Long-term results of type I tympanoplasty with perichondrium reinforced cartilage palisade vs temporalis fascia for large perforations:A retrospective study

Objective:To compare the rate of graft uptake and postoperative hearing outcomes of Type I tympanoplasty with perichondrium reinforced cartilage palisade to temporalis fascia for large tympanic membrane(TM)perforations over 5 years follow-up period.Materials and methods:This was a retrospective comparative study involving patients with chronic otitis media with large TM perforations.The patients underwent type I tympanoplasty using either perichondrium reinforced cartilage palisade(CP group)or temporalis fascia(TF group)as the graft via a transmeatal approach and under local anesthesia.Morphological and functional results were recorded at three-and five years follow-up.Demographic profiles including age and sex,surgery side,contralateral disease and graft uptake rate,as well as hearing outcomes,were compared between the two groups.Results:At three years follow-up,graft uptake was 94.87%for perichondrium reinforced cartilage palisade and 80.7%for fascia,respectively,(p¼0.67).At five years follow-up,the uptake rate dropped to 87.17%in the CP group,but to 66.6%in the TF group(p¼0.019).Hearing improved after surgery in both groups,and showed no significant difference between the two groups.Conclusion:Over long-term,perichondrium reinforced palisade showed a statistically significant better outcome regarding graft uptake than temporalis fascia in type Itympanoplasty for large TM perforations with comparable audiometric results.

Comparative study between intramedullary interlocking nailing and minimally invasive percutaneous plate osteosynthesis for distal tibia extra-articular fractures

Purpose:Treatment of distal tibia fractures poses significant challenge to orthopedic surgeon because of poor blood supply and paucity of soft tissue coverage.There is considerable controversy regarding the superior option of treatment for distal tibia fracture between the minimally invasive percutaneous plate osteosynthesis(MIPPO)technique and intramedullary interlocking(IMIL)nailing for extra-articular distal tibia fractures.The aim of our study is to compare the functional outcome between the two treatment methods.Methods:This was the prospective comparative study of 100 patients with distal third tibia fractures divided into two groups.The first group of patients were treated with MIPPO technique while the second group of patients were managed by IMIL nailing.Patients were followed up in outpatient department to assess the functional outcomes,malunion,delayed union,nonunion,superficial and deep infection between the two groups.Statistical analyses were performed using the SPSS software(version 16.0).Results:Average malunion(degrees)in the MIPPO group was 5(3—7)±1.41 vs.10.22(8—14)±2.04 in the IMIL group(p=0.001).Similarly postoperative knee pain in the IMIL group was 10%vs.2%in the MIPPO group(p=0.001).In terms of superficial infection and nonunion,the results were 8%vs.4%and 2%vs.6%for the MIPPO and IMIL group,respectively(p=0.001).Conclusion:Both procedures have shown the reliable method of fixation for distal extra-articular tibia fractures preserving the soft tissue,bony vascularity and fracture hematoma that provide a favourable biological environment for fracture healing.Considering the results of the study,we have slightly more preference for the MIPPO technique.

Combined fracture dislocation of the navicular bone along with cuboid, cuneiform and longitudinal split fracture of the lateral malleolus： a rare combination of fractures

船形的骨头，长方体的破裂，楔形文字，和侧面的踝的纵的裂口骨折的破裂脱臼是破裂的稀罕联合。这是高速度损害破裂并且能被脚的强迫的脚底的屈曲和倒置在影响的时候引起到地面上。这里，我们在被开的减小和固定为侧面的踝与三分之一个管状的盘子为船形的骨头，和二个 interfragmentary 螺丝钉与一个部分线程的螺丝钉和二 K 电线对待的一个 35 岁的男病人报导了如此的一个案例。K 电线被移开 6 &#xA0；在外科以后的星期由部分重量适用列在后面。在 6 &#xA0 以后；月，病人能最小的疼痛地通常走并且脚胀大。