Objective To evaluate the safety and efficacy of the newly combined anterior platerod system in treatment of acute thoracolumbar burst fracture combined with neurologic deficit.Methods A retrospective study was carried out on 84 consecutive patients with acute thoracolumbar burst fracture combined with neurologic deficits treated by anterior surgery,bone fusion,and internal fixation with the new plate-rod system.There were 61 males and 23 females with a mean age of 31.4 years (range,19-53 years).Primary pathogenesis was high falls in 67 patients,traffic accidents in 13 patients and others in 4 patients.Fractured segments included T11 in 19 patients,T12 in 22,L1 in 25,and L2 in 18.Visual analogue scale (VAS),spinal canal encroachment,and loss of kyphosis correction were measured for all patients to evaluate radiologic and neurological outcomes.Results Bony union occurred in all patients at the 3-5 months of follow-up.There was no pseudarthrosis or vascular complications related to the fixation device.Percentage of canal encroachment decreased from preoperative 70％ to postoperative 2％.Mean segmental kyphotic angle measured 27.9 ° before operation and 7.4 ° after operation,with a mean correction of 20.5°.All patients demonstrated at least one grade of neurological improvement at final follow-up.Mean VAS was improved significantly from preoperative 7.3 points to postoperative 2.9 points.Conclusion The new anterior plate-rod system is safe and effective in treatment of acute thoracolumbar burst fracture combined with neurologic deficit.

Objective:To explore the clinical effect of a two-staged repair and reconstruction of composite soft tissue defect of dorsal wrist with transfer of free flap (in stage-one) repair and followed by transplantation of allogeneic tendon (in stage-two) reconstruction.Methods:From December 2018 to January 2021, 6 cases with dorsal wrist composite tissue injury and extensor tendon defect were treated in the Department of Hand and Microsurgery of the Fourth People's Hospital of Guiyang City. Four cases were treated with free anterolateral thigh flap (ALTF) combined with allogeneic tendon in the first stage to reconstruct finger dorsiflexion function, and 2 cases were treated with free ilioinguinal flap combined with allogeneic tendon in the second stage to reconstruct finger dorsiflexion function. The age of the patients ranged from 22 to 62 years old. The areas of defect were 5.0 cm×12.0 cm-8.0 cm×20.0 cm. Two cases had 2 extensor tendons defect, 1 had 3 extensor tendons defect, 2 had 4 extensor tendons defect, and 1 had 5 extensor tendons defect. The length of extensor tendon defects was 7.0-22.0 cm. In 5 cases, the wounds were covered by VSD for 5 to 7 days after complete emergenly debridement. Then, after the wounds had been cleared and clean, the wounds of 3 cases were covered with free ALTF, 2 with free ilioinguinal flap, and 1 with free ALTF after skin graft scar resection. At 3-4 months later, the extension function of digit was reconstructed with the transplantation of allogeneic tendons. Postoperative appearance of the flaps and functions of digits were observed at the outpatient clinics during the follow-up.Results:The postoperative follow-up lasted for 10 to 26 (15 in average) months. All 6 flaps surrived completely, and 1 case was further treated with flap thinning at 4 months after the second surgery. During the follow-up, all flaps healed well and were good in appearance and texture. Meanwhile, the donor areas were all healed well with no dysfunction nor sensory disorder. All the transplanted tendons were in good glide without adhesion. The active motion of metacarpophalangeal joints ranged from (10±10) ° to (80±10) °. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, at the final follow-up, 4 cases were excellent and 2 cases were good.Conclusion:It is safe and effective that using the two-staged procedure in repair of composite tissue defect of dorsal wrist with stage-one ALTF or ilioinguinal flap transfer combined with stage-two reconstruction with transplantation of allogeneic tendon. It can minimize the adhesion after tendon transplantation and donor site damage

AIM: To compare the efficacy, safety, and complications of 27G and 25G vitrectomy in the treatment of rhegmatogenous retinal detachment(RRD)involving the macular area.METHODS:This retrospective study analyzed 60 patients(60 eyes)initially diagnosed with RRD involving the macular area and undergoing 25G or 27G vitrectomy combined with retinal reattachment at our hospital from January 2021 to December 2023. Patients were divided into 25G group(30 eyes)and 27G group(30 eyes). Best corrected visual acuity(BCVA), intraocular pressure(IOP), surgical duration, retinal reattachment rate and complications of both groups of patients were compared before and after surgery.RESULTS: The mean surgical time in the 27G group was slightly longer than in the 25G group(40.20±7.52 vs 36.97±7.47 min). Incision leakage occurred in 7 eyes(23%)in the 25G group versus 1 eye(3%)in the 27G group, though the difference was not statistically significant between two groups(P>0.05). At 6 mo postoperatively, BCVA(LogMAR)improved significantly in both groups(27G: 0.37±0.19 vs preoperative 0.98±0.32; 25G: 0.40±0.17 vs preoperative 0.84±0.33; all P<0.05), with no statistical difference in BCVA(P>0.05). At 1 d postoperatively, the 25G group had lower mean IOP(12.29±2.86 mmHg)compared to the 27G group(15.87±3.70 mmHg; P<0.001), but no differences were observed at 1 wk or 1 mo postoperatively(all P>0.05). Retinal reattachment rates and complications(intra- or postoperative)showed no significant intergroup differences(all P>0.05).CONCLUSION: Both 25G and 27G vitrectomy are safe and effective in treating rhegmatogenous retinal detachment. However, the 27G vitrectomy offers advantages such as small incisions, better self-sealing properties, and more stable IOP.