Chinese Med J Peking
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Chinese Med J Peking · Aug 2008
Anterolateral muscle sparing approach total hip arthroplasty: an anatomic and clinical study.
Many kinds of approaches have been used for minimally invasive surgery of total hip arthroplasty (MIS-THA). However, until now when considering the balance of efficacy and associated surgical injury there is no approach widely accepted for MIS-THA. In this study, a modified anterolateral muscle sparing approach was developed to optimize MIS-THA. ⋯ The incision of the anterolateral muscle sparing approach should be directed from the anterior tubercle of the greater trochanter toward 6 cm posterior to the anterior superior iliac spine. The proximal part of the incision should be within 6 cm from the anterior tubercle of the greater trochanter, and it is safe to be extended distally. The anterolateral muscle sparing approach is a minimally invasive approach for total hip arthroplasty, through which the surgeon can operate on the acetabulum and femoral sides in a single incision without muscle detachment, and fluoroscopy assistance is not needed. The surgeon should pay more attention to protecting the gluteus medius from injury by distraction before femoral neck cutting and during the preparation of the femoral side.
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Chinese Med J Peking · Aug 2008
Semi-rigid thoracoscopy for undiagnosed exudative pleural effusions: a comparative study.
Thoracoscopy is highly sensitive and accurate for detecting pleural effusions. However, most respiratory physicians are not familiar with the use of the more common rigid thoracoscope or the flexible bronchoscope, which is difficult to manipulate within the pleural cavity. The semi-rigid thoracoscope combines the best features of the flexible and rigid instruments. Since the practice with this instrument is limited in China, the diagnostic utility of semi-rigid thoracoscopy (namely medical thoracoscopy) under local anesthesia for undiagnosed exudative pleural effusions was evaluated. ⋯ Medical thoracoscopy is a simple, safe, and cost-effective tool, with a high positive rate. Physicians should extend its access to proper patients if the facilities for medical thoracoscopy are available.