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<p><b>OBJECTIVE</b>To investigate clinical effect of transverse tibial bone transport micro vessels regeneration technology combined with vacuum drainage in treating diabetic foot ulcer.</p><p><b>METHODS</b>From November 2015 and December 2016, clinical data of 19 diabetic foot ulcer patients treated with transverse tibial bone transport micro vessels regeneration technology combined with vacuum drainage were retrospective analyzed, including 15 males and 4 females aged from 42 to 82 years old with an average of (64.57±7.14) years old;the courses of diabetic ranged was (14.62±6.19) years;12 cases on the left side and 7 cases on the right side;the area of ulcer ranged from 2 cm×3 cm to 8 cm×6 cm. All patients were stage D according to Texas classification, 3 cases were grade 2, 10 cases were grade 3 and 6 cases were grade 4. Ankle-brachial index and Michigan Neuropathy Screening Instrument (MNSI) were used to evaluate recovery of peripheral vessel and nerve before and after operation, the result of angiography and vascular ultrasound were also compared after operation.</p><p><b>RESULTS</b>Seventeen of 19 patients were followed up from 3 to 13 months with an average of 6.9 months. Seventeen patients' surface wound were healed. Ankle-brachial index was increased from (0.51±0.20) before operation to (0.93±0.18) at 3 months after operation, and had significant difference(=13.63, =0.000);MNSI was increased from (4.06±1.36) before operation to(5.76±1.44) at 3 months after operation, and differences were statistically significant (=7.31, =0.000). Postoperative angiography and vascular ultrasound showed satisfied regeneration of micro-vessel and affected foot achieved normal movement and daily life.</p><p><b>CONCLUSIONS</b>Transverse tibial bone transport micro vessels regeneration technology could reconstruct micro-vessel under lower affected limb, promote recovery of peripheral vessel and nerve, while with vacuum drainage could promote wound healing, has advantages of simple operation, obvious clinical effect, and high success rate of limb-salvage, and is one of ideal treatment for diabetic foot ulcer.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Angiography , Ankle Brachial Index , Diabetic Foot , General Surgery , Drainage , Regeneration , Retrospective Studies , Tibia , Treatment Outcome , Ultrasonography , VacuumABSTRACT
<p><b>OBJECTIVE</b>To study the clinical outcome of total hip arthroplasty(THA) for traumatic arthritis after acetabular fracture.</p><p><b>METHODS</b>From June 2010 to June 2014, 33 hips in 33 patients with traumatic arthritis after acetabular fracture were retrospective analyzed including 21 males and 12 females with a mean age of 44.6 years old. All the patients received THA with bio-prostheses. Harris score was used to evaluate the hip function of patients before and after operation, the X-ray was adopted for radiographic evaluation of the hip prosthesis.</p><p><b>RESULTS</b>All patients were followed up for 7 to 38 months with an average of 21.6 months. The Harris score increased from preoperative 53.6±2.4 to 94.0±3.0 at the final follow-up, the difference was statistically significant(=55.37,<0.05). The X-ray evaluation showed the prosthesis was in good position, no loosening of the prosthesis, dislocation and periprosthetic osteolysis.</p><p><b>CONCLUSIONS</b>THA is an effective treatment for the traumatic arthritis after acetabular fracture;internal fixation of acetabular fractures could not be removed if it shows difficult but does not affect the prosthesis placement.</p>
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<p><b>PURPOSE</b>To compare the efficacy and safety of open reduction and internal fixation through ilioinguinal approach and Stoppa approach for the treatment of displaced acetabular fractures.</p><p><b>METHODS</b>Case-controlled trials (CCTs) published from January 2010 to August 2015 that compared the ilioinguinal approach and Stoppa approach in the management of displaced acetabular fractures were retrieved from the databases of Cochrane Library, Pubmed, CNKI, and so on. Methodological quality of the trials was critically assessed. Statistical software RevMan 5.0 was used for data analysis.</p><p><b>RESULTS</b>Eight articles were included in the meta-analysis. Through comparing the efficacy and safety of ilioinguinal approach and Stoppa approach in the treatment of displaced acetabular fracture, statistical significance was found in the average operation time [WMD = 68.29, 95% CI (10.52, 126.05), p < 0.05] and the median intraoperative blood loss [WMD = 142.26, 95% CI (9.30, 275.23), p < 0.05]. However, there existed no statistical significance in the fracture end reset satisfaction rate [RR = 0.63, 95% CI (0.17, 2.37), p > 0.05], the early complications rate [RR = 0.89, 95% CI (0.33, 2.40), p > 0.05], the late complications rate [RR = 0.91, 95% CI (0.27, 3.01), p > 0.05], and Harris hip score good function rate [RR = 0.52, 95% CI (0.25, 1.10), p > 0.05].</p><p><b>CONCLUSION</b>Though both techniques can obtain satisfactory clinical functions in the treatment of displaced acetabular fractures, Stoppa approach is superior to the ilioinguinal approach in terms of operation time and intraoperative blood loss.</p>
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<p><b>PURPOSE</b>To compare the efficacy of quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation versus AO hollow compression screw fixation in the treatment of femoral neck fracture for Chinese young and middle-aged patients.</p><p><b>METHODS</b>Case-controlled studies (CCTs) were used to compare the two operative methods in the treatment of femoral neck fractures. Data were retrieved from the Cochrane Library, Pubmed Database, CNKI, Chinese Biomedical Database. Wanfang Data published during the period of January 2005 to December 2014. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical Software Revman 5.0 was used for data-analysis.</p><p><b>RESULTS</b>Eight articles were included in the meta-analysis. The results showed that there was statistical significance in the rate of fracture healing [OR = 5.43, 95% CI (2.89, 10.20), p < 0.05], the rate of good function of hip joint [OR = 5.12, 95% CI (3.21, 8.17), p < 0.05], the rate of femoral head necrosis [OR = 4.21, 95% CI (2.02, 8.76), p < 0.05], the time of fracture healing [WMD = -46.85, 95% CI (-65.13, -28.56), p < 0.05] between the two groups.</p><p><b>CONCLUSIONS</b>For the treatment of femoral neck fractures, the transplantation of quadratus femoris muscle pedicle bone flap combined with hollow compression screw; fixation is superior to the AO hollow compression screw fixation in terms of the rate; of fracture healing, the rate of good function of hip joint, the rate of femoral head; necrosis and the time of fracture healing.</p>
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<p><b>PURPOSE</b>To compare the efficacy of percutaneous poking reduction and fixationwith open reduction and fixation in the treatment of displaced calcaneal fractures.</p><p><b>METHODS</b>Reports of studies using case-controlled trials (CCT) to compare the percutaneous poking reduction and fixation with the open reduction and fixation in the management of calcaneal fractures were retrieved from the Cochrane Library, PubMed Database, CNKI, Chinese Biomedical Database, Wanfang Data (from January of 2005 to August of 2015). Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman 5.0 was used for data-analysis.</p><p><b>RESULTS</b>Fifteen articles were included in the meta-analysis. Comparison of the efficacy of percutaneous poking reduction and fixation with open reduction and fixation in the treatment of calcaneal fractures revealed statistical significance in the incidence of complications after operation [RR = 0.32, 95% CI (0.20, 0.5), p < 0.05]. However, there were neither statistical significance in the degrees of recovery for calcaneal Bohler angle [WMD = -1.65, 95% CI (-3.43, 0.14), p > 0.05] and calcaneal Gissane angle [WMD = -3.21, 95% CI (-6.75, 0.33), p > 0.05], nor statistical significance in the rate of good foot function after operation [RR= 0.95, 95% CI (0.90, 1.00), p > 0.05].</p><p><b>CONCLUSION</b>For the treatment of calcaneal fractures, percutaneous poking reduction and fixation is su- perior to open reduction and fixation in terms of the incidence of postoperative complications. But both techniques can obtain satisfactory clinical function.</p>
Subject(s)
Humans , Calcaneus , Wounds and Injuries , General Surgery , Fracture Fixation, Internal , Methods , Fractures, Bone , General Surgery , Open Fracture Reduction , Methods , Postoperative Complications , Epidemiology , Publication BiasABSTRACT
Objective To observe the morphological changes of the peripheral nerves,the expression changes of microtubule-associated protein 1B (MAP1B) and the changes of motor function in rats after chronic spinal cord compression.Methods A total of 50 female Wistar rats were randomly divided into normal control group (n=10),sham-operated group (n=10) and chronic compressive groups (n=30).The rats in the chronic compressive groups were given gradual compression on the posterior spinal cord using blunt plastics screw; compression degree reached 20% (n=10),40% (n=10) and 60% (n=10),respectively,after 2 months.Rats in the normal control group did not receive any treatment and rats in the sham-operated group was only given removal of the L5 spinous process and part of the vertebral plate.Following sacrifice of the rats,cells from sciatic nerves were removed for HE staining;light microscopy and electron microscopy were employed to observe the changes; immunohistochemical staining of MAP1B was performed.Results Hypokinesia,and decreased Tarlov scores,Ramp test scores and BBB-21 scores in the chronic compressive groups were noted as compared with those in the normal control group (P<0.05).Peripheral nerve degeneration was noted in all the chronic compressive groups; the more severe the compression,the more significant the degeneration.Expression of MAP1B in the peripheral nerves of the chronic compressive groups was significantly down-regulated as compared with that in the normal control group (P<0.05).Conclusion Spinal cord compressive injury can lead to peripheral nerve degeneration; and neuronal apoptosis and necrosis lead to rare axonal regeneration,which may be one of the important reasons that influences the neural function recovery after chronic spinal cord compression.
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Post-traumatic complex regional pain syndrome type 1 (CRPS1) is uncommon and can cause the disability of patients. Complex dislocation of the metacarpophalangeal joint on the little finger due to interposition of the sesamoid bone is rare and was firstly reported by Pribyl.1 We reported a rare case of CRPS1 after surgery of complex metacarpophalangeal dislocation of the little finger. To our knowledge, this case has not been reported yet.