Clinical effects of suture anchor with V-Y tenoplasty in treating old Achilles tendon rupture / 中国骨伤

OBJECTIVE@#To explore clinical effects of suture anchor with V-Y tenoplasty for the treatment of old Achilles tendon rupture.@*METHODS@#From May 2014 to March 2018, 26 patients with old Achilles tendon rupture treated by suture anchor with V-Y tenoplasty, including 18 males and 8 females aged from 19 to 56 years old with an average of (36.0±11.7) years old, the courses of disease ranged from 42 to 62 days with an average of (49.0±5.3) days; the distances of Achilles tendon-shortening ranged from 2 to 7 cm with an average of (4.0±1.6) cm. Postoperative complications were observed, preoperative and postoperative American Orthopaedic Foot and Ankle Soviety(AOFAS) score were used to evaluate clinical effects.@*RESULTS@#All patients were followed up from 8 to 18 months with an average of(12.0±2.5) months. No Achilles tendon rupture occurred again. Postoperative AOFAS score at 3 months(93.37 ±3.48) was higher than before operation(57.26±5.06)(t=9.564, <0.05), and 14 patients got excellent results, 11 moderate and 1 poor.@*CONCLUSIONS@#Suture anchor with V-Y tenoplasty for old Achilles tendon rupture could achieve stable fixation, relieve pain, improve walking ability and quality of life, and also recover good function of ankle joint.

A comparative study between on-endcaps and non-endcaps titanium mesh cage for the treatment of elderly cervical spondylotic myelopathy complicated with osteoporosis approach for anterior cervical spine surgery / 中国骨伤

<p><b>OBJECTIVE</b>To compare radiographic results and clinical effects of titanium mesh cage with two endcaps(on-endcaps titanium mesh cage) and without endcaps(non-endcaps titanium mesh cage) in anterior cervical corpectomy and fusion(ACCF) for elderly cervical spondylotic myelopathy.</p><p><b>METHODS</b>The clinical data of 60 patients with cervical spondylotic myelopathy underwent ACCF from January 2011 to January 2016 were retrospectively analyzed. There were 26 males and 34 females, aged from 68 to 79 years old with a mean 75.8 years old. The patients were divided into two groups according to the different titanium mesh cage, using on-endcaps titanium mesh cage(group A, 32 cases) or non-endcaps titanium mesh cage (group B, 28 cases). The nerve function was evaluated by JOA score system; the height of intervertebral fusion segments and fusion segmental lordosis angle (Cobb angle) were measured by cervical lateral X-ray films, the bone graft fusion rate of titanium mesh was evaluated by CT.</p><p><b>RESULTS</b>All the patients were followed up from 1 to 2 years with an average of 1.5 years. The preoperative JOA scores of group A were 9.3±1.7, postoperative at 1 week, 3 months, 1 year were 14.2±1.8, 15.7±1.2, 15.4±1.5, respectively; and the preoperative JOA scores of group B were 9.1±1.8, postoperative at 1 week, 3 months, 1 year were 14.5±1.3, 14.9±1.7, 15.2±1.6, respectively. The postoperative JOA scores between two groups were obviously improved than that of preoperative (<0.05). There was no significant difference in JOA scores of 3 time-point after operation between two groups (>0.05). In the group A, preoperative intervertebral height were(42.1±2.4) mm, postoperative at 1 week, 3 months, 1 year were (45.3±3.2) mm, (44.7±2.9) mm, (44.5±3.0) mm, respectively; preoperative Cobb angle of fusion segments were (5.3±1.2)°, postoperative at 1 week, 3 months, 1 year were (10.3±1.9) °, (10.1±1.7) °, (9.9±1.3) °, respectively. And in group B, preoperative intervertebral height were (43.4±2.3)mm, postoperative at 1 week, 3 months, 1 year were (45.7±2.8) mm, (44.2±2.7) mm, (41.5±2.1) mm, respectively; preoperative Cobb angle of fusion segments were (5.4±1.0) °, postoperative at 1 week, 3 months, 1 year were (11.2±1.8)°, (10.8±1.6)°, (7.2±1.4) °, respectively. The postoperative intervertebral height, Cobb angle of fusion segments between two groups were obviously improved than that of preoperative (<0.05). There was no significant difference in intervertebral height and Cobb angle at 1 week, 3 months after operation between two groups(>0.05). One year after operation, intervertebral height and Cobb angle in group A was better than that of group B(<0.05).</p><p><b>CONCLUSIONS</b>On-endcaps titanium mesh cage is superior to non-endcaps titanium mesh cage in the maintenance of cervical intervebral height and segmental lordosis angle postoperatively at elderly spondylotic myelopathy complicated with osteoporosis. The usage of on-endcaps titanium mesh cage can effectively reduce postoperative subsidence rate.</p>

Clinical analysis of an interspinous stabilization system (wallis) in treating lumbar degenerative disease / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate clinical results of an interspinous stabilization system (Wallis) in treating lumbar degenerative disease in the short-term.</p><p><b>METHODS</b>From August 2007 to June 2010,48 patients with lumbar degenerative disease who were treated with interspinous stabilization system, the data of patients were analyzed retrospectively. In all of the 48 cases, there were 30 males and 18 females with an average age of 54.2 years (ranged, 40 to 68 years). Forty-four cases were with single segment and 4 cases with two segments. Of them, 4 cases were in L3, 4, 40 cases were in L4, 5, 4 cases were in L3, 4 and L4, 5. The radiographic data of patients were analyzed. Clinical effects were evaluated by Japanese Orthopedic Association (JOA) score system and low back pain disability questionnaire (Oswestry) and Odom method.</p><p><b>RESULTS</b>All the patients were followed up from 1 to 2 years with an average of 18 months. According to Odom's criteria, 20 cases obtained excellent results, 24 good, 4 fair. JOA score increased from 12.4 +/- 2.7 preoperatively to 26.1 +/- 2.0 postoperatively (P < 0.01). Oswestry score decreased from 14.1 +/- 2.9 preoperatively to 5.5 +/- 1.8 postoperatively (P < 0.01). The posterior height of intervertebral space and height of nerve root canal increased compared with that of preperative height.</p><p><b>CONCLUSION</b>The treatment of lumbar degenerative disease with interspinous stabilization system can obtain satisfactory effects in the near future. It can retain dynamic stable of corresponding segments, expand volume of vertebral canal, and is safe and feasible.</p>

The biomechanical study and clinical application of internal fixation with Kirschner wire placed in the nerval fossa of ulna for GartlandⅢsupracondylar fractures of humerus in children / 中华创伤杂志

Objective To perform a biomechanical study on and compare the stability of internal fixation with closed Kirschner wire in different spots from the epicondylus medialis to sulcus nervi ulnaris and epicondylus lateralis of humerus in the treatment of GartlandⅢsupracondylar fractures of humerus in children in order to provide basis for avoiding cubitus varus in clinic.Methods Twenty models of su- pracondylar fractures were made from ten humerus samples,then divided into two groups(group A and group B).They were fixed with closed Kirschner'wires.Ulnar Kirschner wire varied.In group A five spots were selected averagely from the epicondylus medialis to the sulcus nervi ulnaris.Kirschner wires entered from one of the five spots into another spot of humerus.In group B Kirschner wires entered defferent spots of humerus from the central spot of sulcus nervi ulnaris.Biomechanical tests were carried out,such as axial load,axial displacement,stress intensity,axial rigidity and anti-twisty ability.Forty-six children with Gart- landⅢsupracondylar fracture of humerus were treated and followed up for more than one year.Results In beth groups,with the angle of Kirschner wires and fracture side increasing,the strain and the vertical displacement decreased,the stress intensity and the axial rigidity increased,and the anti-twists ability was enhanced.There was statistic difference(P＜0.05).The follow-up of the 46 patients showed the elbow joint function recovered well with no cubitus varus malformation.Conclusion Internal fixation with closed Kirschner wires in sulcus nervi ulnaris from the epicondylus medialis and the epicondylns lateralis of humerus for GartlandⅢsupracondylar fracture of humerus in children has the advantages of enhancing bio- mechanical stability,effective prevention of secondary replacement of outlying black of the fracture and a- voidance of cubitus varus.It can be widely used clinically.