Objective To observe the effect of motor nerve baby-sitting and different babysitting stages on nerve regeneration in nerve root re-implantation for brachial plexus avulsion injury.Methods Twenty-four SD rats were used to induce the brachial plexus avulsion injury.C5-7 roots were avulsed and C6 anterior root was re-implanted to the spine cord via a posterior approach.Branches erupting from C6 and the branches affiliated to the musculocutaneous nerve were cut away via an anterior approach.Re-implanted C6 anterior root was connected singly with musculocutaneous nerve.After that,the end of one branch of medial pectoral nerve was sutured to the lateral musculocutaneous nerve.The animal was divided into persistence motor nerve baby-sitting group (Group A,n =12) and protophase motor nerve baby-sitting group (Group B,n =12) according to the random number table.Electrophysiological evoked potential,muscle wet weight and muscle fiber cross-sectional area were measured at postoperative 2 and 3 months.Results At postoperative 2 and 3 months,the restoration rates of motor evoked potential in Group A [(12.2 ± 3.3) ％ and (15.1 ± 3.5) ％] revealed significant differences from these in Group B [(30.1 ±4.2)％ and (54.8 ±9.6)％] (P ＜0.01),the restoration rates of muscle wet weight in Group A [(75.9 ± 5.3) ％ and (92.7 ± 8.6) ％] were similar with (76.4 ± 7.3) ％ and (94.3 ± 4.4) ％ in Group B (P ＞ 0.05),and the restoration rates of muscle fibrin cross section area in GroupA [(74.4±5.5)％ and (88.5±7.5)％] were similar with (76.9±6.7)％ and (92.9± 3.5) ％ in Group B (P ＞ 0.05).Conclusions Motor nerve end-lateral baby-sitting can improve functional restoration of the skeletal muscle in the early stage after nerve root re-implantation,but prevent functional restoration of skeletal muscle in the late stge.On the contrary,protophase motor nerve babysitting avoid the inhibitory effect in the late stage,which gains better restoration rate of muscle motion evoked potential.

Orbital fracture often leads to facial collapse, diplopia, enophthalmos, and even blindness. Traditional surgery relies on the experiences of physicians to achieve fracture reduction and orbital wall reconstruction, but the repair effect is not satisfactory. In recent years, with the development of digital technology, technologies such as computer-assisted surgery, 3D printing, surgical navigation systems, and intraoperative CT imaging have become increasingly widespread in the field of orbital reconstruction. Such techniques can avoid dependence on physicians′ experiences and make it easy for estimating and positioning the implantation sites, which subsequently contributes to better surgery efficiency and precise reconstruction of the orbit, improving aesthetics and visual function of patients. To this end, the authors reviewed the recent progress in application of digital technology for orbital fracture reconstruction, so as to provide reference and theoretical basis for clinical practice.

Objective:To analyze the clinical effect of navigation-assisted cosmetic incision for reduction and internal fixation in treating unilateral B-type zygomatic fracture.Methods:A retrospective cohort study was performed on clinical data of 35 patients with unilateral type B zygomatic fracture treated from January 2018 to December 2019 in First Affiliated Hospital of Fujian Medical University. There were 20 males and 15 females at age range of 5-62 years [(38.7±11.3)years]. Navigation-assisted cosmetic incision for reduction and internal fixation was performed for 17 patients (navigation group), and empirical incision to reduction and internal fixation was performed for 18 patients (convention group). The length of bony zygomatic process (zygomatic process) and width of zygomatic temporal point (frontal width) of the bilateral zygomatic bone were measured on the horizontal axis of CT at 1 week after operation. The absolute values of the difference of bony zygomatic process degree and frontal bony width between affected side and the healthy side were compared between the two groups. The patients′ satisfaction and occurrence of complications such as lower eyelid ectropion, incision infection and facial nerve injury were compared between the two groups at half a year after operation.Results:All patients were followed up for 6-24 months [(9.3±1.2)months]. The absolute difference of bony zygomatic process was 0.60(0.25, 0.85) mm in navigation group, and was 0.75 (0.20, 1.98)mm in convention group ( P>0.05). The absolute difference of frontal bony width was (0.37±0.11)mm in navigation group, and was (2.47±0.63)mm in convention group ( P<0.01). Satisfaction rates by both objective evaluation and subjective evaluation in navigation group were better than that in convention group at half a year after operation (both P<0.05). Navigation group showed lower eyelid ectropion in 1 patient and incision infection in 1 patient. Convention group showed facial nerve injury in 1 patient and incision infection in 2 patients. There was no significant difference in the incidence of complications between navigation group [12%(2/17)] and conventional group [17%(3/18)] ( P>0.05). Conclusion:For unilateral type B zygomatic fracture, navigation-assisted cosmetic incision for reduction and internal fixation can more accurately restore the frontal width, and improve satisfaction rate as compared with empirical reduction and internal fixation.