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[Objective] To discuss the clinical manifestations,treatment,and therapeutic efficacy of lumbar disc herniation complicated by lumbar spinal stenosis in elderly patients.[Method]Thirty-six elderly patients with lumbar disc herniation complicated by lumbar spinal stenosis were treated with surgical treatment,including multi-segment fenestration,laminectomy,resection of nucleus pulposus,and internal fixation of pedicle screws.The therapeutic efficacy was retrospectively assessed.[Result]All patients were followed up with an average time of 3 years and 6 months.The good to excellence results was 83%.[Conclusion]In elderly patients with lumbar spinal stenosis,there are patients have special clinical manifestations.Different operations should be adopted for different patients.There are several important factors that affect the efficacy of operation,including operation modes,sufficient decompression,restotation of spinal instability,and postoperative exercises of lumbodorsal muscles.
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[Objective]To evaluated the clinical results of the ulnar osteotomy and external fixation for the treatment of chronic anterior dislocation of head of the radius in children.[Method]From 2002 to 2004,thirteen cases of children with chronic anterior dislocation of the radial head were treated by ulnar osteotomy,external fixation and close or open reduction of elbow joint but without repair of the annular ligament. Their mean age was 5.5 years(2 to 11) and the mean interval between the injury and reconstruction was 19 months(2 months to 3 years).[Result]All radial heads remained reduced at a mean follow-up of 14 months(2 months to 3 years).Normal ranges of movement for flexion,extension,pronation and supination were improved or unchanged in 12 patients.One patient had further decreased in 10? for supination.There were one superficial pin-track infections but with no serious complication.[Conclusion]Angular ulnar osteotomy and external fixation of the ulna can lead to stable reduction of the radial head with minimal complications.Reconstruction of the annular ligament is not necessary if satisfactory re-orientation of the ulnar is achieved in all planes.
ABSTRACT
Objective To study the treatment of severe dysfunction of knee joint after trauma and explore the operative indication and method for total knee replacement treating such kind of disease. Methods From June 1997 to June 2004, total knee replacement using total knee prosthesis system was carried out in 21 knees of 18 cases with severe dysfunction of knee joint at late stage after knee replacement treating knee trauma, of which 12 knees in 10 cases with severe traumatic arthritis underwent total knee surface replacement. Seven knees in six cases with traumatic arthritis combined with 20?-40?varus or valgus or 20?-90?fixity flexion deformity and two knees in two cases with completely bony ankylosis were treated with rotation hinged knee joint. All cases were followed up for mean 3.5 years, ranging from six months to seven years. The Hospital for Special Surgery (HSS) knee rating score system was used to evaluate the clinical results. Results Pain relief, function recovery, rectification of knee deformities, stability and muscle power were all poor before operation. But postoperative valuation of pain relief, function recovery, rectification of knee deformities, stability and muscle power showed excellent result in 12 cases, good in seven and fair in two, with excellence rate of 90% and rate of patient satisfaction of 100%. Conclusion The knee replacement is an effective method for treating severe dysfunction of knee joint at late stage after knee replacement treating knee trauma.