A novel dynamic distraction external fixator for proximal interphalangeal joint fracture dislocation.

OBJECTIVE: To evaluate the efficacy of a novel dynamic distraction external fixator for proximal interphalangeal joint (PIPJ) fracture-dislocation. METHODS: From March 2005 to March 2014, 20 patients with PIPJ fracture-dislocation were treated with our technique. Function scores according to the Michigan Hand Outcome Questionnaire (MHQ) score, union time, grip strength, and range of motion (ROM) were recorded before and after treatment. RESULTS: All patients completed a mean follow-up of 22 months (range, 12-60 months). All patients achieved fracture union and joint reduction. The mean union time was 3 months (range, 2-6 months). The mean postoperative MHQ score was 88.00 ± 3.42 (range, 84.00-92.00). Postoperative grip strength of the affected sides was 92% of the contralateral sides. X-rays showed that the fracture line disappeared completely with a good joint contour. The range of extension in the PIPJ was -5° (range, -10°-0°). The range of flexion in the PIPJ was 89.40° ± 9.79° (range, 75°-100°). Postoperatively, four patients had slight narrowing of the joint space and two had an uneven articular surface. Pin breakage, loosening, and tract infection were not observed. CONCLUSIONS: The novel dynamic distraction external fixator is a promising option for PIPJ fracture-dislocation.

[Abdominal random single pedicled flap of three leaves for the treatment of multiple finger skin defects].

OBJECTIVE: To discuss the effect of abdominal random single pedicled flap of three leaves for skin defects construction of the ends of several fingers. METHODS: From March 2005 to October 2010, 30 patients (90 fingers) with skin defects of the ends of several fingers were treated by abdominal random single pedicled flap of three leaves, including 20 males (60 fingers) and 10 females (30 fingers) with an average age of 36 years old ranging from 15 to 56 years. The degloving injury or transverse defect of distal phalanx were treated with abdominal random single pedicled flap of three leaves. Postoperative survival of skin flap, flap shape, complications were observed, and the static two-point discrimination of flap were determined. RESULTS: All patients were followed up for 12.6 mouths in average. All the flaps survived. The color, texture and shape of the flaps were good. The static two-point discrimination was 5 to 10 mm. The function of the hands recovered satisfactory. CONCLUSION: The method of abdominal random single pedicled flap of three leaves has the advantages of simple, safe and less trauma for the donor site. The effect is satisfatory for skin defects construction of the ends of several fingers.

[Gefitinib in the treatment of advanced non-small cell lung cancer with brain metastasis].

OBJECTIVE: Brain metastasis is frequently found in patient with advanced non-small cell lung cancer. Gefitinib is a inhibitor of epidermal growth factor receptor and can be used for the treatment of advanced non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the antitumor efficacy of Gefitinib in advanced NSCLC patients with brain metastasis. METHODS: Forty-four consecutive NSCLC patients with brain metastases were treated with gefitinib, which was administered orally at daily dose of 250 mg. Of these patients, 30 had been treated with WBRT and 42 received chemotherapy one month before enrolled into the study. RESULTS: Partial response (PR) was observed in 14 patients (31.8%), stable disease (SD) in 21 (47.7%) with an overall disease control rate of 79.5%. Median progression-free survival (PFS) was 9 months and median overall survival (OS) was 13.0 months. The difference in disease control rate between the patients who had previous WBRT and those without was not significant (P = 0.566). The toxicity is mild and tolerable. CONCLUSION: Our data shows that Gefitinib is safe and may be effective on brain metastasis, which may become an alternative treatment option for the patient with advanced NSCLC.