Clinical outcomes of reverse shoulder arthroplasty for the treatment of failed fixation of proximal humeral fracrtures in the elderly patients / 中国骨伤

OBJECTIVE@#To evaluate the clinical outcomes of reverse total shoulder arthroplasty as a revision procedure for the failed fixation of proximal humeral fractures in the elderly patients.@*METHODS@#A retrospective analysis was performed on 8 patients with failed internal fixation of proximal humeral fractures from May 2014 to March 2020, including 3 males and 5 females, aged from 65 to 75 years old. All 8 patients underwent reverse total shoulder arthroplasty, and the mean time between initial fixation and reverse total shoulder arthroplasty ranged from 8 to 16 months. Range of motion(ROM), University of California at Los Angeles(UCLA) shoulder score, visual analogue scale (VAS), self-rating anxiety scale(SAS), and Constant-Murley score of shoulder function were assessed pre-operatively and at the last follow-up. Complications relating to the surgery were recorded.@*RESULTS@#All 8 patients successfully followed up. The mean follow-up after reverse total shoulder arhroplasty ranged from 16 to 28 months. The range of motion (forward flexion, external rotation, abduction and internal rotation) of the affected shoulder was significantly improved after surgery, and the post-operative VAS, SAS and UCLA scores were also significantly improved. For the Constant-Murley score of shoulder joint function, the total scores and the subscores of pain, daily activities, range of motion and strength test at the last follow-up were all significantly improved. Scapular glenoid notch was observed in patient, which was evaluated as grade 1 on imaging. All the other patients did not develop specific or non-specific complications.@*CONCLUSION@#Reverse total shoulder arhroplasty is an appropriate treatment as a revision surgery for failed fixation of proximal humeral fractures. It has shown satisfactory clinical outcomes, accelerating the rehabilitation of shoulder function and improving the quality of life.

Reverse total shoulder arthroplasty for the treatment of old fracture of proximal humerus in elderly patients / 中国骨伤

OBJECTIVE@#To investigate clinical results of reverse total shoulder arthroplasty in treating old fracture of proximal humerus in elderly patients.@*METHODS@#From January 2012 to December 2017, 12 elderly patients with old proximal humeral fractures were treated with reverse total shoulder arthroplasty. There were 5 males and 7 females with an average age of 70.2 years old (ranged from 63 to 81 years old) and an average course of 12.3 months (ranged from 9 to 18 months). VAS score was used to evaluate the degree of pain relief of shoulder joint, Constant-Murley score was used to evaluate the improvement of shoulder joint function and observe the complications during and after operation.@*RESULTS@#All the 12 patients were followed up with an average duration of 22.3 months (ranged from 15 to 56 months). At the latest follow-up, the VAS score was 1.9±1.4, and Constant-Murley score was 83.4±8.4. Among them, shoulder joint flexion was (92.5±7.7)°, abduction was (90.4±14.3)°, external rotation was(31.9±10.0)°, and internal rotation was(58.9±13.1)°. There was statistical significance before and after treatment(<0.05). There were 2 cases with glenoid notch. The imaging findings were grade I and grade II respectively. No loosening was found during follow-up. No infection, acromial fracture, prosthesis loosening, axillary nerve injury and other complications occurred.@*CONCLUSIONS@#Reverse total shoulder arthroplasty in treating old proximal humeral fractures in elderly patients can achieve satisfactory results, however, indications and complications should be noted.

Analysis of incidence rate, characteristics and related risk factors of high intraocular pressure after pars plana vitrectomy / 国际眼科杂志(Guoji Yanke Zazhi)

? AlM: To analyze the incidence, characteristics and related risk factors of high intraocular pressure after pars plana vitrectomy ( PPV) . ?METHODS: Totally, 146 patients (146 eyes) undergone PPV in our hospital were selected. Age, gender, eye, course and operation time of patients were compared, in order to understand the incidence rate and characteristics of high intraocular pressure. Primary diseases, intraoperative treatment methods and intraocular tamponade type were compare, in order to analyze the related risk factors of high intraocular pressure. ? RESULTS: Forty - seven patients occurred high intraocular pressure after operation, the incidence rate was 32. 2%. There was no significant difference in age, gender, eye, course and operation time (P>0. 05). The incidence rate in diabetic patients with simple vitreous hemorrhage and with tractional retinal detachment were 21.1% and 57.6%, respectively (P 0. 05 ). The incidence rate of using silicone oil, C3 F8 and simple ventilation were 59. 7%, 34. 5% and 14. 5%, respectively (P ? CONCLUSlON: After vitrectomy intraocular hypertension incidence and preoperative, intraoperative treatment of primary disease is closely related to factors such as the way and intraocular tamponade.

Effect of vitrectomy combined medication hyperplastic on patients with diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the comparison of vitrectomy combined drug therapy ( Ranibizumab injection ) and single vitrectomy for proliferatived diabetic retinopathy ( PDR ) and the influence of the curative effect and prognosis of patients. METHODS:In this study, 112 cases (125 eyes) with PDR were selected and randomly divided into experimental group and control group ( n= 56 ) . Fifty-six cases ( 61 eyes ) in experimental group were injected by drug therapy of 0. 5mg ranibizumab and received vitrectomy;In control group, 56 cases ( 64 eyes ) were received single vitrectomy. The intraoperative and postoperative differences of clinical indicators were analyzed in two groups. RESULTS: The average operation time, intraoperative electric coagulation hemostasis rate and iatrogenic hiatal incidence of the experimental group were lower than that of the control group:(95. 00±13. 00) min vs (133. 00±14.5) min, 11% vs 34%, 5% vs 20%, respectively (PCONCLUSION: Patients with PDR injected with ranibizumab in vitreous cavity before vitrectomy can effectively reduce the operation time, less intraoperative blood loss, the incidence of iatrogenic hiatus, and intraoperative and postoperative complications. The postoperative visual acuity was better than before.

Effect of oral mucosa transplantation in the treatment of severe contracted conjunctival sac after ocular prosthesis implantation / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To observe the clinic effect of oral mucosa transplantation in the treatment of severe contracted conjunctival sac after ocular prosthesis implantation . METHODS: Thirty-three cases ( 33 eyes ) with globe disorders and severe contracted conjunctval sac were operated ocular prosthesis implantation firstly, and conjunctival sac plasty using oral mucosa after 6mo. RESULTS: Thirty - one cases were successful, no complications appeared. One case had primary ptosis and 1 case had recurrent conjunctival sac contracture. CONCLUSlON:lt is recognised that the methods of oral mucosa transplantation in severe contracted conjunctival sac after ocular prosthesis implantation are effective on those cases.