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Abstract: Introduction: Distal biceps tear can lead to loss in flexion and supination strength. Early repair in active patients is recommended. Postoperative rehabilitation varies according to surgeon experience and surgical technique used. The aim of this study is to present the results of a series of patients using a standardized home rehabilitation protocol after a distal biceps repair with double incision technique. Material and methods: This is a retrospective case study. We registered 21 patients with distal biceps tear, surgically treated using a double incision technique and transosseous suture fixation, followed by a home-based exercise program. Patients were evaluated using MEPS score, DASH questionnaire, and the subjective/objective scoring system of Andrews and Carson. Radiographic assessment was done for heterotopic bone formation. Results: Mean MEPS was 95 (range 70 to 100), DASH score 0.4 (range 0 to 4.2), and subjective and objective Andrews and Carson score was 99 (range 90 to 100). Two patients developed heterotopic ossifications. Range of motion was recovered in every patient. All patients went back to their previous surgical activities. Conclusions: Patients treated with double incision repair for distal biceps tear can undergo a home rehabilitation protocol, expecting normal range of motion and strength recover.
Resumen: Introducción: Las lesiones del bíceps distal pueden generar pérdida de fuerza de flexión y supinación. En pacientes activos, se recomienda la reparación temprana. La rehabilitación postoperatoria varía de acuerdo con la experiencia del cirujano y la técnica quirúrgica utilizada. El objetivo del estudio es presentar los resultados de una serie de pacientes utilizando un protocolo de rehabilitación estandarizado posterior a la reparación del bíceps distal mediante la técnica de doble abordaje. Material y métodos: Este es un estudio retrospectivo. Se registraron 21 pacientes con lesión del bíceps distal, que fueron tratados quirúrgicamente utilizando un doble abordaje y fijación transósea con suturas, seguido de un programa de ejercicios en el domicilio. Los pacientes fueron evaluados utilizando el score de MEPS, el cuestionario DASH y el puntaje subjetivo/objetivo de Andrews y Carson. Se realizaron radiografías para evaluar osificaciones heterotópicas. Resultados: La media del MEPS fue 95 (rango de 70 a 100), del DASH 0.4 (rango 0 a 4.2) y del score de Andrews y Carson fue 99 (rango 95 a 100). Dos pacientes desarrollaron calcificaciones heterotópicas. El rango de movilidad se recuperó en todos los pacientes. Todos volvieron a sus actividades previas a la cirugía. Conclusiones: Los pacientes que fueron tratados mediante un doble abordaje por lesiones del bíceps distal pueden realizar un protocolo de ejercicios en su domicilio, siendo esperable un rango de movilidad normal y recuperación de la fuerza muscular.
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@#AIM: To explore the effects of double-incision phacoemulsification combined with trabeculectomy on visual acuity, intraocular pressure and complications in patients with glaucoma complicated with cataract. <p>METHODS: The clinical data of each 68 patients(68 eyes)with glaucoma and cataract who were given double-incision(observation group)and single-incision(control group)phacoemulsification combined with trabeculectomy from April 2016 to October 2017 were retrospectively analyzed. The visual acuity and corneal endothelial cell status(density, area)before operation and at 1mo after operation, and occurrence of complications(hyphema, corneal endothelial edema, anterior chamber fibrinous exudation, filtering bleb scarring)within 1mo after operation were recorded in the two groups. And the differences of intraocular pressure and astigmatism degree were compared between the two groups before operation and at 1 and 6mo after operation. <p>RESULTS:At 1mo after operation, the visual acuity in the two groups was better than that before operation(<i>P</i><0.05). However, there was no significant difference between the two groups(<i>P</i>>0.05). At 1mo after operation, the area of corneal endothelial cell in the two groups was larger than that before operation(<i>P</i><0.05)while the density of corneal endothelial cell was lower than that before operation(<i>P</i><0.05), and the changes in control group were greater than those in observation group(<i>P</i><0.05). The total incidence rate of postoperative complications in observation group was significantly lower than that in control group(<i>P</i><0.05). The intraocular pressure in the two groups after operation was lower than that before operation(<i>P</i><0.05), but there was no significant difference between at 1mo after operation and at 6mo after operation(<i>P</i>>0.05). And there was no statistically significant difference between the two groups(<i>P</i>>0.05). The postoperative astigmatism degree in the two groups was higher than that before operation(<i>P</i><0.05), and the index at 1mo after operation was higher than that at 6mo after operation(<i>P</i><0.05), and the index in control group was higher than that in observation group(<i>P</i><0.05). <p>CONCLUSION:Double-incision phacoemulsification combined with trabeculectomy has significant effects on patients with glaucoma and cataract. Although double-incision surgery and single-incision surgery have similar effects in improving visual acuity and intraocular pressure, double-incision surgery has less damage to the operative area, and it can reduce the postoperative corneal endothelial injury and the postoperative astigmatism degree, and it can also reduce the postoperative complications, and has a positive significance in promoting the disease outcomes.
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@#AIM:To investigate the effect of double incision trabeculectomy combined with phacoemulsification and intraocular lens implantation for the treatment of glaucoma complicated with cataract. <p>METHODS:Selected 36 patients(40 eyes)with acute or chronic angle-closure glaucoma and cataract in our hospital from June 2014 to January 2016 were treated with double incision trabeculectomy combined phacoemulsification and intraocular lens implantation. All patients were followed up for 1mo to observe preoperative and postoperative visual acuity, anterior chamber depth, scope of anterior chamber angle open and intraocular pressure. At the same time, we observed the patients' postoperative filtering bleb and intraoperative and postoperative complications.<p>RESULTS: Intraocular pressure before treatment were between 19-36mmHg, the average was 26.02±2.42 mmHg, and after the treatment intraocular pressure was patients between 11-22mmHg, the average was 13.62±4.38 mmHg, preoperative and postoperative intraocular pressure had the obvious difference(<i>t</i>=33.273, <i>P</i><0.05). Preoperatively 85.0%(32 cases, 34 eyes)was with vision less than 0.3, and 53%(19 cases, 21 eyes)after surgery with eyesight over 0.3. All of the eyes formed good filtering bleb after surgery. Scope of anterior chamber angle open, anterior chamber angle open distance and central anterior chamber depth after operation increased in 36 cases compared with preoperative(<i>t</i>=5.832, 5.924, 33.293, <i>P</i><0.05). There were 7 eyes with mild edema of the cornea, all disappear within 3d after surgery; one eye with bleeding when the iris was cut and absorbed after 2d; 4 eyes with fibrin effusion on lens surface and anterior chamber and absorbed with 6d. There were not any other severe complication in this study.<p>CONCLUSION: Double incision trabeculectomy combined with phacoemulsification and intraocular lens implantation for glaucoma with cataract can effectively improve the patient's vision, and can better control the intraocular pressure after surgery.
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Abstract?AIM: To observe the effect of acute angle closure glaucoma with cataract patients treated with glaucoma trabeculectomy combined two incision phacoemulsification and intraocular lens ( IOL ) implantation ( two incision triple surgery) .?METHODS: Patients admitted in our hospital during Jan.2013 to Jan.2016.The acute angle closure glaucoma with cataract patients in 40 cases ( 58 eyes ) were randomly divided into two groups:the observation group of 20 cases ( 29 eyes ) with two incision triple surgery treatment, and the control group of 20 cases ( 29 eyes ) with single incision triple after treatment.Visual acuity, intraocular pressure, bleb, corneal endothelial cell density, the area at 1mo before and after surgery, and postoperative complications of two groups were analyzed.?RESULTS: Postoperative visual acuity of two groups were significantly improved, but there was no significant difference between groups ( P >0.05 ); postoperative intraocular pressure, bleb formation rate of the observation group were 14.41 ±1.38mmHg, 90%, and the control group 14.40 ±1.40mmHg, 86% without statistical significance ( P>0.05 ), corneal endothelial cell density and area of observation group after 1mo were 1696.6±300. 8/mm2 , 540.8±71.6μm2 , and control group 1410.6±288.5/mm2 and 594.3 ±72.8μm2 with significant differences ( P0.05).?CONCLUSION: For patients with acute angle closure glaucoma and cataract given two incision triple surgery and single incision triple surgery treatment can get good outcomes, but the effect of double incision on corneal endothelial cell injury is less.
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Objective Conducting phacoemulsification combined with trabeculectomy through double incision to treat glaucoma and cat-aract,and observing the visual acuity,intraocular pressure before and after the operation and complications of this therapy. Methods Totally 60 patients (78 eyes) with glaucoma and cataract from January 2010 to December 2013 in our hospital were observed. 32 patients (40 eyes) who were given phacoemulsification combined with trabeculectomy through double incision were regarded as the observation group,and the other 28 patients (38 eyes) who were merely given phacoemulsification were regarded as the control group. The visual acuity,intraocular pres-sure and anterior chamber of the two groups were observed and recorded,and they were followed up for 36 months. Results Visual acuity and intraocular pressure of the two groups were improved after operation,but the observation group achieved a better result which showed a significant difference (P< 0. 05). Anterior chamber inflammation occurred in patients of the observation group,and 2 cases were of anterior chamber exudation. The control group,by contrast,has less anterior chamber inflammation. There was no hyphema,shallow anterior chamber, choroidal detachment occurred in both of the two groups. Conclusion Using phacoemulsification combined with trabeculectomy through double incision to treat glaucoma and cataract could receive a good recovery of visual acuity and intraocular pressure. Although,more severe anterior chamber inflammation occurred after operation compared with the control group,it can be alleviated soon after medication. This meth-od is a good therapy which can reduce pain and economic burden of patients from multiple operations. But it requires a strict selection of ap-propriate case.
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AlM:To observe the effects of double incision combined surgery of single - stab trabeculectomy and phacoemulsification. METHODS: Totally 28 cases ( 30 eyes ) with glaucoma and cataract undertook the modified combined surgery of single - stab trabeculectomy and phacoemulsification. After traditional phacoemulsification, cut the bulbar conjunctiva and Tenons capsule from the 11 o'clock to 1 o'clock, then puncture into the anterior chamber in 2mm behind the corneal limbus with 3mm tunnel knife, shaping a 3mm wide, 1/3-1/4 thickness scleral tunnel. Getting into the trabecular tunnel, bite off 3 pieces of trabecular tissue about 1mm × 1mm size. The changes in the imtraocular pressure ( lOP ) and the visual acuity before and after the surgery as well as filtering bleb ( OCT confirmed) and complications were carefully observed in 3-6mo postoperatively. RESULTS: The postoperative visual acuity in 1wk postoperatively less than 0. 1 was found in 3 eyes, from 0. 1 to 0. 3 was found in 6 eyes,from 0. 3 to 0. 6 in 13 eyes, from 0. 6 to 0. 8 in 8 eyes. One eye had malignant glaucoma, and 8 eyes had cornea edema and slightly fibrin exudation in the pupil area; ln all cases maintained function conjunctival blebs of filtering, OCT confirmed this. lOP remained normal in 28 eyes in 3-6mo follow up, lOP of 2 other eyes could be controlled by anti-glaucoma eye drops. CONCLUSlON:Double incision combined surgery of single- stab trabeculectomy and phacoemulsification is effective and safe, reduces the postoperative complications and is worthy of promotion.
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Objective To investigate the clinical results and related key points of surgical treatment for Hawkins Ⅲ talus neck fractures.Methods Forty-one patients with Hawkins Ⅲ talus neck fracture were treated.The fractures occurred on the left side in 21 patients and on the right side in 20 patients.All patients were performed internal fixation by internal and lateral approaches.The weight bearing should be adjusted with follow-up.The functional results were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS).Results The average duration of follow-up was (37.7 ± 8.2) months.All fractures gained union and the average union time was (4.1 ±0.5) months.The average AOFAS score after treatment was (79.3 ± 2.6) scores which was higher than that before treatment [(35.1 ± 8.0) scores],and there was significant difference (P =0.026).There were 11 cases in excellent,17 cases in good,11 cases in fair and 2 cases in poor.The excellent and good rate was 68.3％ (28/41).Traumatic arthritis occurred in 18 cases (43.9％,18/41),involved tibial astragaloid joint in 4 cases,involved subtalar joint in 6 cases,involved tibial astragaloid joint and subtalar joint in 8 cases.Avascular necrosis occurred in 7 cases (17.1％,7/41).Conclusions The effect of surgical treatment for Hawkins Ⅲ talus neck fracture via a bilateral approaches is satisfactory.Pay more attention to protect blood circulation intraoperative and perform anatomic reduction according to the characteristic of body of talus displacement.After operation,functional rehabilitation should be directed by the principle of early movement,later weighted.
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A preliminary study was conducted to evaluate the immediate postoperative recovery and socioeconomic efficacy with the surgical release of Carpal tunnel syndrome by double incision technique. Sixty cases of carpal tunnel syndrome were operated by one surgeon between 1993 and 1995 and 44 cases in 39 patients were available for this study. Surgery was done under axillary block and patients were evaiuated preoperatively, 3 weeks and 6 weeks each postoperatively. The evaluation was focused on the immediate recovery in terms of subjective symptoms of pain and paresthesia, local tenderness, strength of grip power and pinch power and postoperative disability. 1l was noted that surgical release of carpal tunnel syndrome utilizing double incision technique was as effective as seen in the endoscopic release in terms of quicker recovery of pain, local tenderness and strength. It was also noted that this double incision technique was as safe and economically beneficial as observed in the conventional open procedure.