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To find an effective method of minimally invasive treatment combining prevention and assistance in the middle zone of conservative treatment and fusion surgery for lumbar degenerative diseases, through the clinical effect observation and the advantage and disadvantage comparison of several commonly used lumbar interspinous dynamic stabilization systems, by analyzing the physiological structure, biomechanics and relevant data of lumbar interspinous processes, based on fully understanding of memory alloy materials, a new dynamic lumbar interspinous fixation device with a memory alloy material has been independently designed and researched, which can not only reconstruct the normal biomechanical characteristics of the lumbar spine and satisfy the normal activities of the human spine, but also avoid damage to the original structure and reduce the incidence of postoperative complications. In addition, the device can be used to optimize the current therapeutic methods. According to our research, the dynamic lumbar interspinous process stabilization device with a memory alloy has theoretically achieved satisfactory results, which can be used to overcome the shortcomings of the existing technology and is superior to the current several dynamic lumbar interspinous process stabilization systems.
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Humans , Alloys , Biomechanical Phenomena , Lumbar Vertebrae/surgery , Postoperative Complications , Prostheses and Implants , Spinal FusionABSTRACT
Objective:To explore the clinical application value of Bodyfix fixation device in stereotactic body radiotherapy (SBRT) for elderly patients with lung cancer.Methods:The clinical data of 63 elderly patients with lung cancer who received SBRT in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January to October 2021 were retrospectively analyzed. According to different fixation methods, the patients were divided into Bodyfix combined with vacuum bag fixation device group (Bodyfix group, 20 cases) and 4D respiratory gating technology combined with vacuum bag fixation device group (vacuum bag group, 43 cases). Cone beam CT (CBCT) was used for position verification before each treatment, linear and rotational errors in the horizontal (X), head-to-foot (Y), front-to-back (Z) directions were recorded.Results:The linear errors of Bodyfix group in the X, Y and Z directions were 1.7 mm (1.3 mm, 3.0 mm), 4.6 mm (4.3 mm, 5.3 mm) and 1.3 mm (0.8 mm, 2.8 mm), and the rotational errors were (0.46±0.04)°, (-0.48±0.05)° and 0.64°(0.38°, 1.07°); the linear errors of vacuum bag group in the X, Y and Z directions were 2.1 mm (1.6 mm, 3.3 mm), 2.8 mm (1.8 mm, 3.7 mm) and 3.0 mm (2.3 mm, 3.8 mm), and the rotational errors were (0.69±0.04)°, (-0.70±0.04)° and 0.64° (0.42°, 0.86°). The differences in linear errors in the Y and Z directions and rotational errors in the X and Y directions between the two groups were statistically significant ( P values were <0.001, <0.001, 0.003 and 0.007). Conclusions:Compared with the 4D respiratory gating technology, the Bodyfix fixation device has smaller rotational errors in the X and Y directions and linear errors in the Z direction. It can be used as an effective method of postural fixation for SBRT in elderly patients with lung cancer.
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OBJECTIVE@#Whether the developed new type of radiotherapy auxiliary fixation device compatible with the head and neck joint coil can improve the quality of magnetic resonance images in radiotherapy and verify whether it can be applied to clinical treatment.@*METHODS@#The clinical trial selected patients with brain metastases and nasopharyngeal cancer patients, using thermoplastic film and head and shoulder molds for posture fixation, and treatment on the ELekta Versa accelerator. SPSS 20.0 statistical software was used to analyze the data. The measurement data were expressed by @*RESULTS@#Considering the influence of the outer contour of the device, the target dose meets the clinical requirements. The setting error is less than 2 mm in the three translation directions, and the rotation error is less than 2@*CONCLUSIONS@#There is no statistical difference between the treatment results of patients using the new type of fixation device and the conventional method. The target area threatens the organ dose, and the positioning error meets the treatment requirements.
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Humans , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Nasopharyngeal Neoplasms , Neck , PostureABSTRACT
Objective:To compare the difference between active breathing coordinator (ABC) technique and free breathing (FB) mode combined with bodyfix stereotactic radiotherapy (SBRT) for chest tumors.Methods:40 thoracic tumor patients receiving SBRT were randomly selected and divided into the ABC technique group and FB model group. After fixation with bodyfix fixing devices in two groups, cone-beam CT (CBCT) scan images before each SBRT were matched with the plan reference images. The setup errors in the left-right (LR), superior-inferior (SI) and anterior-post (AP) directions were obtained. Then, the setup errors were corrected. SBRT was performed and split intra-fraction CBCT was conducted simultaneously, which was repeated until the end of treatment.Results:In the ABC technique group, the setup errors in the LR, SI and AP directions were (0.25±0.21) cm, (0.28±0.21) cm, and (0.21±0.24) cm, significantly less compared with (0.31±0.22) cm, (0.32±0.21) cm and (0.37±0.23) cm in the FB model group (all P<0.05). The V 30Gy of the heart, the V 20Gy and V 30Gy of the lung in the ABC technique group were significantly less than those in the FB model group (0.31%∶7.35%; 24.5%∶32.9%; 19.5%∶25.8%, all P<0.05). Conclusions:ABC technique combined with bodyfix fixation device may be superior to FB mode in SBRT for chest tumors, which remains to be validated by subsequent studies with large samples.
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MRI simulation images quality of head and neck coil scanning is better than that of radiotherapy surface coil, but currently the head and neck coil is not compatible with radiotherapy positioning devices. In this paper, a new fixation device is developed based on computer reverse engineering technology, which can be used in combination with head and neck coil. This article focuses on discussing the feasibility of the new device in radiotherapy. The obtained ACR phantom and Cat phantom 504 images were used to analyze MR and CT images quality assurance indicators. The dose attenuation of 6 MV photons was measured using the ionization chamber. The results showed each index met the clinical application requirements of intracranial tumor radiotherapy, thereby it can be used in intracranial tumor radiotherapy.
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Humans , Feasibility Studies , Head and Neck Neoplasms , Diagnostic Imaging , Magnetic Resonance Imaging , Phantoms, Imaging , Radiotherapy Planning, Computer-AssistedABSTRACT
Objective: To summarize the evolving concept in treatment of intertrochanteric fractures and the development of internal fixation devices. Methods: Related literature concerning the implant devices to treat intertrochanteric fractures was reviewed and analyzed in terms of the biomechanical characteristics, clinical application, and complications. Results: The treatment of intertrochanteric fractures has undergone an evolving concept from conservative treatment to surgical treatment. Surgery strategies include extramedullary fixation and intramedullary fixation. Intramedullary fixation has gradually become the main treatment of intertrochanteric fractures due to its minimally invasive and biomechanical advantages. However, the current intramedullary fixation system still can not reconstruct the medial cortical support of the proximal femur, which leads to some failures in the treatment of unstable fractures. Conclusion: The development of internal fixation of intertrochanteric fractures is based on the deep understanding and biomechanical theory of intertrochanteric fractures in clinical practice. In the future, the updated design of internal fixation devices will depend on the treatment principle of reconstruction of medial support and secondary stabilization of intertrochanteric fractures, and finally the purpose of improving success rate and reducing postoperative complications of intertrochanteric fracture will achieved.
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BACKGROUND: Cortical suspensory femoral fixation is commonly performed for graft fixation to the femur in anterior cruciate ligament (ACL) reconstruction using hamstring tendons. The purpose of this study was to compare graft healing in the femoral tunnel, implant-related failure, and clinical results between fixed- and adjustable-length loop devices in outside-in ACL reconstruction. METHODS: A total of 109 patients who underwent ACL reconstruction using the outside-in technique from December 2010 to July 2014 were included. For femoral graft fixation, a fixed-length loop device was used in 48 patients (fixed-loop group) and an adjustable-length loop device was used in 61 patients (adjustable-loop group). For evaluation of graft healing in the femoral tunnel, magnetic resonance imaging was performed at postoperative 6 months and the signal-to-noise ratios (SNRs) of the tendon graft and tendon-bone interface in the femoral bone tunnel were evaluated. The presence of synovial fluid was evaluated to determine loop lengthening at the femoral tunnel exit. Clinical results assessed using International Knee Documentation Committee score, Tegner-Lysholm Knee Scoring scale, and knee instability tests were compared between groups. RESULTS: The SNRs of the tendon graft and tendon-bone interface were not statistically different between groups. The presence of synovial fluid at the femoral exit showed no statistical difference between groups. Clinical results were not significantly different between groups. CONCLUSIONS: The adjustable-length loop device provided comparable graft healing, implant-related failure, and clinical results with the fixed-length loop device, allowing adaptation of the graft to the different tunnel lengths. Therefore, it could be effectively used with an adjustment according to the femoral tunnel length.
Subject(s)
Humans , Anterior Cruciate Ligament Reconstruction , Anterior Cruciate Ligament , Femur , Knee , Magnetic Resonance Imaging , Signal-To-Noise Ratio , Synovial Fluid , Tendons , TransplantsABSTRACT
Objective To study the effect of clinically applying catheter fixing device to fix indwelling needle in vein. Methods From July to September 2015, 3 725 patients using ordinary transparent dressing to fix the venous indwelling needle for infusion were assigned in the traditional fixed group, while from November 2015 to January 2016, 3 615 patients applying catheter for fixation and using dressing A type ventilation glue to fix intravenous indwelling needle for infusion were taken as a new fixed group. The detachment rate of venous indwelling needle from tube, rate of again paste film change due to the curl of film edge, the incidence of medical adhesive-related skin injury (MARSI), rate of allergy to medical paste, rate of nurse again fixing the tail of the venous indwelling needle and rate of patient satisfaction in two groups were observed. Results The detachment rate of intravenous indwelling needle from tube [0 vs. 0.75% (28)], rate of again changing paste film [1.55% (56) vs. 11.3% (421)], incidence of MARSI [0 vs. 0.72% (27)], rate of allergy to medical paste [0.06% (2) vs. 0.72% (27)], rate of nurse again fixing venous indwelling needle tail [3.54% (128) vs. 57.5% (2 141)] of new fixed group were obviously less than those of traditional fixed group, the difference being statistical significant (all P < 0.05); the rate of patients' satisfaction of new fixed group was significantly higher than that in traditional fixed group [96.0% (3 576/3 725) vs. 78.6% (2 841/3 615),χ2= 98.135, P = 0.015], the difference being statistically significant (P < 0.05). Conclusion Patients using catheter fixation device to fix venous indwelling needle for infusion can protect the blood fluently flowing through the vascular pathway, avoid inducing the occurrence of complications due to poor fixation, reduce the amount of nurse workload and elevate the rate of patients' satisfaction.
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Objective To develop a new radial artery puncture fixing device to conquer the deficiencies of traditional method. Methods The device was composed of an arm support,a hand support,a wrist part,an arm fixing belt,a palm fixing belt and a tourniquet.The arm support was concave-shaped,and was connected with the hand support with the wrist part.The wrist part had a raised block which was gifted with an inflatable bag.The balloon linked with an inflation balloon with an inflation tube.There was a valve between the inflation tube and balloon.The fixing belt had one end directly connected with the arm support, hand support and wrist part, and the other end linked with the other ends of the above components with Velcro. There was a compression hemostatic balloon at the internal surface of the tourniquet. Results The device behaved well in puncture time and success rate,and decreased the incidence rates of errhysis and hematoma after withdrawing the puncture needle while increased the satisfaction of medical staffs and patients. Conclusion The device gains advantages in simple structure,convenience,practicability and safety,and meets the desired requirements.[Chinese Medical Equipment Jour-nal,2018,39(5):44-46]
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Objective To design a new type of external fixator for bone fracture and verify its rationality and feasibility. Methods The frame and screw of stainless steel achieved fracture fixation in vitro with a threaded locking structure.At the same time the increasing thickness of body frame, the inclined nail holes and the raised bottoms were designed to greatly enhance the strength and overall stability of body frame.FEM (finite element method),measuring the relative displacement and stress distribution after axial load,was used to verify the rationality of the design.An animal experiment with sheep was used to verify the feasibility of fracture treatment. Results Simulated result of FEM indicated that the biggest relative displacement between the separated bones was 0.04 mm,which was much less than the minimum value 1 mm required for fracture healing.The maximum stresses applied on the frame of the fixator,fixator screw,and bone were 35,26,and 6 MPa, respectively, which was much less than the allowable stress. In the animal experiment, fracture site was fixed firmly after operation and was well cured 3 months later.Conclusion The design of this new device is feasible and it can be used as a new method of fracture treatment.
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Objective To evaluate effects of design of compression and fixation device for wound after permanent pacemaker implantation on compression hemostasis, working intensity of nursing staff and patients′ comfort. Methods Cotton cloth, Velcro tape and snap-fastener were used to design a compression and fixation device for wound after permanent pacemaker implantation. Sixty patients after permanent pacemaker implantation were randomly divided into compression and fixation device group (observation group), and traditional compression group (control group). In addition, the effects of postoperative complications, allergy to medical tape and working intensity of nursing staff for caring wound were evaluated. Results Comparing to the control group, there were significantly lower incidence rate of skin allergy (P<0.05) and shorter working hours needed for nursing staff to care wound (P<0.05).The complications of two groups have no significant differences (P>0.05). Conclusions This design of compression for wound after permanent pacemaker implantation is able to decrease working intensity of nursing staff, improve patients′comfort and show no effects on increasing postoperative complications.
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Objective To evaluate effects of design of compression and fixation device for wound after permanent pacemaker implantation on compression hemostasis, working intensity of nursing staff and patients′ comfort. Methods Cotton cloth, Velcro tape and snap-fastener were used to design a compression and fixation device for wound after permanent pacemaker implantation. Sixty patients after permanent pacemaker implantation were randomly divided into compression and fixation device group (observation group), and traditional compression group (control group). In addition, the effects of postoperative complications, allergy to medical tape and working intensity of nursing staff for caring wound were evaluated. Results Comparing to the control group, there were significantly lower incidence rate of skin allergy (P<0.05) and shorter working hours needed for nursing staff to care wound (P<0.05).The complications of two groups have no significant differences (P>0.05). Conclusions This design of compression for wound after permanent pacemaker implantation is able to decrease working intensity of nursing staff, improve patients′comfort and show no effects on increasing postoperative complications.
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OBJECTIVE:To evaluate the effects of clinical pharmacists'intervention on prophylactic use of antibiotics in re-moval of internal fixation device for fracture. METHODS:Totally 117 patients underwent removal of internal fixation device for fracture were selected from some on third grade class A hospital during Mar.-Jul. 2015 as pre-intervention group. Totally of 266 pa-tients underwent removal of internal fixation device for fracture were selected during Aug. 2015-May 2016 as post-intervention group. Clinical pharmacists performed interventions based on Rationality Evaluation Criteria for Prophylactic Use of Antibiotics in Removal of Internal Fixation Device for Fracture. The prophylactic use of antibiotics was compared between 2 groups before and af-ter intervention. RESULTS:No unreasonable single dose or additional drug during surgery was found before and after intervention. After intervention,utilization rate of antibiotics for prophylactic use,the proportion of patients receiving antibiotics without indica-tions,the proportion of medication duration more than 24 h decreased from 84.6%,71.8%,48.7% to 17.3%,9.8%,4.9%,re-spectively. Average antibiotics cost,the proportion of total drug cost in hospitalization cost,the proportion of antibiotics cost in to-tal drug cost were all decreased significantly compared to before intervention,with statistical significance(P0.05). CONCLUSIONS:Clinical pharmacists'interventions significantly reduce the utilization rate of antibiotics for pro-phylactic use in patients underwent removal of internal fixation device for fracture,improve drug use without indications and ratio-nality of prophylactic use of antibiotics. There still are problems,such as unreasonable medication timing,continuous use time of more than 24 h,etc. It is necessary to continuous follow-up intervention.
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The anterior cruciate ligament (ACL) TightRope RT (TR) was recently introduced as a novel cortical suspension device for ACL reconstruction. It has an adjustable graft loop that gives the surgeon some advantages during ACL reconstruction. We report three patients who required removal of the TR after an outside-in anatomical ACL reconstruction because of lateral knee pain. We assumed that the knee pain was associated with friction between the TR button of the posterolateral bundle and iliotibial band (ITB). Placing the TR button close to the lateral epicondyle and tissue interposition between the TR button and lateral femoral cortex may be potential risk factors for ITB irritation. Therefore, we recommend not placing the TR button close to the top of the lateral epicondyle and reducing the tissue interposition between the TR button and lateral femoral cortex as much as possible.
Subject(s)
Humans , Anterior Cruciate Ligament Reconstruction , Anterior Cruciate Ligament , Friction , Knee , Risk Factors , TransplantsABSTRACT
Objective To summarize the clinical effect of transpedicular Dynesys dynamic fixation for treating degenerative lum-bar disease.Methods 34 cases of degenerative lumbar disease were treated by transpedicular Dynesys dynamic fixation and per-formed the retrospective analysis.The VAS score of lumbago was (6.01±0.98),the VAS score of skelalgia was (5.47±0.63), ODI was(64.47 ±2.06)%.The cranial intervertebral space height in the fixed segment was(12.01±1.08)mm,the intervertebral space height in the fixed segment was(11.47±1.13)mm;the caudal intervertebral space height in the fixed segment was(11.95± 1.06)mm;the intervertebral motion range of the cranial segment in the fixed segment was(8.11±1.21)°,the intervertebral motion range of the fixed segment was(8.47±1.63)°,the intervertebral motion range of the caudal segment in the fixed segment(7.86± 1.36)°.39 intervertebral spaces in 27 cases adopted the decompression combined with Dynesys fixation,the single intervertebral space in 7 cases was performed with Dynesys fixation alone.Results All patients smoothly pulled through the perioperative period. No complications of wound infection,leakage of cerebralspinal fluid and nerve inj ury occurred,wound infection,leakage of cerebro-spinal fluid and nerve injury.All patients were followed up for 25-45 months,averaged 31.2 months.The VAS score of lumbago at the last time of follow up was (1.85±1.03),the VAS score of skelalgia was(1.54±0.18),ODI was(11.42±1.51)%,the cranial intervertebral space height in the fixed segment was(11.85±0.93)mm,the intervertebral space height of the fixed segment was (11.34±1.02)mm,the caudal intervertebral space height in the fixed segment was(11.62±0.97)mm;the intervertebral space motion range of the cranial segment in the fixed segment was(8.85 ± 1.33)°,the intervertebral space motion range of thye fixed segment was(4.54±1.78)°,the intervertebral space motion range of the caudal segment in the fixed segment was(7.62±1.21)°. Conclusion Transpedicular Dynesys dynamic fixation for treating degenerative lumbar disease can confine and reserve the motion range of the fixed segment,lessen lumbago and skelalgia,improve the function of waist and leg and have no obvious influence on the adjacent segment,its short-term therapeutic effect is satisfactory,but long-term therapeutic effect needs the clinical observation of long time and large amount cases.
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Objective To explore the efficacy and safety of coflex interspinous dynamic fixation device implantation in the lumbar spinal stenosis. Methods Eighty-three patients with lumbar spinal stenosis were randomly divided into two groups, and 80 cases were followed up. Coflex group (38 patients) received coflex implantation,posterior lumbar interbody fusion (PLIF) group(42 patients) received PLIF treatment. Indicators of surgical trauma degree (operation time, blood loss volume, wound drainage volume within 48 hours, incision pain (VAS) score after surgery 3 days,postoperative ambulation time),indicators of clinical effect (waist and leg pain VAS scores,Japan Orthopaedic Association JOA score,Oswestry functional disability index ODI score),intervertebral space height and median sagittal diameter (MSO) were measured and compared between the two groups. Results In the Coflex group, the operation time, blood loss volume, wound drainage volume within 48 hours, incision pain (VAS) score after surgery 3 days,postoperative ambulation time were (104.3 ±9.5) min,(230. 7 ±29.6) ml,(110. 6 ±34. 5)ml,3. 2 ±1.3, (13. 6 ±2.0) d,which were significantly lower than those of (174. 6 ±24. 2) min,(536. 8 ±163.3) ml, (319. 2 ± 142. 8) ml,4. 8 ±2. 7, (15. 7 ±2. 6) d in the PLIF group(t= 16. 720,11. 380,8. 771,3. 320,4.018,Ps 0. 05) on severe complications such as internal fixation loosening and spinous process fractures.Conclusion The two surgical methods both can effectively increase the foraminal area and intervertebral height to maintain the stability of the spinal posterior colum. However, Coflex interspinous dynamic fixation device implantation had more advantages,such as shorter operation time,less bleeding,less trauma,and early functional exercises.
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OBJETIVO: Avaliar a diferença do comportamento mecânico de tendões flexores solidarizados e não solidarizados para verificar se a solidarização tem função efetiva. MÉTODOS: Vinte e quatro tendões digitais bovinos frescos foram usados. Para determinar a área da secção transversal utilizou-se alginato. Dez tendões foram solidarizados seguindo as orientações do fabricante; outros 10 pares não. Foram desenvolvidas garras para fixação dos enxertos à máquina universal para simulação da fixação, sendo a superior bipartida e de passagem controlada dos pinos e a inferior com dentes alternados. RESULTADOS: A carga máxima dos corpos de prova não solidarizados foi de 849,4 N ± 386,8 a área 30,4 mm²± 7,7, tensão de 29 ± 17 Mpa. Os solidarizados obtiveram carga máxima de 871,8 N ± 484,9 área 35 mm²± 5,8, tensão de 24 ± 10 Mpa. Não houve diferença estatística entre os dois grupos (p>0,05). CONCLUSÃO: A distribuição de probabilidade mostra que para 400 N os tendões não solidarizados apresentam confiabilidade de 83,8 por cento e os solidarizados de 78,5 por cento por cento.
OBJECTIVE:To evaluate the difference of the mechanical behavior of bended tied (sewed) and not tied hamstring tendons in order to evaluate if it has any effective function. METHODS: Twenty-four fresh bovine digital tendons had been used. Alginate to determine the area of the tendon transversal section was used. Ten bovine tendons had been bended and tied following the manufacturer orientation, ten others pairs had not been tied. Claws had been developed for the grafts fixation to the universal machine, for the setting simulation. The superior one was characterized to be bipartite and to have controlled passage for the pins and the inferior claw is characterized to have alternating teeth. RESULTS: The maximum load of the not tied samples of the test was 849,4 N ± 386,8 the area was 30,4 mm² ± 7,7, and 29 ± 17 Mpa of tension. The tied ones had gotten maximum load of 871,8 N ± 484,9, area of 35 mm² ± 5,8, and 24 ± 10 Mpa of tension. It did not have statistical difference between the two groups (p>0,05). CONCLUSION: The probability distribution showed that with 400 N the not tied tendons represents 83,8 percent of trustworthiness and the tied ones represents 78,5 percent.
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Animals , Cattle , Anterior Cruciate Ligament/surgery , Suture Techniques , Tendons/surgery , Anterior Cruciate Ligament/physiology , Biomechanical PhenomenaABSTRACT
[Objective]To research the effect of using Ilizarov technique in bone transmission and fascia skin flap for large defeciency of bone and soft tissues of lower limb.[Method]There were 12 patients in our group,11 patients had severe compound trauma of the leg,one in arm.Bone defeciency range was 4～12 cm,average 8 cm,cotaneous defeciency was 4?5 cm2～14?5 cm2,and all of them had acute infection.Nine had been treated with leg lateral fascia skin flap,1 had been treated with leg fascia skin flap,1 had been treated with the opposide leg skin flap,1 had been treated with the arm fascia skin flap,in 12 bone transport,elongation range was 4～12 cm,average 8 cm.Eight had been used double arms external fixation device,4 cases had been used circle shape external fixation device.[Result]Totally 12 patients were followed up for 2～10.8 years(average,4.2 years) elongation part and compressed part healed naturally,all of the fascia shin flap were alive.No bone ununion and chronic osteomyelitis appeared.[Conclusion]Using Ilizarov bone transport technique and fascia skin flap is a good way for treating large defeciency of bone and soft tissue.Its advantages:(1)The wound limb can maintain stability by external fixatian device.The methed of the bone transportation can fill big section bone deficiency;(2) In the same time the fascia shin flap may be transported,and repair soft tissue deficiency,provide good condition to bone's healing and control infection;(3)The external fixation device can provide distraction and compression functions,this function makes elongation part and compressed part obtain the reasonable biomechanics condition which would be good to bone healing;(4)The course of bone transmission can stimulate bone repair mechanisms,to enhance the wound limb metabolism,increase blood supply circularation,the grown bone factor aggregation,enhance the body's initiative repair mechanisms and infection controlling mechanism;(5)In the protection of the external fixation device,the patient's wound limb can do early rehabilitation,thus can avoid osteoporosis and joint dyfunction because of the lone-term immobility;(6)To use these methods,the treatment period will be shortened,antibiotic application will be decreased,the treatment cost will be lower than other methods and complications will be decreased as well.
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@#ObjectiveTo observe the clinical therapeutic effect of postoperative infection of fracture bone of lower extremity treated with external fixation device combined with closed irrigation.Methods32 patients of long bones fracture of lower extremities with postoperative infections were treated with composite external fixation device combined with focus clearance and continuing closed irrigation.ResultsThrough 1.5～3 years follow-up, there was no infection relapse in 31 extremities, 26 bones' fractures healed in half a year, there was no malunion such as crispation or angulation and there was no complication of serious anchylosis.ConclusionIt is an efficient way to treat postoperative infection of fracture bone of lower extremity with external fixation device combined with closed irrigation.
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PURPOSE: We wanted to improve the setup reproducibility of breast cancer patients when utilizing a commercially available breast board for radiation therapy. The breast board was modified by using a new head rest and 2 types of board fixation devices. MATERIALS AND METHODS: A conventional head/neck rest was modified to be positioned in various slots of the breast board, and it was fabricated 1 cm thinner to provide more comfort to a patient when the patient's neck was rotated. This rest improves the uncertainty of the daily setup. Also, the sagging problems at the left and right sides became negligible with the two types of board fixation devices: (1) the stair type, and (2) the arm type. The first device consists of an upper/lower holder with 4 stair-types of grooves and 4 rectangular inserts. In order to cover the whole range of vertical setup of the breast board, 4 rectangular inserts were needed, and each covered 10 steps. The arm-type fixation device was also fabricated and attached to the breast board. It had two aluminum bars that were fixed by utilizing a lock-type of screw. These devises were evaluated with two volunteers in order to prove the effectiveness of the improved setup accuracy. RESULTS: The developed cranio-caudal fixation device demonstrated that it could reduce the cranio-caudal error by nearly 55% compared to the old device. As for left-and-right inclination, the stair-type and arm-type fixation devices can reduce the relative inclination by nearly 80% and 90%, respectively, compared to the breast board without the fixation device. CONCLUSION: It was verified that the developed devices were effective for positioning the patients and for avoiding inclination of the breast board.