ &Ⅲ via sinus tarsi approach.Methods We designed a new locking plate assembly suitable for treatment of displaced calcaneal fractures of Sanders types Ⅱ & Ⅲ via sinus tarsi approach.Its biomechanical performance was tested by standard electronic and mechanical devices.From March 2014 to October 2015,18 patients with displaced calcaneal fracture were treated with our self-designed new locking plate assembly.They were 14 men and 4 women,aged from 32 to 66 years (average,50.4 years).All the fractures were unilateral closed ones,with 7 cases of the left side and 11 ones of the right side.By the Sanders classification,14 cases belonged to type Ⅱ (8 to type Ⅱa,4 to type Ⅱb and 2 to type Ⅱc) and 4 to type Ⅲ (2 to type Ⅲab,one to type Ⅲac and one to type Ⅲbc).The B(o)hler angle,Gissane angle,and height,width and length of the calcaneus were measured and compared at preoperation,postoperative 3 months and final follow-ups.The clinical outcomes were evaluated using Maryland foot score system atfinal follow-ups.Results This new locking plate assembly could tolerate a maximum vertical load of 1,396.03 N and a maximum horizontal anti-bending load of 427.15 N.It broke after it had been subjected to 93,003 loadings in a repeated 500 N stress test.All the 18 patients were followed-up for an average of 9.3 months (from 6.0 to 13.5 months).Follow-ups at 3 months postoperation showed significant improvements in B(o)hler and Gissane angles and calcaneal height,width and length compared with pre-operative parameters (P ＜ 0.05),but no significant differences were observed in the above parameters between 3 and final follow-ups postoperation (P ＞ 0.05).Maryland foot scores demonstrated 12 excellent cases,3 good ones and 3 fair ones.No incision infection,implant failure,nonunion or malunion happened in this series.Conclusions This new locking plate assembly suitable for sinus tarsi approach can be used in clinic because it has advantages of easy placement,rigid fixation,satisfactory functional recovery of the foot and limited complications.
ABSTRACT
Objective To report a new self-designed locking plate assembly suitable for treatment of displaced calcaneal fractures of Sanders types Ⅱ &Ⅲ via sinus tarsi approach.Methods We designed a new locking plate assembly suitable for treatment of displaced calcaneal fractures of Sanders types Ⅱ & Ⅲ via sinus tarsi approach.Its biomechanical performance was tested by standard electronic and mechanical devices.From March 2014 to October 2015,18 patients with displaced calcaneal fracture were treated with our self-designed new locking plate assembly.They were 14 men and 4 women,aged from 32 to 66 years (average,50.4 years).All the fractures were unilateral closed ones,with 7 cases of the left side and 11 ones of the right side.By the Sanders classification,14 cases belonged to type Ⅱ (8 to type Ⅱa,4 to type Ⅱb and 2 to type Ⅱc) and 4 to type Ⅲ (2 to type Ⅲab,one to type Ⅲac and one to type Ⅲbc).The B(o)hler angle,Gissane angle,and height,width and length of the calcaneus were measured and compared at preoperation,postoperative 3 months and final follow-ups.The clinical outcomes were evaluated using Maryland foot score system atfinal follow-ups.Results This new locking plate assembly could tolerate a maximum vertical load of 1,396.03 N and a maximum horizontal anti-bending load of 427.15 N.It broke after it had been subjected to 93,003 loadings in a repeated 500 N stress test.All the 18 patients were followed-up for an average of 9.3 months (from 6.0 to 13.5 months).Follow-ups at 3 months postoperation showed significant improvements in B(o)hler and Gissane angles and calcaneal height,width and length compared with pre-operative parameters (P ＜ 0.05),but no significant differences were observed in the above parameters between 3 and final follow-ups postoperation (P ＞ 0.05).Maryland foot scores demonstrated 12 excellent cases,3 good ones and 3 fair ones.No incision infection,implant failure,nonunion or malunion happened in this series.Conclusions This new locking plate assembly suitable for sinus tarsi approach can be used in clinic because it has advantages of easy placement,rigid fixation,satisfactory functional recovery of the foot and limited complications.
ABSTRACT
Objective To evaluate different operative modalities for sphincter-preserving procedures in patients of lower rectal cancer. Methods A total of 137 patients with lower rectal cancer underwent sphincter-perserving surgery between January 2003 and January 2008. In the operation, the proximal colon with satisfactory blood supply was pulled down to reestablish intestinal continuity without any tension. Results Among the 137 patients, 102 patients underwent low anterior resection by double stapling technique, 16 patients were dealed with the Parks operation, 19 patients were dealed with the modified Bacon operation. In the double-stapling technique group, the distance between the anal verge and inferior margin of the tumor was 6-8 cm in 91 patients and 5-6 cm in 11 patients whose tumors were located at posterior rectal wall. In the other two groups, the distance between the anal verge and inferior margin of the tumor was 5-6 cm. In the Parks operation, the sigmoid colon was anastomosed with the anus in all of 19 patients. In the modified Bacon operation group, the descending colon was pulled through anus in all of 16 patients. Conclusions The low anterior resection with double stapling technique can be applied to a patient if the distance from the inferior margin of the tumor to the anal verge is 6 cm to 8 cm. The Parks operation or the modified Bacon operation can be applied to a patient if the the distance from the inferior margin of the tumor to the anal verge is 5 to 6 cm, The Parks operation can be performed with the sigmoid colon being anastomosed with the anus if the length of the sigmoid colon is long enough to reach the anus, the modified Bacon operation can be performed with the descending colon being pulled through the anus by mobilization of splenic flexure or left colon if the length of the sigmoid is not long enough to reach the anus.