RESUMEN
As a common disease of knee joint disease, the diagnosis and treatment of patellofemoral arthritis has not clear clinical consensus at present, conservative treatment only has a certain value for the disease with early stage and single disease. With the continuous improvement of understanding of pathogenesis and advancement of surgical techniques, minimally invasive and joint replacement technology has been rapid development, more and more alternative treatment options could be chosen. Technique of osteotomy of tibial tuberosity and removal of patella at the early stage were seldom used. According to development stage of disease, and combined with age, economic capacity, patients considering knee joint functional requirements and other factors, the balance of soft tissue under arthroscopy and denervation for cartilage injury in elderly patients with grade I to III surgery is more appropriate, and joint replacement is effective for cartilage injury in elderly patients with grade IV. Early debate is focus on total knee arthroplasty whether exist excessive medical treatment, patellofemoral joint replacement meet to demand for replacement of single patellofemoral degeneration with improvement of prosthesis design. Due to technical difficulties of cartilage transplantation and anatomical characteristics of patellofemoral joint, report of application of cartilage transplantation for patellofemoral arthritis is less, but with continuous improvement of technology, cartilage transplantation will be a good method for improving clinical symptoms, reducing medical costs, putting off joint replacement time.
RESUMEN
<p><b>OBJECTIVE</b>To investigate the method of medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus.</p><p><b>METHODS</b>From January 2010 to December 2013,31 patients with medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus, including 18 males and 13 females ranging in age from 26 to 58 years old with a mean of 37 years old. The time between injury and operation was 1 to 8 days with an average of 4.5 days. According to AO classification, 7 fractures were type A1, 3 fractures were type A2, 6 fractures were type A3, 2 fractures were type B1, 4 fractures were type B2, 2 fractures were type B3, 4 fractures were type C, 3 fractures were type C2. No patients had any signs of radial nerve injury. The results were evaluated with DASH (disability of arm-shoulder-hand) Questionnaire by the American Academy of Orthopedic Surgeons (AAOS) which 0 indicated normal upper extremity function, and 1 to 100 indicated varying degrees of damage to the function of the upper extremties.</p><p><b>RESULTS</b>There was no neurologic complication or postoperative wound infection in this series. The followed-up period ranged form 8 to 15 months (means 11 months) postoperatively. The clinical outcomes were evaluated with DASH Questionnaire, the score before operation was 76.2±11.8, the final follow-up score was 8.2±7.4, the final follow-up score was significant higher than before operation (P<0.01). The function of the upper extremities recovered satisfactorily.</p><p><b>CONSLUSION</b>The method of medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus can avoid iatrogenic radial nerve injury effectively.</p>