Multilevel lumbar fusion usually requires a large quantity of iliac crest bone graft but the supply is usually insufficient, so an alternative bone graft substitute for autograft is needed. This prospective study inve...Multilevel lumbar fusion usually requires a large quantity of iliac crest bone graft but the supply is usually insufficient, so an alternative bone graft substitute for autograft is needed. This prospective study investigated the efficacy of calcium sulfate by comparing the fusion rates between the experimental material (calcium sulfate pellets with bone chips from laminectomy) and autologous iliac bone graft in long segment (three-or four-level) lumbar and lumbosacral posterolateral fusion. Forty-five patients with degenerative scoliosis or spondylolisthesis received multilevel spine fusion and decompression. The experimental material of calcium sulfate pellets with decompression bone chips was placed on the experimental side and the iliac crest bone graft was placed on the control side. The fusion status was assessed radiographically at three-month intervals, and solid fusion was defined as a clear continuous intertransverse bony bridge at all levels. The average follow-up period was 34.4 months. Twenty-nine (64.4%) patients showed solid fusion on the experimental side and 39 (86.7%) patients on the control side. The overall fusion rate was 86.7%. A statistically significant relation was found between the two sides with the Kappa coefficient of agreement of 0.436. Compared to the control side, the fusion rate of experimental side is significantly reduced (p = 0.014). The fusion ability of autograft is higher than the experimental material in multilevel lumbar posterolateral fusion. However, the overall fusion rate of calcium sulfate pellets is improved, compared with previously reported rates, which suggested that such material may be considered as an acceptable bone graft extender.展开更多
Objective To retrospect the long-dated curative effect of grafting of iliac bone fl ap with deep iliac circumflex vessel in treatment of femoral head ischemic necrosis.Methods79cases of femoral head ischemic nec rosis...Objective To retrospect the long-dated curative effect of grafting of iliac bone fl ap with deep iliac circumflex vessel in treatment of femoral head ischemic necrosis.Methods79cases of femoral head ischemic nec rosis treated by promoted Smith-Petersen incision,neck of femur notch,focus cleaning decompression,grafting of iliac bone flap with deep iliac circumflex vessel and screw fixation.13cases treated by transplanting granular bone after d ecompression.Results Grafting of iliac bone flap with deep iliac circumflex vessel treatment g roup were followed up from 3to 9years,the planting bone healed 3to 6months averagely.Two cases suffered femoral head i schemic necrosis continuous-ly.Other cases received good results.Transplanting granular bone afte r decompression group were followed up 3to 9years,3cases suffered femoral head ischemic necrosis cont inuously,hip joint function was lim ited,patients received hip replacement finally.Conclusion Place of iliac bone flap with deep iliac circumflex vessel is fixed,curative effects ar e credible,which can become the firs t-choice therapy to femoral head is-chemic necrosis of middle age and you ng people(Ficat I ～III stage).展开更多
To assess the effect of using buttress plate associated with antografting of fibula and iliac bone for the treatment of distal femoral C3 type fracture.Methods Seventeen cases of distal femoral C3 type fracture usin...To assess the effect of using buttress plate associated with antografting of fibula and iliac bone for the treatment of distal femoral C3 type fracture.Methods Seventeen cases of distal femoral C3 type fracture using buttress plate associated with antografting of fibula and iliac bone were analyzed retrospectively.Results All cases were followed up for an average of 24 months（8～55 months）.The average time of octets bridge forming were 4 months（3～5 months） while the average time for bone union were 8 months （6～14 months）.According to Shelbourne rating system,result of all 18 cases were excellent and no malunion,infection were found.Conclusion Buttress plate associated with antografting of fibula and iliac bone is an effective alternative for the treatment of distal femoral C3 type fracture.It can provide more stable fixation to the bone and earlier functional exercises can be achieved.5 refs,3 figs,1 tab.展开更多
目的分析并对比自体带骨膜髂骨移植与同种异体骨骨粉联合富血小板凝胶(platelet rich gel,PRP)治疗HeppleⅤ型距骨骨软骨损伤(osteochondral injury,OLT)。方法选取浙江中医药大学附属金华中医院2018年10月至2022年10月收入的HeppleⅤ型...目的分析并对比自体带骨膜髂骨移植与同种异体骨骨粉联合富血小板凝胶(platelet rich gel,PRP)治疗HeppleⅤ型距骨骨软骨损伤(osteochondral injury,OLT)。方法选取浙江中医药大学附属金华中医院2018年10月至2022年10月收入的HeppleⅤ型OLT患者62例为研究对象,根据其治疗方式将其分为移植组(接受自体带骨膜髂骨移植治疗,31例)、联合组(接受同种异体骨骨粉联合PRP治疗,31例)。对患者进行术后12个月门诊随访研究,评估并比较两组患者术后12个月治疗效果、踝关节活动度(range of motion,ROM)、美国骨科足踝外科学会(American Society of Orthopedic Foot andAnkle Surgeons,AOFAS)踝-后足评分、疼痛评分、满意度、并发症发生率差异。结果移植组治疗总有效率(96.77%)与联合组(93.55%)相比,差异无统计学意义(P>0.05)。术后12个月两组ROM、AOFAS评分均改善(P<0.05),组间差异无统计学意义(P>0.05)。两组患者术后1个月、3个月、6个月、12个月,两组疼痛评分均较术前有所降低(P<0.05)。移植组患者主观总满意度(77.42%),低于联合组(96.77%,P<0.05)。移植组并发症总发生率(19.35%)与联合组(3.23%)相比,明显更高(P<0.05)。结论同种异体骨骨粉联合PRP可避免额外手术切口,患者主观满意度更高,术后并发症发生率低。展开更多
BACKGROUND Recurrent anterior shoulder instability is a common traumatic injury,the main clinical manifestation of which is recurrent anteroinferior dislocation of the humeral head.The current follow-up study showed t...BACKGROUND Recurrent anterior shoulder instability is a common traumatic injury,the main clinical manifestation of which is recurrent anteroinferior dislocation of the humeral head.The current follow-up study showed that the effect of arthroscopic Bankart repair is unreliable.AIM To evaluate the clinical efficacy of arthroscopy with subscapularis upper one-third tenodesis for treatment of anterior shoulder instability,and to develop a method to further improve anterior stability and reduce the recurrence rate.METHODS Between January 2015 and December 2018,male patients with recurrent anterior shoulder instability were selected.One hundred and twenty patients had a glenoid defect<20%and 80 patients had a glenoid defect>20%.The average age was 25 years(range,18–45 years).Patients with a glenoid defect<20%underwent arthroscopic Bankart repair with a subscapularis upper one-third tenodesis.The patients with a glenoid defect>20%underwent an arthroscopic iliac crest bone autograft with a subscapularis upper one-third tenodesis.All patients were assessed with Rowe and Constant scores.RESULTS The average shoulder forward flexion angle was 163.6°±8.3°and 171.8°±3.6°preoperatively and at the last follow-up evaluation,respectively.The average external rotation angle when abduction was 90°was 68.4°±13.6°and 88.5°±6.2°preoperatively and at the last follow-up evaluation,respectively.The mean Rowe scores preoperatively and at the last follow-up evaluation were 32.6±3.2 and 95.2±2.2,respectively(P<0.05).The mean Constant scores preoperatively and at the last follow-up evaluation were 75.4±3.5 and 95.8±3.3,respectively(P<0.05).No postoperative dislocations were recorded by the end of the follow-up period.CONCLUSION Arthroscopy with subscapularis upper one-third tenodesis was effective for treatment of recurrent anterior shoulder instability independent of the size of the glenoid bone defect,enhanced anterior stability of the shoulder,and did not affect postoperative range of motion of the affected limb.展开更多
文摘Multilevel lumbar fusion usually requires a large quantity of iliac crest bone graft but the supply is usually insufficient, so an alternative bone graft substitute for autograft is needed. This prospective study investigated the efficacy of calcium sulfate by comparing the fusion rates between the experimental material (calcium sulfate pellets with bone chips from laminectomy) and autologous iliac bone graft in long segment (three-or four-level) lumbar and lumbosacral posterolateral fusion. Forty-five patients with degenerative scoliosis or spondylolisthesis received multilevel spine fusion and decompression. The experimental material of calcium sulfate pellets with decompression bone chips was placed on the experimental side and the iliac crest bone graft was placed on the control side. The fusion status was assessed radiographically at three-month intervals, and solid fusion was defined as a clear continuous intertransverse bony bridge at all levels. The average follow-up period was 34.4 months. Twenty-nine (64.4%) patients showed solid fusion on the experimental side and 39 (86.7%) patients on the control side. The overall fusion rate was 86.7%. A statistically significant relation was found between the two sides with the Kappa coefficient of agreement of 0.436. Compared to the control side, the fusion rate of experimental side is significantly reduced (p = 0.014). The fusion ability of autograft is higher than the experimental material in multilevel lumbar posterolateral fusion. However, the overall fusion rate of calcium sulfate pellets is improved, compared with previously reported rates, which suggested that such material may be considered as an acceptable bone graft extender.
文摘Objective To retrospect the long-dated curative effect of grafting of iliac bone fl ap with deep iliac circumflex vessel in treatment of femoral head ischemic necrosis.Methods79cases of femoral head ischemic nec rosis treated by promoted Smith-Petersen incision,neck of femur notch,focus cleaning decompression,grafting of iliac bone flap with deep iliac circumflex vessel and screw fixation.13cases treated by transplanting granular bone after d ecompression.Results Grafting of iliac bone flap with deep iliac circumflex vessel treatment g roup were followed up from 3to 9years,the planting bone healed 3to 6months averagely.Two cases suffered femoral head i schemic necrosis continuous-ly.Other cases received good results.Transplanting granular bone afte r decompression group were followed up 3to 9years,3cases suffered femoral head ischemic necrosis cont inuously,hip joint function was lim ited,patients received hip replacement finally.Conclusion Place of iliac bone flap with deep iliac circumflex vessel is fixed,curative effects ar e credible,which can become the firs t-choice therapy to femoral head is-chemic necrosis of middle age and you ng people(Ficat I ～III stage).
文摘To assess the effect of using buttress plate associated with antografting of fibula and iliac bone for the treatment of distal femoral C3 type fracture.Methods Seventeen cases of distal femoral C3 type fracture using buttress plate associated with antografting of fibula and iliac bone were analyzed retrospectively.Results All cases were followed up for an average of 24 months（8～55 months）.The average time of octets bridge forming were 4 months（3～5 months） while the average time for bone union were 8 months （6～14 months）.According to Shelbourne rating system,result of all 18 cases were excellent and no malunion,infection were found.Conclusion Buttress plate associated with antografting of fibula and iliac bone is an effective alternative for the treatment of distal femoral C3 type fracture.It can provide more stable fixation to the bone and earlier functional exercises can be achieved.5 refs,3 figs,1 tab.
文摘目的分析并对比自体带骨膜髂骨移植与同种异体骨骨粉联合富血小板凝胶(platelet rich gel,PRP)治疗HeppleⅤ型距骨骨软骨损伤(osteochondral injury,OLT)。方法选取浙江中医药大学附属金华中医院2018年10月至2022年10月收入的HeppleⅤ型OLT患者62例为研究对象,根据其治疗方式将其分为移植组(接受自体带骨膜髂骨移植治疗,31例)、联合组(接受同种异体骨骨粉联合PRP治疗,31例)。对患者进行术后12个月门诊随访研究,评估并比较两组患者术后12个月治疗效果、踝关节活动度(range of motion,ROM)、美国骨科足踝外科学会(American Society of Orthopedic Foot andAnkle Surgeons,AOFAS)踝-后足评分、疼痛评分、满意度、并发症发生率差异。结果移植组治疗总有效率(96.77%)与联合组(93.55%)相比,差异无统计学意义(P>0.05)。术后12个月两组ROM、AOFAS评分均改善(P<0.05),组间差异无统计学意义(P>0.05)。两组患者术后1个月、3个月、6个月、12个月,两组疼痛评分均较术前有所降低(P<0.05)。移植组患者主观总满意度(77.42%),低于联合组(96.77%,P<0.05)。移植组并发症总发生率(19.35%)与联合组(3.23%)相比,明显更高(P<0.05)。结论同种异体骨骨粉联合PRP可避免额外手术切口,患者主观满意度更高,术后并发症发生率低。
文摘BACKGROUND Recurrent anterior shoulder instability is a common traumatic injury,the main clinical manifestation of which is recurrent anteroinferior dislocation of the humeral head.The current follow-up study showed that the effect of arthroscopic Bankart repair is unreliable.AIM To evaluate the clinical efficacy of arthroscopy with subscapularis upper one-third tenodesis for treatment of anterior shoulder instability,and to develop a method to further improve anterior stability and reduce the recurrence rate.METHODS Between January 2015 and December 2018,male patients with recurrent anterior shoulder instability were selected.One hundred and twenty patients had a glenoid defect<20%and 80 patients had a glenoid defect>20%.The average age was 25 years(range,18–45 years).Patients with a glenoid defect<20%underwent arthroscopic Bankart repair with a subscapularis upper one-third tenodesis.The patients with a glenoid defect>20%underwent an arthroscopic iliac crest bone autograft with a subscapularis upper one-third tenodesis.All patients were assessed with Rowe and Constant scores.RESULTS The average shoulder forward flexion angle was 163.6°±8.3°and 171.8°±3.6°preoperatively and at the last follow-up evaluation,respectively.The average external rotation angle when abduction was 90°was 68.4°±13.6°and 88.5°±6.2°preoperatively and at the last follow-up evaluation,respectively.The mean Rowe scores preoperatively and at the last follow-up evaluation were 32.6±3.2 and 95.2±2.2,respectively(P<0.05).The mean Constant scores preoperatively and at the last follow-up evaluation were 75.4±3.5 and 95.8±3.3,respectively(P<0.05).No postoperative dislocations were recorded by the end of the follow-up period.CONCLUSION Arthroscopy with subscapularis upper one-third tenodesis was effective for treatment of recurrent anterior shoulder instability independent of the size of the glenoid bone defect,enhanced anterior stability of the shoulder,and did not affect postoperative range of motion of the affected limb.
