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Resumen Introducción: Las lesiones de la mano son uno de los padecimientos más frecuentemente atendidos en el Servicio de Cirugía Plástica y Reconstructiva del Hospital Central Militar, dentro de la amplia variedad de estas lesiones se encuentran las lesiones del sistema flexor. Objetivo: Estimar la incidencia, funcionalidad y tiempo de reintegración laboral en pacientes con lesiones de sistema flexor de la mano tratados en el Hospital Central Militar en el periodo del 1º de marzo del 2020 al 1º de marzo del 2022. Metodología: Estudio observacional, retrospectivo, longitudinal descriptivo en pacientes adultos con lesión de sistema flexor de la mano, en los cuales la causa de la lesión no haya condicionado un trauma complejo de la mano. Se utilizó como referencia los criterios de recuperación funcional de Strickland y Goglovac. Resultados: A pesar de que las lesiones de la zona II flexora en la literatura presentan un peor pronóstico para la recuperación de la función normal de la mano, los resultados demuestran que la mayor parte de los pacientes se encuentra en una escala funcional buena. Limitaciones del estudio: El estudio fue llevado a cabo durante el periodo comprendido por la pandemia COVID, por lo que las consultas subsecuentes con tiempos más alargados y el inicio tardío de las consultas de rehabilitación pudieron haber contribuido hacia una recuperación más deficiente de la recuperación funcional de los pacientes.
Abstract Introduction: Hand injuries are one of the conditions most frequently treated in the Plastic and Reconstructive Surgery Service of the Hospital Central Militar, within the wide variety of these injuries are injuries to the flexor system. Objective: To estimate the incidence, functionality and labor reintegration time in patients with hand flexor system injuries treated at the Hospital Central Militar in the period from March 1, 2020 to March 1, 2022. Methodology: Observational, retrospective, longitudinal, descriptive study in adult patients with injury to the flexor system of the hand, in whom the cause of the injury did not result in complex trauma to the hand. The Strickland and Goglovac functional recovery criteria were used as reference. Results: Despite the fact that flexor zone II lesions in the literature present a worse prognosis for the recovery of normal hand function, the results show that most of the patients are in a good functional scale. Limitations of the study: The study was carried out during the period covered by the COVID pandemic, so that subsequent consultations with longer times and the late start of rehabilitation consultations could have contributed to a poorer recovery of functional recovery. from the patients.
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OBJECTIVE@#To assess the effectiveness of a novel minimally invasive Achilles tendon suture instrument in the treatment of fresh closed Achilles tendon rupture.@*METHODS@#A retrospective study was conducted on 150 patients who underwent surgical intervention for fresh closed Achilles tendon rupture. Eighty patients were treated with the novel minimally invasive Achilles tendon suture instrument (minimally invasive group) and 70 patients with traditional open surgery (traditional group). The two groups were comparable in terms of gender, age, injured side, cause of injury, the interval between injury and operation, and the distance from the fracture end to the calcaneal tuberosity ( P>0.05). The operation time, intraoperative blood loss, incision length, hospital stays, hospitalization expenses, and complications were recorded and compared. At 1 year after operation, the ankle joint function was evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score.@*RESULTS@#The minimally invasive group demonstrated significantly shorter operation time, smaller incision length, and lower intraoperative blood loss when compared with the traditional group ( P<0.05). However, there was no significant difference in terms of hospital stays and hospitalization expenses between the two groups ( P>0.05). All patients were followed up 12-24 months after operation (mean, 15.5 months). In the traditional group, 6 cases of incision necrosis and 7 cases of Achilles tendon adhesion occurred, while in the minimally invasive group, all incisions healed at first intention and no Achilles tendon adhesion occurred. The differences in the incidences of the two complications between the two groups were significant ( P<0.05). At 1 year after operation, the AOFAS ankle-hindfoot score in the minimally invasive group was superior to that of the traditional group ( P<0.05).@*CONCLUSION@#In comparison with traditional open surgery, the use of self-designed novel minimally invasive Achilles tendon suture instrument proves to be an ideal technique for treating fresh closed Achilles tendon ruptures. This approach offers the benefits of smaller incisions, fewer complications, and better postoperative functional recovery, without increasing hospital costs.
Subject(s)
Humans , Blood Loss, Surgical , Retrospective Studies , Neurosurgical Procedures , Achilles Tendon/surgery , Tendon Injuries/surgery , Ankle Injuries , Surgical Wound , SuturesABSTRACT
Objective: To investigate the effectiveness of modified suture technique in the treatment of acute closed Achilles tendon rupture.
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[Objective]To investigate new methods of the management of closed rupture of Achilles tendon surgery to reduce postoperative skin necrosis.[Method]Small incisions and Absorbable sutures were used to manage 39 cases of closed Achilles tendon rupture,with proximal stump a Bunnell-type suture and remote stump percutaneous repair.[Result]In the 39 cases,three developed slight skin necrosis,of which two healed by changing dressings,the other one healed by debriding and sutureing.Follow-up of 10 months to 36 months was available for 35 cases.According to Arner-Lindholm efficacy evaluation standard,29 cases (82.9%) had excellent result,4(11.4%) had good result,with the good to excellent result of 94.3%.[Conclusion]Small incisions and Absorbable sutures used to manage the closed Achilles tendon rupture,with proximal stump a Bunnell-type suture and remote stump percutaneous repair is an effective and reliable methord for closed Achilles tendon repture,with small invasion,less impact on the skin blood supply,less skin necrosis,less re-rupture reinfection,and faster recovery.
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45 patients with closed injury of the kidney who underwent CT scanning and an internal therapy or an operation at Viet Duc Hospital were studied. Results showed the high values of the diagnosis of morphological injuries in casualty of kidney such as morphological change, contusion and parenchymal congestion, kidney rupture, retroperitoneal congestion, with absolute level of sensitivity and positive predictive value at high level. Moreover, CT scanning permitted the diagnosis of combining injuries of various organs in abdomen cavity and the evaluation of the function of injured kidney and healthy kidney through the contrast injection CT scanning could evaluate the kidney injury with 90.5% of accuracy. 3/3 cases of grade IV damage and 93.3% of grade III damage were detected. The damages of grade II and grade I detected in CT scanning were treated internal and got good clinical progress
Subject(s)
Tomography, X-Ray Computed , Diagnosis , Wounds and Injuries , KidneyABSTRACT
Objective To observe the effect of physical factors and promotion canalization on closed injury of brain.Method 68 cases of closed injury of brain were given the comprehensive rehabilitation therapy with many physical factors and promoting canalization technique.Result The patients' consciousnesses were significantly improved after treatment.The motorial function of hemiplegic limbs was distinctly improved(P< 0.05).The balance functions were distinctly improved(P< 0.001).The activities of daily living abilities were significantly improved(P< 0.05).Conclusion The physical factors and promoting canalization treatment on the closed injury of brain are functionally effective.
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Objective To explore the diagnosis and surgical treatment for rupture of small intestine.Methods Diagnostic methods and surgical treartment of 78 closed rupture of small intestine were analyzed retrospectively.Results The positive rates of abdominal puncture and abdominal X ray were 89.7% and 32.0%,respectively 30.7% cases were complicated with other organs injured.All the patients were performed on the surgical operation,among which repairment for the small intestine rupture was performed in 58 cases(74.4%),partial resection of small intestine was performed in 18 cases (23.1%) and anastomsis of small intestine performed in 2 cases (2.5%).4 cases were reoperated because of delayed rupture of small intestine.3 cases died of MODS.Conclusion Diagnostic abdominal puncture plays an important role in the early diagnosis of closed rupture of small intestine.The selection of operative method is based on the degree of rupture.Suitable application of antibiotics is the key to reducing the complications.