Zhonghua wai ke za zhi [Chinese journal of surgery]
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Zhonghua Wai Ke Za Zhi · Mar 2017
[Application of three-dimensional printing personalized acetabular wing-plate in treatment of complex acetabular fractures via lateral-rectus approach].
Objective: To investigate reduction and fixation of complex acetabular fractures using three-dimensional (3D) printing technique and personalized acetabular wing-plate via lateral-rectus approach. Methods: From March to July 2016, 8 patients with complex acetabular fractures were surgically managed through 3D printing personalized acetabular wing-plate via lateral-rectus approach at Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University. There were 4 male patients and 4 female patients, with an average age of 57 years (ranging from 31 to 76 years). ⋯ According to the modified Merle D'Aubigné and Postel scoring system, 5 cases were excellent, 2 cases were good, 1 case was fair. Conclusions: Surgical management of complex acetabular fracture via lateral-rectus approach combine with 3D printing personalized acetabular wing-plate can effectively improve reduction quality and fixation effect. It will be truly accurate, personalized and minimally invasive.
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Zhonghua Wai Ke Za Zhi · Mar 2017
[Minimally invasive tarsal sinus incision combined with manipulative reduction and internal fixation for calcaneal fractures of Sanders typeⅡ and Ⅲ].
Objective: To evaluate the method and curative effect of plate fixation or percutaneous screws for the treatment of calcaneal fractures of Sanders type Ⅱ and Ⅲ via a minimally invasive sinus tarsi incision combined with a variety of manipulative reduction methods. Methods: Twenty-one patients with closed calcaneal fractures treated in the Department of Orthopedics, the First Affiliated Hospital of Nanchang University from January 2014 to January 2016 were collected. There were 15 men and 6 women, with an average age of 39.3 years(from 25 to 63 years). ⋯ Compared to 3 days after surgery, calcaneal width, Böhler angle and Gissane angle kept normal 3 months after surgery, there were no statistically differences (F=0.26, 1.35, 2.60, all P>0.05). By the AOFAS scoring, 10 cases were rated as excellent, 7 were good and 4 were fair. Conclusions: Fixation with plate and percutaneous screws via the mini-open sinus tarsi approach is an effective treatment for Sanders types Ⅱ and Ⅲ calcaneal fractures, which with the advantages of small wound, simple operation, reliable fixation, no incision complication, especially suitable for elderly patients and the patients with severe injury of local soft tissue.
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Zhonghua Wai Ke Za Zhi · Mar 2017
[Causal analysis and management strategies of 30-day unplanned revision surgery following single-stage posterior vertebral column resection for severe spinal deformity].
Objective: To investigate the causes of 30-day unplanned revision surgery following one-stage posterior vertebral column resection (PVCR) for severe spinal deformity and the methods of prevention and management. Methods: A total of 112 severe deformity patients underwent one-stage PVCR for surgical treatment in the 306(th) Hospital of People's Liberation Army from May 2010 to December 2015 were retrospectively reviewed. Six patients required reoperation within 30 days after PVCR, including 2 males and 4 females with average age of 21 years (ranging from 12 to 38 years). ⋯ Conclusions: One-stage PVCR could be an effective method for treatment of severe spinal deformity. The causes of 30-day unplanned reoperation after PVCR are as followed: cerebrospinal fluid leak, dural buckling, residual bone compression and hematoma compression. Timely surgical exploration can gain good clinical outcomes.
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Zhonghua Wai Ke Za Zhi · Mar 2017
[Proximal junctional kyphosis after posterior hemivertebra resection and instrumented fusion in young children with congenital scoliosis].
Objective: To investigate the risk factors of proximal junctional kyphosis(PJK) in young children who underwent posterior hemivertebra resection and instrumented fusion. Methods: This study reviewed the charts and radiographs of 136 consecutive young children with congenital scoliosis who underwent posterior hemivertebra resection and instrumented fusion in Department of Orthopaedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2009 to June 2014, including 75 males and 61 females, with an average age of (5.0±1.7)years(3-10 years). Proximal junctional angle(PJA), spino-pelvic parameters and segmental kyphosis (SK) were recorded pre- and post-operation and at last follow-up. ⋯ At the time of the final follow-up visit, ten patients received brace treatment, with no significant progression of PJA. Conclusions: PJK might mainly occurs within 3 months postoperatively. Its prognostic factors include preoperative hyperkyphosis, over correction of kyphosis and ligamentous failure.
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Zhonghua Wai Ke Za Zhi · Mar 2017
[Clinical analysis of cervical posterior internal fixation titanium plate and silk suspension internal fixation cervical spondylosis].
Objective: To evaluate the clinical effect and imaging evaluation of cervical spine myelopathy treated with Centerpiece. Methods: A retrospective study of 60 patients underwent posterior cervical spine surgery because of cervical myelopathy in Spinal Department of Peking University People's Hospital from July 2011 to January 2013. According to the different fixation methods, all patients were divided into cervical posterior open-door Centerpiece fixation group (group A) and cervical posterior open-door silk suspension fixation group (group B). ⋯ There was no statistical difference between the two groups of the whole spinal cord backward shift distance(P>0.05). There were significant differences between the two groups at the angle of the open door (P<0.05). Conclusion: Centerpiece cervical posterior titanium plate can achieve good clinical efficacy in the treatment of multi segmental spinal cervical spondylosis.