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Objective: To investigate the short-term effectiveness of modified tarsal sinus approach and traditional tarsal sinus approach in the treatment of Sanders Ⅱ-Ⅲ type calcaneal fractures. Methods: Between January 2015 and August 2017, 53 patients with Sanders Ⅱ-Ⅲ type calcaneal fractures were selected and divided into observation group (21 cases, using modified tarsal sinus approach for fracture reduction after exposure of the subtalar joint below the long and short fibular tendon) and control group (32 cases, using traditional tarsal sinus approach) by random number method. There was no significant difference between the two groups in terms of gender, age, side, cause of injury, fracture type, injury to operation time, and preoperative Böhler angle, Gissane angle, visual analogue scale (VAS) core ( P>0.05), which were comparable. The operation time, postoperative drainage volume, postoperative Böhler angle, Gissane angle, and postoperative angle improvement values of the two groups were recorded and compared. VAS score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and short-form 36 health survey scale (SF-36) score were used to evaluate the effectiveness. Results: All the 53 patients successfully completed the operation without serious complications such as vascular and nerve injury and perioperative death. There was no significant difference in operation time and postoperative drainage volume between the two groups ( P>0.05). Patients in both groups were followed up 12-36 months (mean, 17 months). No infection, fracture displacement, failure of internal fixation, and malunion of fracture occurred after operation. None of the patients underwent secondary joint fusion. There was no significant difference in fracture healing time between the two groups ( t=0.30, P=0.77). The postoperative Böhler angle and Gissane angle at 2 days in the two groups were significantly improved when compared with those before operation ( P0.05). VAS scores at 24 hours and 1 year after operation were significantly improved when compared with that before operation in both groups ( P0.05). There was no significant difference in AOFAS scores between the two groups at 1 year after operation ( t=1.46, P=0.15). However, the SF-36 scale score at 1 year after operation was significantly higher than that of the control group ( t=2.08, P=0.04). At last follow-up, 2 patients in the observation group and 8 patients in the control group presented subtalar joint stiffness or pain, and there was no significant difference in the incidence between the two groups ( χ2=1.98, P=0.16). Conclusion: The modified tarsal sinus approach for the treatment of Sanders Ⅱ-Ⅲ type calcaneal fractures has the advantages of minimal invasion, clear reduction under direct vision, reliable reduction and fixation, and low incision complications.
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Objective To discuss the efficacy of surgery combined with intra-operative I125 particles implantation in treatment of intracranial tumor.Methods The data of 25 cases diagnosed with intracranial tumors in general hospital of Shenyang Military Region from January 2015 to November 2016 were retrospectively analyzed.All patients received the combination of surgery and I125 particles intra-operative implantation.The therapeutic effect was observed and evaluated.Results All the patients were followed up for 6 to 18 months and there was no signs of recurrence or adverse reactions in the short term.Conclusion The combination of surgery and I125 particles intra-operative implantation could avoid the pain of postoperative radiotherapy and inhibit the short-term recurrence of multiple intracranial tumors.
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Hepatic resection has been the main form of the treatment of liver benign and malignant tumors. With the popularity of applications of minimally invasive techniques in surgery in recent years, laparoscopic hepatectomy(LH) application has also achieved a rapid development. It' s advantages are known as a small open incision, light systemic response and rapid recovery, meanwhile it can also attain the same efficiency as the open surgery does. However, there also exist disadvantages, such as complicated conduct, expensive instruments, and bleeding problems. This article reviews the process of development of laparoscopic liver resection, and elaborates its current status, existing problems, and evaluation of its treatment and efficiency.
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[Objective]To investigate the possibility of percutaneous minimally invasive technique in treating patients with type C1 pelvic fracture injured in the earthquake.[Method]Thirteen patients with Type C1 pelvic fracture determined by Tile Classification received reduction with external fixation frame for pelvic anterior ring and with cannulated lag screw for pelvic posterior ring fixation guided under C-arm X-ray.[Result]The cannulated lag screw was successfully implanted percutaneously guided under C-arm X-ray,and post-operation X-ray showed satisfactory reduction.[Conclusion]It is an optimum choice for treating C1 pelvic fracture with external fixation frame combined with cannulated lag screw percutaneously implanted under C-arm X-ray.