Filtration of the Best Medicine Concentration for Treatment of Open Soft Tissue Damage with the Improved Gudaofang / 现代医院

Objective To observe the clinical efficacy of improved Gudaofang at different concentrations for the treatment of soft tissue damage so as to determine its optimal concentration.Methods 150 patients with open soft tissue damage treated in our hospital from June 2014 to June 2016 were randomly divided into treatment Group A (n=40) and Group B (n=40), Group C(n=30)and control Group D (n=40).Group A, Group B and Group C were treated with 10%, 20%, 30% of improved Gudaofang respectively, while the control Group D was treated with 75% of alcohol.Its clinical efficacy was evaluated by tenderness score and swelling degree.Results Compared with post-treatment, different concentrations of improved Gudaofang significantly reduced the tenderness score and swelling degree (P<0.05).The total effective rate of Group A, Group B, Group C were 92.5%, 97.5% and 97.5%, respectively, were significantly better than the control Group D with 77.5% (P<0.05).Conclusion Different concentrations of improved Gudaofang has a certain clinical efficacy on treating open soft tissue damage.20% concentration of improved Gudaofang has the best cost-effective and is optimal drug concentration.

Application of feet wrist branch perforators flap transplantation free re-pair of hand skin soft tissue defect / 中国现代医生

Objective To explore feet wrist of artery perforators flap free transplantation repairing skin and soft tissure defect of hands. Methods From January 2012 to October 2013 in our hospital ,selected 19 cases of hand skin soft tis-sue defect in the patients with ulnar artery wrist free perforators flap transplant , blood vessels by end to end anasto-mosis method. Results In 19 patients with postoperative flaps all survived, and after follow-up, the appearance of the skin flap, texture and color are satisfied, finger function and sensation recovery are satisfied, two-point discrimination 8~17 mm,the average 9 points to distinguish sleep <10 mm,flap sensation recovery S3 class above,for area feel no ef-fect on daily work and life. Finger function evaluation criteria:15 cases were best,3 cases were better, and 1 case was poor, fine rate was 94.7%. Conclusion Wrist branch perforators flap repair of hand skin soft tissue defect free trans-plantation effect is remarkable,patient tolerance degree is high,the fingers feel and function recovered well,does not affect the hand appearance,worth clinical promotion use.

The Relationship between Soft Tissue Damages and Neurologic Deficits in Distractive Extension Injury of the Lower Cervical Spine / 대한정형외과학회잡지

PURPOSE: To evaluate the relationship between the damage to anterior soft tissues and neurological deficit in distractive extension injury of the lower cervical spine. MATERIALS AND METHODS: Ninety-two patients who were treated surgically for distractive extension injury of the lower cervical spine were included in this study. Soft tissue swelling was evaluated on plain radiographs. Damage to the longus colli muscle, anterior longitudinal ligament, superior end plate, inferior end plate, annulus fibrosus, and posterior longitudinal ligament were intraoperatively checked and the relationship between these findings and clinical neurologic deficits was analyzed. RESULTS: Soft tissue swelling was increased to 92% in the retropharyngeal space and to 89% in the retrotracheal space but there was no significant difference. No relationship was found between the damage to the prevertebral fascia, longus colli muscle and neurological deficit. Injuries to the inferior end plate and annulus fibrosus showed a directly propotional relation with neurological deficit, but it was not significant. Injuries to the anterior longitudinal ligament (p<0.01), superior end plate (p=0.02), posterior longitudinal ligament (p=0.04) showed significant relations with neurological deficit. CONCLUSION: The distractive extension injury combined with the damage to the anterior longitudinal ligament, superior end plate or posterior longitudinal ligament showed high frequency of neurological deficit. Hence, these are regarded as the important structures for maintaining the stability of the lower cervical spine.

Soft Tissue Damage in Cervical Spine Extension Injury / 대한정형외과학회잡지

PURPOSE: To diagnose the extent of soft tissue damage with MRI, and to evaluate the relationship between soft tissue damage and a spinal cord injury in an extension injury to the lower cervical spine trauma. MATERIALS AND METHODS: Eighty-one patients who treated surgically for an anextension injury to the cervical spine over the past 5 years, were analyzed. All patients had undergone MRI after the injury, and for the specific grading of soft tissue damage, the grades were defined from grades 1 to 5. RESULTS: The spinal cord injury developed with more than grade 3 soft tissue damage associated with a rupture of the posterior longitudinal ligament (p<0.01). The changes in signal intensity of the spinal cord also developed according to the severity of soft tissue damage (p<0.01). There was no relationship between the soft tissue damage and the spinal cord injury in spinal stenosis (p=0.75). CONCLUSION: The extent of soft tissue damage was diagnosed precisely with MRI, and there was an close relationship between the soft tissue damage and spinal cord injury in the distractive- extension injury to the lower cervical spine trauma.

Relationship between Soft Tissue Damages and Spinal Cord Injury in Lower Cervical Spine Trauma / 대한정형외과학회잡지

PURPOSE: To determine the implications of soft tissue damage and to evaluate the correlations between the extent of soft tissue damages and spinal cord injury after a lower cervical spine trauma. MATERIALS AND METHODS: This study analyzed the medical records, plain radiograms, and MRI of the consecutive 89 patients who underwent operative treatment in the lower cervical trauma. The radiological parameters of soft tissue damage including anterior longitudinal ligament (ALL), intervertebral disc (Disc), posterior longitudinal ligament (PLL), ligamentum flavum (LF), interspinous ligament (ISL), supraspinous ligament (SSL), posterior muscle group (PM), cord compression (CC), and cord signal changes (CS) were evaluated using plain radiograms and magnetic resonance imaging. The relationship between the level of cord injury and the type of soft tissue damage, injury type and severity was determined. RESULTS: There was a significant correlation between the extent of cord injury and the injury type. Cord injury frequently occurred as a result of compressive extension (3 of 4 cases), combined injury (4 of 7 cases) and distractive extension (14 of 23 cases). On the other hand, only 11 of the 16 cases with compressive flexion had a cord injury. In the distractive-extension cord injury cases (2 out of 10 cases in stage I, 12 out of 13 cases in stage II) the frequency of cord injury increased with increasing degree of the soft tissue damage. The incidence of cord injury was higher in the distractive-flexion cases (stage I, 0 out of 6 cases, stage II, 8 out of 35 cases, stage III, 3 out of 5 cases), (p=0.082). Multiple logistic analysis revealed a significant correlation between the cord injury and soft tissue damage including parameters such as the injury type, PLL injury, CC and CS. There was more frequent cord injury encountered in patients with more extensive injuries to the posterior neck muscles (p=0.063). CONCLUSION: There was a significant correlation between the injury type and the incidence of cord injury. In distractive extension and distractive flexion, there was more increasing incidence of cord injury with increasing severity of the injury. In addition, there was a high incidence of cord injury associated with not only the injury type but also a PLL and posterior neck muscle injury.