ABSTRACT
Objective:To determine the effectiveness of the interve ntion of burning mouth syndrome(BMS) reported by Chinese articles and to assess the quality of the studies by evidence-based medicine. Methods: relevant literatures were searched and identified in Chinese Medical Bio logical Database (CMB) and Chinese Technological Periodical Database (VIP) . Stu dies were selected with following criteria: study design- randomized controlle d trials; participants-patients with BMS. An evidence-based analysis was perfo rmed to the literatures. Results: There were totally 47 articles examined and only 11 of them met the criteria . Meta analysis was not possible due to the low quantity and poor quality, However, as far as the p ublished articles concerned, Lusunjing capsule showed good short-term effect in the treatment and nerve block with vitamin B 1 and B 12 was more effec tive than oral admenistering of vitamin. Conclusion: Th e quantity and quality of the reviewed studies are far from satisfaction and ca n not meet the clinical needs. Further trials of high methodological quality ne ed to be undertaken in order to develop effective treatment of BMS.
ABSTRACT
Objective To explore the results of surgical treatment for disp la ced intra-articular glenoid fractures. Methods From June 1997 to June 2002, 19 p atients with more than 5 mms displaced glenoid fractures were open reduced and internally fixed. All fractures were classified according to Ideberg system, ty pe-Ⅰ fractures in 8 cases, Type-Ⅱ in 2, Type-Ⅲ in 3, Type-Ⅳ in 2, and Type-Ⅴ in 4 were retrospectively analyzed. The incidence of associated injuries was 78.9%(15/19). According to their patterns, fractures were exposed through poste rior approach (11 cases), anterior approach (6 cases) and posterosuperior approa ch (2 cases) and fixed with reconstruction plates and lag screws after satisfyin g reduction. Results All patients were followed up for an average of 17.5 months . According to Constant and Murley score, the median score was 93(range 11-100, mean 81). Fractures were manipulated under direct vision and anatomical reductio n was accomplished in 16 fractures. The radiographs showed a residual displaceme nt of more than 2 mm in 3 fractures after operation. The post-traumatic shoulder arthritis was found in 2 cases and the glenohumeral joint instability in 1 case . Conclusion To glenoid rim fractures combined humeral head subluxation, more th an 3-5 mm step-off displaced intra-articular fractures, and superior shoulder su spensory complex injury associated with glenoid fractures, early surgical interv ention is required to restore shoulder joint functions. The prognosis of glenoid fractures is determined by multiple factors such as associated injuries, qualit y of fracture reduction and surgical complications.
ABSTRACT
Objective To summarize the surgical techniques and results of b oth-column acetabular fracture through combination of ilioinguinal and Kocher-La ngenbeck approaches. Methods Between March 1990 and July 2001, 66 patients affec ted by both-column acetabular fractures were treated surgically through the comb ination of ilioinguinal and Kocher-Langenbeck approaches. There were 39 males an d 27 females with an average age of 37 years (range, 19 to 56 years). According to Letournel classification, all patients were diagnosed as the both-column frac tures of acetabulum. Of 66 patients, 14 were associated with dislocation or subd islocation of femoral head, 8 with dislocation of ipsilateral sacro-iliac joint, and 8 with intra-articular fragments. The interval from injury to operation was within 2 weeks in 24 and more than 2 weeks in 42. The surgical indications were as follows: 1) dislocation of both column fractures over 3 mm; 2) anterior colu mn fracture associated with severe posterior column comminuted fracture or poste rior wall fracture; 3)injury lasting more than 2 weeks; 4) injury associated wit h femoral head dislocation; 5) injury associated with intra-articular fracture f ragment. Postoperative reduction quality and long-term radiographic results were evaluated according to the Matta and the Epstein criterion separately; the d’A ubigne rating scale was used for the functional results. Results The average ope rative time was 4 hours, the average blood loss was 1 400 ml. Anatomic reduction were obtained in 57 cases (86%), satisfactory reduction in 6 (9%) and unsatisfa ctory in 3 (5%). The follow-up were from 2 to 13 years with an average of 6 year s. The clinical results were 89% excellent and good, 6% fair and 5% poor respect ively; the roentgenographic results were 82% excellent, 10% fair and 8% poor res pectively. 5 cases(8%) with Grade Ⅲ heterotopic ossification were found in Ko cher-Langenbeck approach, and no heterotopic ossification was in ilioinguinal ap proach. There was 1 deep infection (1.5%) in the ilioinguinal approach, and no i nfection in the Kocher-Langenbeck approach. Conclusion The results achieved thro ugh the combined approaches were significantly better than that of the both-colu mn acetabular fractures using the extended iliofemoral approach. The combined ap proach is an ideal method for the operation of the both-column acetabular fractu res with an excellent exposure, satisfactory reduction, shorter operating time, less blood loss, and lower operative complication rate.