Restoration of fracture alignment by osteotomy is crucial for the management of humeral nonunion. In the present study, we introduced a new way of osteotomy (Z-shaped) in treating humeral shaft nonunion secondary to f...Restoration of fracture alignment by osteotomy is crucial for the management of humeral nonunion. In the present study, we introduced a new way of osteotomy (Z-shaped) in treating humeral shaft nonunion secondary to failed plate osteosynthesis. Clinical data of 24 patients with humeral shaft nonunion following implant failure (from 2010 to 2014) were retrospectively evaluated. These patients underwent Z-shaped osteotomy in revision surgery after the initial surgery, plate osteosynthesis, was failed. Outcomes were evaluated using visual analogue scale (VAS) and Constant and Murley score. Repeated analysis of variance (ANOVA) was used for statistical analysis. Patients were followed up for a minimum of 24 months (26.83±4.33 months). The operative time was 102.33±10.16 min, and hospital stay averaged 9.75±2.13 days. All patients achieved clinical union at the latest follow-up. Complications included radial palsy (n=1) and superficial wound infection (n=1). The postoperative VAS scores decreased significantly compared to preoperative score (F=257.99, P<0.01). Constant and Murley score increased and reached 81.33±0.95 at 24 months' follow-up 0=247.35, P<0.01). Among all the cases, 15 cases were graded as "excellent", and 9 as "good". In conclusion, Z-shaped osteotomy was easy to perform, and it provided additional medial support with more bone contact areas. Revision surgery using locking plate and Z-shaped osteotomy achieved high union rate and improved functional outcome. It was a reasonable and safe option for treating humeral nonunion following implant failure.展开更多
Infantile Blount's disease is a condition that causes genu varum and internal tibial torsion. Treatment options include observation, orthotics, corrective osteotomy, elevation of the medial tibial plateau, resecti...Infantile Blount's disease is a condition that causes genu varum and internal tibial torsion. Treatment options include observation, orthotics, corrective osteotomy, elevation of the medial tibial plateau, resection of a physeal bar, lateral hemi-epiphysiodesis, and guided growth of the proximal tibial physis. Each of these treatment options has its disadvantages. Treating the coronal deformity alone(genu varum) will result in persistence of the internal tibial torsion(the axial deformity). In this report, we describe the combination of lateral growth modulation and distal tibial external rotation osteotomy to correct all the elements of the disease. This has not been described before for treatment of Blount's disease. Both coronal and axial deformities were corrected in this patient. We propose this combination(rather than the lateral growth modulation alone) as the method of treatment for early stages of Blount's disease as it corrects both elements of the disease and in the same time avoids the complications of proximal tibial osteotomy.展开更多
Acetabular dysplasia is one of the most important reasons for development ofsecondary osteoarthrosis of the hip joint. This paper introduced a method of modifiedWagner’s procedure, called acetabular rotation osteotom...Acetabular dysplasia is one of the most important reasons for development ofsecondary osteoarthrosis of the hip joint. This paper introduced a method of modifiedWagner’s procedure, called acetabular rotation osteotomy for the treatment of severeacetabular dysplasia in ten adults patients. These were followed up for 1-4 years. Fivecriteria including pain, gait, range of motion, measurement of roentgenographic changees,and CT scan were evaluated. From the limited information of this paper, it showed thatin all cases pain improved and range of motion did not reduced significantly. Comparingthe pre- and post-operative x-ray films, CE angle increased and exceeded the normal val-ue. Tonnis hip value decreased and approached the normal value, anteversion of theacetabulum improved, and the percentage of acetabular coverage increased as well.展开更多
目的:探讨应用Ilizarov技术在旋转中心穹顶状截骨治疗青少年股骨远端外翻畸形的疗效。方法:采用回顾性研究分析2016年1月至2020年10月收治并获得完整随访的11例股骨远端外翻畸形患者的临床资料,其中男7例,女4例;右侧6例,左侧5例;年龄10...目的:探讨应用Ilizarov技术在旋转中心穹顶状截骨治疗青少年股骨远端外翻畸形的疗效。方法:采用回顾性研究分析2016年1月至2020年10月收治并获得完整随访的11例股骨远端外翻畸形患者的临床资料,其中男7例,女4例;右侧6例,左侧5例;年龄10~14岁。在股骨远端畸形处找出成角旋转中心(center of roration of angulation,CORA),以CORA为中点,行穹顶状截骨,根据Ilizarov外固定穿针原则安装环形外固定架,截断股骨远端,即时矫正股骨远端目测下外翻畸形,外固定架固定维持。术后根据双下肢负重全长正侧位X线片提示的下肢力线及长度结果,矫正残余畸形及短缩。结果:11例均得到随访,时间13~25个月,带架时间12~17周。末次随访拍摄双下肢负重全长正侧位X线片测量11例双下肢长度均等长,畸形均矫正。采用美国特种外科医院(Hospital Special Surgery,HSS)评分评价膝关节功能,均为优。结论:应用Ilizarov技术在旋转中心穹顶状截骨治疗青少年股骨远端外翻畸形,术中即时矫正目测下股骨外翻畸形,术后根据双下肢负重正侧位片提示的下肢力线及短缩程度,动态调整矫正残余畸形及短缩,损伤小,恢复快。展开更多
文摘Restoration of fracture alignment by osteotomy is crucial for the management of humeral nonunion. In the present study, we introduced a new way of osteotomy (Z-shaped) in treating humeral shaft nonunion secondary to failed plate osteosynthesis. Clinical data of 24 patients with humeral shaft nonunion following implant failure (from 2010 to 2014) were retrospectively evaluated. These patients underwent Z-shaped osteotomy in revision surgery after the initial surgery, plate osteosynthesis, was failed. Outcomes were evaluated using visual analogue scale (VAS) and Constant and Murley score. Repeated analysis of variance (ANOVA) was used for statistical analysis. Patients were followed up for a minimum of 24 months (26.83±4.33 months). The operative time was 102.33±10.16 min, and hospital stay averaged 9.75±2.13 days. All patients achieved clinical union at the latest follow-up. Complications included radial palsy (n=1) and superficial wound infection (n=1). The postoperative VAS scores decreased significantly compared to preoperative score (F=257.99, P<0.01). Constant and Murley score increased and reached 81.33±0.95 at 24 months' follow-up 0=247.35, P<0.01). Among all the cases, 15 cases were graded as "excellent", and 9 as "good". In conclusion, Z-shaped osteotomy was easy to perform, and it provided additional medial support with more bone contact areas. Revision surgery using locking plate and Z-shaped osteotomy achieved high union rate and improved functional outcome. It was a reasonable and safe option for treating humeral nonunion following implant failure.
文摘Infantile Blount's disease is a condition that causes genu varum and internal tibial torsion. Treatment options include observation, orthotics, corrective osteotomy, elevation of the medial tibial plateau, resection of a physeal bar, lateral hemi-epiphysiodesis, and guided growth of the proximal tibial physis. Each of these treatment options has its disadvantages. Treating the coronal deformity alone(genu varum) will result in persistence of the internal tibial torsion(the axial deformity). In this report, we describe the combination of lateral growth modulation and distal tibial external rotation osteotomy to correct all the elements of the disease. This has not been described before for treatment of Blount's disease. Both coronal and axial deformities were corrected in this patient. We propose this combination(rather than the lateral growth modulation alone) as the method of treatment for early stages of Blount's disease as it corrects both elements of the disease and in the same time avoids the complications of proximal tibial osteotomy.
文摘Acetabular dysplasia is one of the most important reasons for development ofsecondary osteoarthrosis of the hip joint. This paper introduced a method of modifiedWagner’s procedure, called acetabular rotation osteotomy for the treatment of severeacetabular dysplasia in ten adults patients. These were followed up for 1-4 years. Fivecriteria including pain, gait, range of motion, measurement of roentgenographic changees,and CT scan were evaluated. From the limited information of this paper, it showed thatin all cases pain improved and range of motion did not reduced significantly. Comparingthe pre- and post-operative x-ray films, CE angle increased and exceeded the normal val-ue. Tonnis hip value decreased and approached the normal value, anteversion of theacetabulum improved, and the percentage of acetabular coverage increased as well.
文摘目的:探讨应用Ilizarov技术在旋转中心穹顶状截骨治疗青少年股骨远端外翻畸形的疗效。方法:采用回顾性研究分析2016年1月至2020年10月收治并获得完整随访的11例股骨远端外翻畸形患者的临床资料,其中男7例,女4例;右侧6例,左侧5例;年龄10~14岁。在股骨远端畸形处找出成角旋转中心(center of roration of angulation,CORA),以CORA为中点,行穹顶状截骨,根据Ilizarov外固定穿针原则安装环形外固定架,截断股骨远端,即时矫正股骨远端目测下外翻畸形,外固定架固定维持。术后根据双下肢负重全长正侧位X线片提示的下肢力线及长度结果,矫正残余畸形及短缩。结果:11例均得到随访,时间13~25个月,带架时间12~17周。末次随访拍摄双下肢负重全长正侧位X线片测量11例双下肢长度均等长,畸形均矫正。采用美国特种外科医院(Hospital Special Surgery,HSS)评分评价膝关节功能,均为优。结论:应用Ilizarov技术在旋转中心穹顶状截骨治疗青少年股骨远端外翻畸形,术中即时矫正目测下股骨外翻畸形,术后根据双下肢负重正侧位片提示的下肢力线及短缩程度,动态调整矫正残余畸形及短缩,损伤小,恢复快。
