Arthroscopic treatment of symptomatic anterior cruciate ligament cysts of the knee / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical symptom and effect of arthroscopic treatment of symptomatic anterior cruciate ligament (ACL) cysts of the knee.</p><p><b>METHODS</b>Clinical data from 12 symptomatic ACL cysts patients from January 2005 to December 2010 were retrospectively analyzed,including 8 males and 4 females,with an average age of (33.7±9.5) years old (ranged, 19 to 53 years old). The locations were the left knee in 5 cases and the right knee in 7 cases. The disease duration ranged from 3 to 48 months,with a mean of (15.8±13.2) months. All cysts were arthroscopically resected. Range of motion was measured preoperatively and postoperatively, and Lysholm scoring system was used to evaluate the knee function.</p><p><b>RESULTS</b>All the incisions healed by first intention, and no complications occurred. Twelve patients were followed up for an average of (32.3±6.6) months(ranged, 24 to 48 months). The symptoms of arthralgia,swelling and interlocking of the affected knees disappeared. There was no recurrence during the follow-up. There were significant differences in the range of motion and Lysholm score between pre-operation and post-operation.</p><p><b>CONCLUSION</b>Arthroscopic surgery, showing its advantages of minimal invasion and rapid recovery,is an effective measure in the treatment of ACL cysts.</p>

Application of orientation to the mechanical alignment of lower limbs in operation of high tibial osteotomy / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the effects of orientation to the mechanical alignment of lower limbs in high tibial osteotomy (HTO).</p><p><b>METHODS</b>From March 2005 to July 2010, the data of 57 patients (63 knees) with medial compartment osteoarthritis were retrospectively analyzed. There were 24 males and 33 females with an average age of 52 years (ranged, 34 to 68). HTO was used in all the patients, and with wire the exact orientation to the mechanical alignment of lower limbs was performed in order to obtain good angle of intercepted bone. X-rays of full-length lower limbs were done at the 3rd month after operation and final follow-up, in which femorotibial angle would be observed. Clinical results were evaluated according to Hospital for Special Surgery knee scores (HSS) including pain, function, activities, myodynamia, deformity and instability.</p><p><b>RESULTS</b>All patients were followed up from 24 to 60 months with an average of 36.7 months. All osteotomy site achieved radiographic healing. The femorotibial angle was corrected from preoperative (182.8 +/- 2.9) degrees to postoperative (167.6 +/- 2.5) degrees and (168.1 +/- 2.5) degrees at final follow-up (compared with preoperative data, P < 0.01). Pain relieved and genu valgum recovered. HSS score improved from preoperative 69.5 +/- 7.1 to postoperative 91.1 +/- 4.9 and 92.2 +/- 5.6 at final follow-up. According to HSS standard, 43 knees got excellent results, 18 good and 2 fair.</p><p><b>CONCLUSION</b>The orientation to mechanical alignment of lower limbs using wire during operation of HTO is a good method in correcting femorotibial angle and treating medial compartment osteoarthritis of the knee. Moreover, the method is simple and precise for orthopedist.</p>

The use of minimally invasive injectable graft and internal fixation in tibial plateau fractures / 中华外科杂志

<p><b>OBJECTIVE</b>To value the use of an injectable minimally invasive calcium sulfate cement for displaced tibial plateau fractures.</p><p><b>METHODS</b>Thirteen patients with lateral tibial plateau fractures treated with internal fixation and bone grafting were matched with 13 patients treated using internal fixation and an injectable calcium sulfate cement. The clinical data were retrospectively analyzed. All patients were followed up for a minimum of one year. The peri-operative complication, quality of reduction, maintenance of reduction, function assessment and development of post-traumatic osteoarthritis was compared in both groups.</p><p><b>RESULTS</b>Ten patients in the internal fixation and bone graft group had excellent anatomical reductions as judged on immediate post-operative radiographs but some loss of reduction on follow-up at one year was observed in 8 of the 13 (61%) cases. Twelve patients from the MIIG group had an excellent reduction on immediate post-operative radiographs but 3 (23%)demonstrated some loss of reduction of the plateau at one year follow-up (P < 0.05).</p><p><b>CONCLUSIONS</b>The use of MIIG and internal fixation is associated with more favourable clinical results than conventional treatment with internal fixation and bone grafting for lateral tibial plateau fractures.</p>

Percutaneous reduction and fixation of osteoporotic fractures for the proximal humerus in a geriatric population / 中华外科杂志

<p><b>OBJECTIVE</b>To appraise the value of clinical treatment of percutaneous reduction and fixation of osteoporotic fractures for the proximal humerus in a geriatric population.</p><p><b>METHODS</b>Postoperation complication, mortality in hospital and within the first three months postoperation, operation time, blood transfusion requirement, the functional outcome of the shoulder had been analysed and observed in 37 cases for open and closed fixation.</p><p><b>RESULTS</b>Closed reduction provided the benefit of obtaining and holding adequate reduction without the soft-tissue dissection of open reduction and internal fixation. The general complication and mortality in the first three months postoperation in the open reduction and internal fixation cases were more severe than the percutaneous cases.</p><p><b>CONCLUSIONS</b>Open operation increases the risk of the geriatric population with osteoporotic proximal humerus fracture; percutaneous reduction and fixation may be preferable.</p>