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A patient with 20-segments multi-planar amputation of the 2nd-5th fingers of the right hand was treated in December 2020 in the Department of Hand and Microsurgery, Affiliated Taihe Hospital of Hubei Universtiy of Medicine. The groupings was performed with microscopic anastomosis and splicing, and the replantation was finally completed. Followed-up at 1 year after surgery, the 17 segments of 20 severed finger segments finally survived. According to the Chinese Medical Association's Hand Surgery Branch's Functional Evaluation Criteria for Replantation of Amputated Fingers, the patient's finger function rating was 57 points and the function was poor at 1-year follow-up. The range of motion of the metacarpophalangeal joint was significantly improved compared with half a year after the operation. The simple grasping, pinching and fingering can be completed. The finger sensation was improved compared with half a year after the operation, but the finger body of right hand atrophied progressively, the interphalangeal joint was stiff, wirheut flexion nor extension range of motion. The function of the replanted finger was limited.
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Objective To explore the application effects of segmental design principles in the small incision approach rigid internal fixation for the treatment of maxillofacial fractures.Methods With a retrospective study,from September 2012 to April 2016,172 patients with maxillofacial fractures were selected as the research object in our hospital.All the patients were divided into the observation group of 100 patients and control group of patients according to the different treatment methods.Two groups were treated with mall incision approach rigid internal fixation.The observation group were given the preoperative design based on the segmental design principles.The other operation process were similar with the control group.Results All patients were completed the operation,the fracture were healed by Ⅰ stage.The postoperative 3months of total effective rates of the observation group and the control group were 98.0％ and 83.3％.The total effective rate of the observation group was significantly higher than that of the control group (P ＜ 0.05).The postoperative 3months of infection,nerve injury,salivary fistula,screw loosening and complication rate in the observation group was 3.0％,so that was 20.8％ in the control group,the observation group was significantly lower than the control group (P ＜ 0.05).The postoperative 3months of occlusal relationship and normal rates of the observation group were 99.0％ and 98.0％,respectively.The control group was 93.1％and 90.3％,respectively.There were between the two groups statistically significance difference(P ＜ 0.05).Conclusion The segmental design principles in the small incision approach rigid internal fixation for the treatment of maxillofacial fractures can improve the therapeutic effect,reduce the incidence of postoperative complications,improve the occlusal relationship with normal mouth opening rate.It is an ideal method for the treatment of maxillofacial fracture.
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Objective To compare the safety and effectiveness between ozone (O3) and hyaluronic acid (HA) in treating knee osteoarthritis(KOA) by using the meta analysis method.Methods The relevant randomized controlled trials(RCTs) in PubMed,Cochrane Library (issue 1,2016),Embase,CNKI,CBM,VIP,and Wan-Fang databases were retrieved from their establishment to January 23,2016.Two reviewers independently screened the literatures,extracted the data and evaluated the quality of the included RCTs.The results were performed the statistical analysis by using the RevMan5.3 and Stata13.0 software.Results Twenty RCTs involving 2 136 KOA patients were included.Compared with the HA treatment of KOA,the O3 treatment had higher treatment effective rate[odds ratio(OR) =2.78,P＜0.01],and better pain relief effect[at 1,3,6 month after treatment:mean difference(MD) =-0.25,-0.71,-1.70,P＜0.01].There were no statistically significant differences in complications between the two treatment methods[OR=0.84,P=0.56].Conclusion Current evidences indicate that the short-term therapeutic effect of O3 for KOA is superior to HA,and the safety is similar.
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Objective To investigate the effect of arthroscopic reconstruction of anterior cruciate ligament on the expression of serum osteopontin (OPN) and CD44.Methods Ninety-six cases patients with joint cross ligament injury who were teated in Taihe Hospital Affiliated to Hubei University of Medicine from February 2013 to June 2015 were selected and randomly equally divided into treatment group and control group.Two groups were adopted arthroscopic surgical treatment,and the control group were given the singletunnel reconstruction,the treatment group were given the double-tunnel reconstruction.Results The IKDC scores of 3 months after operation in the treatment group and control group were (92.44±5.13)points and (85.25±4.67) points,both significantly lower than before operation ((57.24 ± 4.19) points,(57.10 ± 4.87)points;P ＜ 0.05)),while there was statistically significant difference between groups (P ＜ 0.05).The total complication rate after 3 months operation in the treatment group was 6.3％,significantly less than that of the control group (35.4％;x2 =5.838,P＜0.05).The OPN expression levels of before and 3 months after operation in the treatment group were (31.98±4.21) μg/L,(7.13±2.89) μg/L,and CD44 were (419.45±20.45) μg/L,(167.24± 18.46) μg/L,the differences were significant (t =34.214,21.774;P＜ 0.05).The OPN expression levels of before and 3 months after operation in the control group were (32.09 ± 3.98) μg/L,(15.98 ± 3.67) μg/L,and CD44 were (421.87 ± 19.45) μg/L,(245.98 ± 20.56) μg/L,the differences were significant (t=21.833,14.099;P＜0.05).There were significant differences on OPN and CD44 of after operation between the two groups (t =12.847,7.498;P＜ 0.05).Conclusion Compare to single-tunnel reconstruction,double-tunnel reconstruction for the anterior cruciate ligament endoscopic surgery can increase restore knee function and reduce postoperative complications,and its mechanism may effectively reduce the levels of OPN and CD44 expression.
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Objective To investigate the clinical values of sodium hyaluronate combined arthroscopic joint clean-up surgery for the patellofemoral arthritis knee pain patients.Methods From June 2012 to September 2015 in Taihe Hospital Affiliated to Hubei Medical College,136 patellofemoral arthritis knee pain patients were selected and randomly divided into treatment group (68 cases) and control group (68 cases).All patients were given arthroscopic joint clean-up surgery,the control group were given the postoperative glucosamine sulfate capsules treatment,and the treatment group were given the postoperative intra-articular injection of sodium hyaluronate choose treatment,the treatment period was 5 weeks.Results Five weeks after treatment,the response rates in the treatment group and control group were 98.5％ (67/68) and 89.7％ (61/68),and the effect of the treatment group was better(x2 =4.202,P＜0.05).The pain scores in the treatment and control group were (1.34±0.45) points and (2.89±0.62) points,significandy lower than that of before operation ((7.30 ± 0.76) points and (7.31 ± 0.56) points;t =34.855,25.142;P ＜ 0.05).The Lysholm score in the treatment and control group were (88.87 ± 6.33) points and (76.13 ± 5.98) point,significantly higher than before operation ((44.23 ± 4.29) points and (44.67 ± 5.13) point;t =14.875,8.113;P＜0.05).The incidence of adverse events during the treatment in the treatment group and the control group were 8.8％(6/68) and 13.2％(9/68) respectively,there was no significant differemce between the two groups (x2 =0.391,P＞0.05).All adverse reactions after symptomatic treatment were improved.Conclusion Sodium hyaluronate combined arthroscopic joint clean-up surgery for the patellofemoral arthritis knee pain patients can effectively play the role of promoting the knee pain and function,and has good efficacy and safety,and is worth popularizing and applying.
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Objective To observe the effects of Shenmai injection on cardiac hemodynamics of isolated heart in rats of myocardial infarction model. Methods 30 myocardial infarction rat models created by ligation of left anterior descending coronary artery were randomly divided into a model group, a captopril group and a Shenmai group. 24 hours after successfully setup the models, all rat models were executed and their hearts were taken. Langendorff isolated heart perfusion method was adopted, and each group was perfused with 0.05mol/L amount of corresponding medicine, the model group was perfused with KH nutritive medium. left ventricular peak pressure(LVSP)and left ventricular ejection fraction(LVEF), left ventricular pressure increase/decrease rate(dp/dtmax±LV)(mmHg/s)and left ventricular end systolic diameter(LVESD)(%)and left ventricular end diastolic diameter(LVEDD)(%) was observed 5 min before the perfusion and 0.5 h, 1 h, 2 h after the perfusion. Results LVSP(9.47%± 0.15%vs. 3.34%± 0.05%),(11.25%± 1.31%vs. 3.79%± 0.04%) and LVEF reducing rate (7.44%± 0.10%vs. 4.94%± 0.04%), (10.24%± 0.31%vs. 5.34%± 0.05%) were elevated, and ±dp/dtmax(5 011 ± 253 mmHg/s vs. 5 827 ± 227 mmHg/s), (4 732 ± 212 mmHg/s vs. 5 837 ± 254 mmHg/s);(3 139 ± 127 mmHg/s vs. 4 722 ± 231 mmHg/s), (2 997 ± 125 mmHg/s vs. 4 793 ± 241 mmHg/s) was reduced in the Shenmai group 1 and 2 hours after the administration, which showed statistical difference compared to the model group (P<0.05). Conclusions Shenmai injection reduce myocardial contractility and intraventricular pressure of isolated heart o myocardial infarction rat models.
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Objective To describe the method and the clinical effect of the transplantation of cutaneous iliac flap and external fixation for the repair of the defect of tibia and soft tissue of the leg. Methods Between May 1998 and May 2001, 22 tibial fractures associated with bone and soft tissue defects of the leg were treated with Bastiani external fixation device and transplantation of the groin osteocutaneous flap with the deep circumflex iliac vessels. There were 15 males and 7 females with the the age ranged from 16 to 58 years and an average of 37 years. The follow-up period ranged from 5 to 36 months, with an average of 25. 5 months. Results All the osteocutaneous flaps survived completely after operation; the defects were repaired at one setting; the external fixation apparatuses were steady and the fracture healed smoothly. The bone graft healed with the host bone in three to six months. The recovery of function of the limb were satisfactory. There were no major complicaton in this series. Conclusion The groin osteocutaneous flap with the deep circumflex iliac vessels can be used to repair the bone and soft tissue defects in the tibia at one setting. The external fixation device provides a convenient condition for bone graft and prevents the stress protection effect.
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Objective This article provides a reform operative method for repairing non union in proximal or middle ulna Methods According to anatomical stady of recurrent interosseous artery from both blood supply and biology strength designs the transposition of proximal ulna periosteal bone flap, combining external fixator to repair non union in ulna Results Twelve cases of non union in proximal or middle ulna were treated by this means, these results were encouraging Conclusions Periosteal bone flap based on recurrent interosseous artery has a stable position, reliable blood supply and no injuring main vessel Moreover external fixator has many advanture, such as steady fixation, rarely damage, simply operation, function train early to prevent producing stiff joint, activate fracture with physiological force, Both can prompt the healing of fracture, It is an efficient method to cure non union in proximal or middle ulna