A follow up study on the treatment of tibial fractures with intramedullary interlocking nail through the suprapatellar approach / 中国骨伤

OBJECTIVE@#To investigate the short-term effect of suprapatellar interlocking intramedullary nail in the treatment of tibial fractures.@*METHODS@#Eighty patients with tibial fractures treated from January 2016 to June 2018 were treated with interlocking intramedullary nail, who were divided into observation group (suprapatellar approach) and control group (patellar ligament approach) according to different surgical approaches. There were 40 cases in the observation group, including 28 males and 12 females, aged 28 to 67 years with a mean of (46.70±10.34) years. There were 40 cases in the control group, including 30 males and 10 females, aged 31 to 69 years with a mean of(49.38±10.74) years. The operation time, incision length, intraoperative C-arm X-ray fluoroscopy times, intraoperative blood loss, fracture healing time, postoperative active straight leg raise (SLR) time, hospital stay, visual analogue scale (VAS), knee pain rate and postoperative Hospital for Special Surgery (HSS) score were recorded and compared between two groups.@*RESULTS@#All the patients were followed up, and the duration ranged from 19 to 38 months, with an average of(24.60±4.52) months. In the observation group, the operation time was(53.83± 7.01) min;the incision length was (3.98±0.83) cm;the number of intraoperative C-arm X-ray fluoroscopy was (18.90±1.75) times;the fracture healing time was (10.03±0.89) weeks;the postoperative active SLR time was (1.19±0.25) days;and the hospital stay was(6.73±1.06) days. The above indexes were better than those in the control group (@*CONCLUSION@#The treatment of tibial fractures with suprapatellar interlocking intramedullary nail has the advantages of less trauma and better recovery of knee function. It can obtain more satisfactory clinical results and can be further widely used.

Anterior cervical intervertebral space decompression under microscope for cervical spondylotic myelopathy in elderly patients / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects of anterior cervical intervertebral space decompression under microscope in treating cervical spondylotic myelopathy in elderly patients.</p><p><b>METHODS</b>From June 2009 to March 2012, 43 patients with cervical spondylotic myelopathy were treated with anterior cervical intervertebral space decompression and intervertebral fusion under microscope. There were 26 males and 17 females, aged from 60 to 72 years old with an average of (64.9±3.7) years. Japanese Orthopaedic Association System (JOA) score was from 7 to 12 points with an average of (9.5±1.8) points before operation. The function of nerves was assessed before and after operation according to JOA.</p><p><b>RESULTS</b>All patients were followed up from 10 to 18 months with an average of (14.7±1.6) months. Postoperative JOA score was (13.81±1.44) points (ranged, 10 to 16), had significantly higher than preoperative (P<0.01). According to the rate of the improved JOA score, 9 cases got excellent results, 26 good, 7 fair, 1 poor.</p><p><b>CONCLUSION</b>Anterior cervical intervertebral space decompression under microscope for cervical spondylotic myelopathy in elderly patients is safe and effective.</p>

Arthroscopic treatment of acute patellar dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate therapeutic effects of arthroscopic treatment for acute patellar dislocation.</p><p><b>METHODS</b>From May 2002 to March 2009, 36 patients with acute patellar dislocation were treated with arthroscopy, including taking out of the free cartilage chips, relaxing lateral retinaculum and tight suturing medial retinaculum. Among the patients, 6 patients were males and 30 patients were females, ranging in age from 12 to 30 years (averaged, 20.5 years). Fifteen patients had the dislocations on the left an 21 patients had the dislocations on the right. The development of condyles of femur and Q trianglel were detected by preoperative radiology. The Lysholm criteria system was used to evaluate the clinical effects.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 13 to 60 months (averaged, 42 months). All the patients had no complications such as infection, and the knee range of motion recovered to normal without pain. The Lysholm score improved from preoperative (28.9 +/- 2.5) to postoperative (95.1 +/- 8.4). All the patients had no redislocation.</p><p><b>CONCLUSION</b>Acute dislocation of the patella is an potential devastating injury. The arthroscopic treatment for acute patellar dislocation has advantages such as less trauma, faster recovery and more reliable.</p>

Repair of soft tissue defects on the lower limbs with the facial pedicled flap with vascular perforating branch of leg / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the operative techniques and clinical results of the facial pedicled flap with vascular perforating branch of leg.</p><p><b>METHODS</b>From May 1998 to January 2009,62 patients with soft tissue defects on the lower limbs were treated by four kinds of flap pedicled with the medial, posterior,anterolateral and posterolateral vascular perforating branches in the leg, included 50 males and 12 females, aged from 7 to 78 years old. There were 23 cases of the facial pedicled flap based on the perforating branch of the tibialis posterior artery, 9 cases of the facial pedicled flap based on the distal perforating branch of peroneal artery, 22 cases of the facial pedicled flap based on the peroneal artery perforator, 8 cases of the facial pedicled flap based on the lateral popliteal cutaneous artery.</p><p><b>RESULTS</b>The remaining flaps were completely survived except for 2 cases with epidermal necrosis and scab of distal flap, and 1 case with skin necrosis and skingrafting later. The patients were followed-up for from 1 month to 3 years, the appearance of the flaps were satisfied and the function were good.</p><p><b>CONCLUSION</b>The blood supply area of single perforator vascular of the leg is insufficient, so the presence facial pedicled flap of arterial chains will expend obviously the area of perforator flap that be good to blood supply and venous return.</p>

Repair of wound defect with exposed tibia with facial flap pedicled with vascular perforating branch of leg / 中华创伤杂志

Objective To explore the method of repairing wound defects with exposed tibia. Methods 32 patients with soft tissue defects with exposed tibia were treated with three kinds of flaps pedicled with interior,lateral and posterior vascular perforating branches in the leg,respectively.Re- suits One flap with distal part necrotic was treated with change of dressings and got one-stage healing. One case had delayed union for muscular infection under the flap.Other flaps all were successful and sur- vived.No ostemyelitis was found.Conclusion The flap pedicled with vascular perforating branches of leg has abundant blood supply and is a good method for repairing small or middle wound defect with ex- posed tibia.