Objective：To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy. Methods：One hundred and twenty patie...Objective：To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy. Methods：One hundred and twenty patients with cervical spondylotic myelopathy were treated by anterior decompression and reconstruction using titanium mesh with locking plates. There were 66 men and 54 women ranges in age from 37 to 72 Years（mean age, 58.3 years）. The mean Japanese orthopedic surgery association（JOA） scale was 9.6 points before operation. Patients were followed up clinically and radiographically. Results：Having stood surgery well, the operation time ranged between 60-100 min and bleeding during operation ranged between 20-200 ml. There were no case of postoperative infection, recurrent laryngeal nerve palsy, or esophageal or tracheal laceration or rupture. The average follow-up period was 14.3 months（range, 12 to 24 months） in 96 who were followed up. At the last follow-up visit the mean JOA scale had improved to 14.4 points, reflecting an improvement of 4.8 points. The results were considered to be excellent in 87 patients, good in 25, fair in 6, and poor in 2. No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods. Stable bone union was observed in all cases and the average time required for fusion was 5.7 months. Conclusion：Titanium mesh filled with autologous bone graft can avoid the complications associated with harvesting bone from the iliac crest donor site. When combined with cervical anterior locking plate, it can obtain satisfatory clinical results for the treatment of cervical spondylotic myelopathy.展开更多
Background: complex proximal tibial fractures (Types V & VI of Schautzker classification) are the major problems in orthopedic surgery and associated with high complication rates. There are many alternatives in tr...Background: complex proximal tibial fractures (Types V & VI of Schautzker classification) are the major problems in orthopedic surgery and associated with high complication rates. There are many alternatives in treatment of these fractures. Aim: to evaluate the results of double plating with single anterior incision in complex proximal tibial fractures (Types V& VI of Schautzker classification).Methods and Materials: 22 patients (16 males and 6 females) with Types V and VI of Schautzker classification of proximal tibial fractures (14 cases were Type V and 8 cases were Type VI) were treated by double plating with single anterior incision method between May 2006 and May 2011. The bony and functional outcome was evaluated according to Knee Society Score. Results: According to Knee Society Score, the results were as follows: excellent in 19 patients (86.4%), good in 2 patients (9.1%), fair in 1 patient (4/5%), and poor in no patient (0%).Conclusion: the double plate fixation with single anterior incision is the best, effective and simple procedure in treatment of complex proximal tibial fractures (Types V and VI of Schautzker classification).展开更多
Ankle arthrodesis is a common procedure that resolves many conditions of the foot and ankle; however, complications following this procedure are often reported and vary depending on the fixation technique. Various tec...Ankle arthrodesis is a common procedure that resolves many conditions of the foot and ankle; however, complications following this procedure are often reported and vary depending on the fixation technique. Various techniques have been described in the attempt to achieve ankle arthrodesis and there is much debate as to the efficiency of each one. This study aims to evaluate the efficiency of anterior plating in ankle arthrodesis using customised and Synthes Tomo Fix plates. We present the outcomes of 28 ankle arthrodeses between 2005 and 2012, specifically examining rate of union, patient-reported outcomes scores, and complications. All 28 patients achieved radiographic union at an average of 36 wk; the majority of patients(92.86%) at or before 16 wk, the exceptions being two patients with Charcot joints who were noted to have bony union at a three year review. Patient-reported outcomes scores significantly increased(P < 0.05). Complications included two delayed unions as previously mentioned, infection, and extended postoperative pain. With multiple points for fixation and coaxial screw entry points, the contoured customised plate offers added compression and provides a rigid fixation for arthrodesis stabilization.展开更多
Clavicle fractures are among the most prevalent types of fractures with numerous treatment strategies that have evolved over time.In the realm of lateral-third clavicle fracture management,several surgical methods are...Clavicle fractures are among the most prevalent types of fractures with numerous treatment strategies that have evolved over time.In the realm of lateral-third clavicle fracture management,several surgical methods are available,with plate and screw constructs being one of the most frequently employed options.Within this construct,numerous choices exist for fixing the fracture.This editorial provides an overview of the common plate options utilized in the management of distal third clavicle fractures underscoring the critical considerations and approaches that guide clinicians in selecting the most appropriate fixation techniques,considering the complex landscape of clavicle fractures and their challenging management.展开更多
目的比较胫距跟关节融合时应用前路锁定钢板与逆行髓内钉固定的疗效。方法回顾性分析2018年6月至2022年12月南京医科大学附属逸夫医院行胫距跟关节融合术治疗的43例患者资料。其中男20例,女23例;年龄36~74岁,平均(59.0±7.5)岁;左...目的比较胫距跟关节融合时应用前路锁定钢板与逆行髓内钉固定的疗效。方法回顾性分析2018年6月至2022年12月南京医科大学附属逸夫医院行胫距跟关节融合术治疗的43例患者资料。其中男20例,女23例;年龄36~74岁,平均(59.0±7.5)岁;左侧20例,右侧23例。24例行前路锁定钢板内固定术(钢板组),19例行逆行髓内钉内固定术(髓内钉组)。比较两种固定方法的手术时间、术中出血量、住院费用、骨性融合率、骨性融合时间、术后并发症、美国足踝外科协会(American orthopaedic foot and ankle society,AOFAS)踝-后足功能评分和简明健康调查问卷(the mos item short form health survey,SF-36)评分。结果钢板组术中出血量(78.3±23.5)mL,髓内钉组术中出血量(84.2±21.7)mL。患者均随访12~22个月,平均(15.8±2.4)个月。随访期间钢板组、髓内钉组患者骨性融合率分别为95.8%(23/24)、94.7%(18/19)。术后钢板组出现1例软组织感染,1例软组织感染和骨不连,1例皮下软组织激惹症状;髓内钉组出现1例骨不连。术后并发症发生率钢板组12.5%(3/24),髓内钉组5.3%(1/19),差异无统计学意义(P>0.05)。钢板组和髓内钉组手术时间分别为(103.3±16.9)min和(115.0±15.3)min;住院费用分别为(40286.8±5162.7)元和(53314.7±6031.6)元;骨性融合时间分别为(4.7±0.5)个月、(4.4±0.4)个月;两组术后6个月随访时AOFAS踝-后足评分分别为(65.7±4.8)分、(69.8±7.3)分,SF-36评分分别为(68.5±8.8)分、(73.4±5.5)分,以上比较,两组间差异均有统计学意义(P<0.05),但末次随访时两组AOFAS踝-后足评分和SF-36评分比较,差异无统计学意义(P>0.05)。结论胫距跟关节融合术中,逆行髓内钉固定较前路锁定钢板固定手术时间长,但骨性融合时间短,术后早期髓内钉较前路锁定钢板固定疗效更优,但最终两组均可获得良好的临床效果。展开更多
目的:探讨义齿咬合板联合综合物理疗法治疗颞下颌关节盘不可复性前移位(anterior disc displacement without reduction,ADDwoR)的疗效。方法:选择2019年1月—2020年12月衡水市人民医院口腔正畸修复科就诊的牙列缺损或牙重度磨耗并诊断...目的:探讨义齿咬合板联合综合物理疗法治疗颞下颌关节盘不可复性前移位(anterior disc displacement without reduction,ADDwoR)的疗效。方法:选择2019年1月—2020年12月衡水市人民医院口腔正畸修复科就诊的牙列缺损或牙重度磨耗并诊断为ADDwoR患者60例,根据治疗方法不同,随机分为义齿咬合板组(A组)和义齿咬合板+综合物理疗法组(B组)。治疗前、治疗时每3周记录患者最大主动开口度(maximum mouth opening,MMO)、视觉模拟量表疼痛评分(visual analog pain score,VAS)。治疗前及治疗后3个月拍摄锥形束CT(CBCT),分析2组患者治疗前、后临床疗效指标变化及颞下颌关节CBCT三维数据差异。采用SPSS 26.0软件包对数据进行统计学分析。结果:治疗后3周,2组VAS和治疗前相比差异有统计学意义(P<0.05)且B组VAS降低较多;治疗后3周起,B组MMO、VAS和治疗前相比差异有统计学意义(P<0.05)。治疗后9周起,A组MMO与治疗前相比差异有统计学意义(P<0.05),但A组与B组MMO、VAS无统计学差异(P>0.05)。CBCT显示,治疗后关节前间隙变窄,关节后间隙增宽,关节上间隙增大,髁突水平角减小,关节结节斜度、髁突高度增大(P<0.05);关节窝深度、髁突前后径、内外径相比差异无统计学意义(P>0.05)。与A组相比,B组治疗后关节前、上、后间隙,髁突水平角,关节结节斜度差异有统计学意义(P<0.05)。结论:义齿咬合板可有效改善ADDwoR症状,义齿咬合板联合综合物理疗法能迅速改善患者开口度,减轻患者关节区疼痛。展开更多
文摘Objective：To observe the clinical effect of anterior decompression and reconstruction using titanium mesh with locking plates in the treatment of cervical spondylotic myelopathy. Methods：One hundred and twenty patients with cervical spondylotic myelopathy were treated by anterior decompression and reconstruction using titanium mesh with locking plates. There were 66 men and 54 women ranges in age from 37 to 72 Years（mean age, 58.3 years）. The mean Japanese orthopedic surgery association（JOA） scale was 9.6 points before operation. Patients were followed up clinically and radiographically. Results：Having stood surgery well, the operation time ranged between 60-100 min and bleeding during operation ranged between 20-200 ml. There were no case of postoperative infection, recurrent laryngeal nerve palsy, or esophageal or tracheal laceration or rupture. The average follow-up period was 14.3 months（range, 12 to 24 months） in 96 who were followed up. At the last follow-up visit the mean JOA scale had improved to 14.4 points, reflecting an improvement of 4.8 points. The results were considered to be excellent in 87 patients, good in 25, fair in 6, and poor in 2. No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods. Stable bone union was observed in all cases and the average time required for fusion was 5.7 months. Conclusion：Titanium mesh filled with autologous bone graft can avoid the complications associated with harvesting bone from the iliac crest donor site. When combined with cervical anterior locking plate, it can obtain satisfatory clinical results for the treatment of cervical spondylotic myelopathy.
文摘Background: complex proximal tibial fractures (Types V & VI of Schautzker classification) are the major problems in orthopedic surgery and associated with high complication rates. There are many alternatives in treatment of these fractures. Aim: to evaluate the results of double plating with single anterior incision in complex proximal tibial fractures (Types V& VI of Schautzker classification).Methods and Materials: 22 patients (16 males and 6 females) with Types V and VI of Schautzker classification of proximal tibial fractures (14 cases were Type V and 8 cases were Type VI) were treated by double plating with single anterior incision method between May 2006 and May 2011. The bony and functional outcome was evaluated according to Knee Society Score. Results: According to Knee Society Score, the results were as follows: excellent in 19 patients (86.4%), good in 2 patients (9.1%), fair in 1 patient (4/5%), and poor in no patient (0%).Conclusion: the double plate fixation with single anterior incision is the best, effective and simple procedure in treatment of complex proximal tibial fractures (Types V and VI of Schautzker classification).
文摘Ankle arthrodesis is a common procedure that resolves many conditions of the foot and ankle; however, complications following this procedure are often reported and vary depending on the fixation technique. Various techniques have been described in the attempt to achieve ankle arthrodesis and there is much debate as to the efficiency of each one. This study aims to evaluate the efficiency of anterior plating in ankle arthrodesis using customised and Synthes Tomo Fix plates. We present the outcomes of 28 ankle arthrodeses between 2005 and 2012, specifically examining rate of union, patient-reported outcomes scores, and complications. All 28 patients achieved radiographic union at an average of 36 wk; the majority of patients(92.86%) at or before 16 wk, the exceptions being two patients with Charcot joints who were noted to have bony union at a three year review. Patient-reported outcomes scores significantly increased(P < 0.05). Complications included two delayed unions as previously mentioned, infection, and extended postoperative pain. With multiple points for fixation and coaxial screw entry points, the contoured customised plate offers added compression and provides a rigid fixation for arthrodesis stabilization.
文摘Clavicle fractures are among the most prevalent types of fractures with numerous treatment strategies that have evolved over time.In the realm of lateral-third clavicle fracture management,several surgical methods are available,with plate and screw constructs being one of the most frequently employed options.Within this construct,numerous choices exist for fixing the fracture.This editorial provides an overview of the common plate options utilized in the management of distal third clavicle fractures underscoring the critical considerations and approaches that guide clinicians in selecting the most appropriate fixation techniques,considering the complex landscape of clavicle fractures and their challenging management.
文摘目的比较胫距跟关节融合时应用前路锁定钢板与逆行髓内钉固定的疗效。方法回顾性分析2018年6月至2022年12月南京医科大学附属逸夫医院行胫距跟关节融合术治疗的43例患者资料。其中男20例,女23例;年龄36~74岁,平均(59.0±7.5)岁;左侧20例,右侧23例。24例行前路锁定钢板内固定术(钢板组),19例行逆行髓内钉内固定术(髓内钉组)。比较两种固定方法的手术时间、术中出血量、住院费用、骨性融合率、骨性融合时间、术后并发症、美国足踝外科协会(American orthopaedic foot and ankle society,AOFAS)踝-后足功能评分和简明健康调查问卷(the mos item short form health survey,SF-36)评分。结果钢板组术中出血量(78.3±23.5)mL,髓内钉组术中出血量(84.2±21.7)mL。患者均随访12~22个月,平均(15.8±2.4)个月。随访期间钢板组、髓内钉组患者骨性融合率分别为95.8%(23/24)、94.7%(18/19)。术后钢板组出现1例软组织感染,1例软组织感染和骨不连,1例皮下软组织激惹症状;髓内钉组出现1例骨不连。术后并发症发生率钢板组12.5%(3/24),髓内钉组5.3%(1/19),差异无统计学意义(P>0.05)。钢板组和髓内钉组手术时间分别为(103.3±16.9)min和(115.0±15.3)min;住院费用分别为(40286.8±5162.7)元和(53314.7±6031.6)元;骨性融合时间分别为(4.7±0.5)个月、(4.4±0.4)个月;两组术后6个月随访时AOFAS踝-后足评分分别为(65.7±4.8)分、(69.8±7.3)分,SF-36评分分别为(68.5±8.8)分、(73.4±5.5)分,以上比较,两组间差异均有统计学意义(P<0.05),但末次随访时两组AOFAS踝-后足评分和SF-36评分比较,差异无统计学意义(P>0.05)。结论胫距跟关节融合术中,逆行髓内钉固定较前路锁定钢板固定手术时间长,但骨性融合时间短,术后早期髓内钉较前路锁定钢板固定疗效更优,但最终两组均可获得良好的临床效果。
