Objective: To report a new method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy. Methods: We modified Dewar’s surgical method as follows: ...Objective: To report a new method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy. Methods: We modified Dewar’s surgical method as follows: (1) Two small incisions, a transversal incision on the acromioclavicular joint and a longitudinal incision on the coracoid, were made instead of a conventional large arc incision from the acromion to coracoid. (2) The foreign body in the acromioclavicular joint was cleared out. The chondral surface at the lateral segment of clavicle was resected to form a pseudarthrosis and meanwhile the residual joint capsule and ligaments were repaired. (3) The coracoid was moved to the anteroinferior edge of the clavicle instead of the anterior margin and (4) the coracoid was moved to the lateral border of the clavicle instead of the superior border of the coracoclavicular ligament. Results: The follow up duration in 30 patients of the series was from 6 to 72 months (mean 41 months). Functional assessment was carried out by the criteria delineated previously by Karkson, in which Grade A was in 24 cases, Grade B in 4cases, and C in 2. Conclusions: This modified technique, having less postoperative complications and less injuries to tissues and according well with the requirement of biomechanics, can achieve a stable reduction of acromioclavicular joint with a good functional and cosmetic result and therefore is preferable to use clinically on a large scale.展开更多
The optimal surgical strategy for multilevel cervical spondylotic myelopathy （CSM） has not been defined, and few comparative researches between hybrid decompression and multilevel corpectorny have been conducted. He...The optimal surgical strategy for multilevel cervical spondylotic myelopathy （CSM） has not been defined, and few comparative researches between hybrid decompression and multilevel corpectorny have been conducted. Here, we reported 28 patients of three-level CSM, of whom 12 underwent hybrid decompression and 16 two-level corpectomy, with each type of procedure chosen according to radiologic characteristics of those patients. Clinical and radiologic parameters of both groups showed various degrees of improvement. However, no statistically significant differences in Japanese Orthopedic Association （JOA） score improvement rate, graft fusion rate, post-operative neck disability index （NDI） or segmental lordosis between the two groups were found. We conclude that both hybrid decompression and two-level corpectomy could obtain satisfying clinical efficacy in the management of three-level CSM for appropriate patients.展开更多
文摘Objective: To report a new method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy. Methods: We modified Dewar’s surgical method as follows: (1) Two small incisions, a transversal incision on the acromioclavicular joint and a longitudinal incision on the coracoid, were made instead of a conventional large arc incision from the acromion to coracoid. (2) The foreign body in the acromioclavicular joint was cleared out. The chondral surface at the lateral segment of clavicle was resected to form a pseudarthrosis and meanwhile the residual joint capsule and ligaments were repaired. (3) The coracoid was moved to the anteroinferior edge of the clavicle instead of the anterior margin and (4) the coracoid was moved to the lateral border of the clavicle instead of the superior border of the coracoclavicular ligament. Results: The follow up duration in 30 patients of the series was from 6 to 72 months (mean 41 months). Functional assessment was carried out by the criteria delineated previously by Karkson, in which Grade A was in 24 cases, Grade B in 4cases, and C in 2. Conclusions: This modified technique, having less postoperative complications and less injuries to tissues and according well with the requirement of biomechanics, can achieve a stable reduction of acromioclavicular joint with a good functional and cosmetic result and therefore is preferable to use clinically on a large scale.
文摘The optimal surgical strategy for multilevel cervical spondylotic myelopathy （CSM） has not been defined, and few comparative researches between hybrid decompression and multilevel corpectorny have been conducted. Here, we reported 28 patients of three-level CSM, of whom 12 underwent hybrid decompression and 16 two-level corpectomy, with each type of procedure chosen according to radiologic characteristics of those patients. Clinical and radiologic parameters of both groups showed various degrees of improvement. However, no statistically significant differences in Japanese Orthopedic Association （JOA） score improvement rate, graft fusion rate, post-operative neck disability index （NDI） or segmental lordosis between the two groups were found. We conclude that both hybrid decompression and two-level corpectomy could obtain satisfying clinical efficacy in the management of three-level CSM for appropriate patients.
