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BACKGROUND:Studies have shown that arthroscopic al-inside technology for meniscus repair has achieved good outcomes, and arthroscopic suture combined with sodium hyaluronate has an important role in the cartilage repair. OBJECTIVE:To observe the therapeutic effect of arthroscopic al-inside suture repair combined with sodium hyaluronate injection in the repair of discoid meniscus tears. METHODS:Twenty-two patients with discoid meniscus injury were subjected to arthroscopic al-inside suture repair combined with sodium hyaluronate injection. Al cases were confirmed to have attached edge relaxation or longitudinal crack in operation. After repair, effective rehabilitation training was done. RESULTS AND CONCLUSION:The operations for the 22 cases were al successful and there was no complication. Al patients were fol owed up for over 18 months. According to Ikenchi’s method (Lysholm knee score criterion), 11 cases were rated excel ent, 8 were rated good, and 3 were rated fair, with an excel ent/good rate of 86.36%. It is demonstrated that the al-inside suture repair under the guide of arthroscopy in discoid meniscus cases can remain the most appropriate anatomical structure of the meniscus that can play an effective function, and has the advantage of minimal invasion. Arthroscopic al-inside suture repair combined with intra-articular injection of sodium hyaluronate and standard rehabilitation training result in a lower complication rate and effectively promotes the meniscus repair.
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Objective To investigate the effect of prosthetic replacement for senior patients with unstable intertrochanteric fractures of the femur.Methods Fifty-three senior patients with comminuted intertrochanteric fracture of the femur were subjected to total hip arthroplasty (n =23) and bipolar artificial femoral head replacement (n =30).Uncemented long-stem prostheses were used in 50 patients and cemented long-stem prostheses in 3.Time interval between admission and surgery was 3-13 days (mean 6 days).Results The total hip arthroplasty had the operation time for mean 90 minutes (range,80-110 minutes) and blood loss for mean 350 ml (range,260-410 ml).While the hemiarthroplasty had operation time for mean 65 minutes (range,50-90 minutes) and blood loss for mean 230 ml (range,180-290 ml).Fifty-one patients were available to mean 49.6-month follow-up (range,13-65 months).Four patients presented with frequent hip pain at a tolerable level after hemiarthroplasty and the symptom was relieved after oral non-steroidal anti-inflammatory drug therapy.One patient with postoperative infection was cured by timely debridement.Seven patients were died of heart and brain disorders in 5 years,with no relation to surgical complications.The period for fracture healing was mean 10 months,with excellence rate of 96％ for hip function but with no acetabulum abrasion,implant loosening or submersion.Conclusion Early prosthetic replacement is an effective treatment for unstable intertrochanteric femoral fractures in the elderly.
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BACKGROUND:The most effective method for the treatment of acetabular fracture is open reduction and internal fixation, however, this treatment for some special types of acetabular fracture cannot get satisfactory prognosis, and is prone to complications, such as traumatic coxarthrosis and avascular necrosis of femoral head. OBJECTIVE:To evaluate the curative effect of open reduction and internal fixation and total hip arthroplasty in the treatment of special acetabular fracture. METHODS:Twelve cases of acetabular fracture were included, including seven cases of traffic accident wound, three cases of crush injury, and two cases of fal ing injury. The type of bone fracture:two cases of posterior wal fracture, two cases of posterior column and posterior wal fracture, one case of T shaped fracture, five cases of transverse and posterior wal fracture, and two cases of acetabular roof sexual fracture. Complications:one case was femoral head centric dislocation, five cases were latter dislocation, and three cases were caput femoris fractures. Before injury, three cases had coxarthrosis, and two cases were avascular necrosis of femoral head. Al the cases were treated with open reduction internal fixation and total hip arthroplasty, of which nine cases were treated with biological prosthesis, and three cases were treated with bone cement prosthesis. The time from hospitalization to surgery was 3-15 days, and average was 6 days. The patients were fol owed-up once every 2 months in 1 year after replacement, and the Harris score was used to evaluate the hip function recovery. RESULTS AND CONCLUSION:No surgical site and deep wound infection, joint dislocation, lower limb deep vein thrombosis, and death were found in these 12 cases. Among them, 11 cases were fol owed-up for a longtime;the fol ow-up was lasted for 6-82 months. The acetabular fracture was healed at 6-16 months after reduction without prosthesis loosening and sinking. The hip function was evaluated during final fol ow-up according to the Harris score:excellent in eight cases, good in two cases, poor in one case, and the excellent and good rate was 91%. Open reduction internal fixation and one-stage total hip arthroplasty can avoid long-term bed, get out of bed as soon as possible, and reduce complications, thus reconstruct the hip joint painlessly and good functional y.
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BACKGROUND:Numerous studies have shown that air wave pressure therapy plays an important role in prevention of deep venous thrombosis of lower limb after a major operation on the hip. OBJECTIVE:To explore the efficacy of air wave pressure therapy on deep vein thrombosis of the lower extremity in patients with total knee arthroplasty. METHODS:A total of 80 patients with total knee arthroplasty were randomly divided into experimental group and control group. Patients in the control group were treated only with conventional method to help the patient massage the lower extremity by the nurse and combined with active functional exercise;patients in the experimental group were treated with air wave pressure therapy at 2 days postoperatively, and were also treated with conventional method to help the patient massage the lower extremity by the nurse and combined with active functional exercise. Swel ing index, coagulation index and the number of patients with deep venous thrombosis of the lower extremity were recorded in both groups. RESULTS AND CONCLUSION:At 2 weeks after treatment, swel ing index, coagulation index and the number of patients with deep venous thrombosis of the lower extremity were significantly reduced in the experimental group, and its effects were significantly better than those in the control group (P<0.05). Early use of air wave pressure therapy after total knee arthroplasty can al eviate limb swel ing effectively and have obvious advantages in improving coagulation index and blood coagulation condition and in preventing deep vein thrombosis of the lower extremity after total knee arthroplasty.
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Objective To investigate clinical effect of surgical repair and reconstruction of traumatic floating shoulder injuries (FSI). Methods Sixteen patients with FSI were treated with open re-duction and reconstructive internal plate fixation. Of all, one patient was with transverse clavicle fracture, six with oblique clavicle fracture and nine with comminuted clavicle fracture. There was one patient with type Ⅰ scapula fracture, three with type Ⅱ, four with type Ⅲ, six with type Ⅳ and two with type Ⅴ. The combined injuries included rib fracture plus hemopneumothorax in six patients, traumatic moist lung in two, craniocerebral injuries in two, hepatic and splenic rupture in two and brachial plexus damage in one. The average time from primary injury to operation was seven days (3-21 days). Results Fifteen out of 16 patients were followed up for 6-28 months (average 11 months). All patients obtained bone u-nion, without infection, loosening or breakage of internal fixation. According to Herscvici evaluation standard of function, the shoulder joint outcome was rated as excellent in 11 patients, good in three and fair in one, with excellence rate of 93%. Conclusion The surgical repair and reconstruction of FSI can, to a greatest extent, recover the anatomical structure and stability around the shoulder joint and shorten the immobilization period of joint, which is beneficial to functional restoration of the joint and de-crease of occurrence of complications.