Objective To evaluate the prognostic factors of tracheoesophageal groove lymph node(TEGLN) metastasis in postoperative esophageal carcinoma.Methods From January 1996 to December 1997,101 postoperative cervical and thoracic esophageal carcinoma patients proved absence from tracheoesophageal groove lymph node(TEGLN) metastasis before and after operation by physical examination and computer tomography examination were entered into this study.The patients were divided into three groups according to the treatment of supraclavicular region: no prophylactic radiotherapy(group A-,30 patients);prophylactic radiotherapy with local dose

Objective:To investigate the biomechanical properties of a new pediatric femoral neck system in the fixation of pediatric femoral neck fractures with a free fracture fragment.Methods:Ten Sawbones model bones were randomly divided into 2 even groups ( n=5), all of which were made into Delbet Type Ⅱ femoral neck fractures with a Pauwels angle of 70°. A free bone block was removed from the bottom at the proximal end of the fracture to simulate a femoral neck fracture with a free fragment. Group A were fixed with traditional inverted triangle cannulated screws, and group B with a new pediatric femoral neck system. After the 2 groups of specimens were placed on a biomechanical testing machine, each specimen was subjected to a static axial compression test, an anti-torsion test and a cyclic load test in turn. The biomechanical results were compared between groups A and B in aspects of axial compression stiffness, torsional stiffness and maximum displacement difference. Results:The axial compression stiffness [(321.718±5.770) N/mm] and torsional rigidity [(1.448±0.079) N·m/°] in group B were significantly higher than those in group A [(266.722±4.788) N/mm and (1.282±0.023) N·m/°] ( P<0.05). The maximum displacement difference in the cyclic load test in group B [(0.063±0.038) mm] was also significantly smaller than that in group A [(0.117±0.056) mm] ( P<0.05). Conclusion:In fixation of pediatric femoral neck fractures with a free fracture fragment, the new pediatric femoral neck system can lead to better biomechanical stability than the traditional inverted triangle cannulated screws.

Objective:To explore the diagnosis and treatment of humeral medial epicondyle fracture combined with radial neck fracture in children and adolescents.Methods:The clinical data were retro-spectively analyzed of the 12 pediatric patients with fractures of the humeral medial epicondyle plus the radial neck who had been admitted from February 2015 to August 2021 to Department of Pediatric Orthopedics, The Second Hospital of Fuzhou. There were 6 males and 6 females, with an age of (11.1 ± 2.5) years. According to the Papavasiliou classification, the humeral medial epicondyle fractures were type Ⅱ in 7 cases, type Ⅲ in 2 cases and type Ⅳ in 3 cases; according to the Judet classification, the radial neck fractures were type Ⅰ in 3 cases, type Ⅱ in 4 cases and type Ⅲ in 5 cases. Two Judet-Ⅰ radial neck fractures were missed by X-ray exam-ination but diagnosed by CT examination. Of the humeral medial epicondylar fractures, 9 were treated by open reduction and hollow screwing and 3 by closed reduction and Kirschner wiring. Of the radial neck fractures, 8 were treated by closed reduction and elastic intramedullary nailing and 4 conservatively. Fracture healing was followed up by postoperative radiographs. At the last follow-up, the carrying angles were measured, Kim Elbow Function Score (KEPS) was used to evaluate the functional recovery of the injured limb, and related complications were recorded.Results:All the 12 patients were followed up for (40.0±25.6) months. Fractures headed after (6.3±1.2) weeks. At the last follow-up, the carrying angle was 15.5°±2.6° on the injured side and 14.7°±2.0° on the healthy side, showing no significant difference ( P>0.05); KEPS was (96.3±5.3) points on the injured side and (98.8±2.3) points on the healthy side, showing no significant difference either ( P>0.05). No incision infection, bone nonunion, elbow valgus, joint stiffness or other complications were found; the postoperative elbow stability recovered well. Conclusions:As the fracture of the humeral medial epicondyle combined with the radial neck fracture is a special type of injury of straightened elbow during valgus stress in children and adolescents, it is likely to be missed in diagnosis. The goal of treatment is good functional recovery by restoring the articular match and elbow stability.

Objective:To evaluate the ultrasonography-guided percutaneous leverage reduction in the treatment of pediatric radial neck fractures.Methods:From May 2016 to May 2018, 42 patients with Judet Ⅲ or Ⅳ radial neck fracture were treated at Department of Pediatric Orthopedics, The Second Hospital of Fuzhou. They were 15 boys and 27 girls, aged from 3 to 12 years. All of them were treated by percutaneous leverage reduction and Métaizeau technique. The operative procedures were guided by ultrasonography in 20 cases and by C-arm fluoroscopy in 22 cases. Postoperative evaluation was based on Métaizeau imaging criteria, Tibone and Stoltz functional criteria; complications such as radial nerve injury were recorded.Results:There were no statistically significant differences between the ultrasonography-guided group and the fluoroscopy-guided group in preoperative general data, showing comparability ( P>0.05). There were no significant differences between the 2 groups in terms of Métaizeau imaging, Tibone or Stoltz functional scores ( P>0.05). The frequency of fluoroscopy was (2.7±0.6) times for the ultrasonography group and (14.6±3.4) times for the fluoroscopy group while the operation time averaged (25.8±5.9) min for the former and (38.1±9.2) min for the latter, showing significant differences ( P<0.05). No postoperative complications were observed in the ultrasonography group while 4 cases of radial nerve injury in the fluoroscopy group, also showing significant difference between the 2 groups ( P< 0.05). Conclusion:Ultrasonography-guided percutaneous leverage reduction is a suitable surgical treatment of radial neck fracture in children, because it is simple, effective and safe.