1.Clinical efficacy of percutaneous minimally invasive anchorage suture in repair of acute closed Achilles tendon rupture
Xingzhang YAO ; Xiongyong LI ; Zhengxing JIANG ; Zhijun HE ; Chunxuan DONG
Chinese Journal of Trauma 2018;34(6):521-526
Objective To investigate the clinical efficacy of percutaneous minimally invasive anchorage in the treatment of acute closed rupture of Achilles tendon. Methods A retrospective casecontrol study was conducted on the clinical data of 32 patients (16 cases on the left side and 16 cases on the right side) with acute closed Achilles tendon rupture treated from January 2015 to January 2017. There were 27 males and five females, aged 24-67 years (mean, 40.8 years). The patients were divided into treatment group which adopted percutaneous minimally invasive combined with anchor suture and control group which used simple minimally invasive suture, with 16 cases in each group. The operation time, hospitalization time, sural nerve injury, single foot heel raise at 3 months and 6 months, difference of calf circumference on the rupture surface between the affected side and healthy side at 6 months, ankle back foot score scale (AOFAS), and infection at 6 months were recorded. Results All patients were followed up for average 8.9 months (range, 6-12 months). In treatment group, the operation time was (35.75 ±3.10) minutes and hospitalization time was (8.38±1.62) days. The AOFAS score was(92.12 ±5.86)points. The result of single foot heel raise was positive in one case at 3 months and in 0 case at 6 months. The difference of calf circumference on the rupture surface between the affected side and healthy side at 6 months was (2.23 ±0.97)cm. In the control group, the operation time was (33.43± 3.89)minutes and hospitalization time was (8.50±1.75)days. The AOFAS score was (91.00 ±7.15) points at 6 months. The result of single foot heel raise was positive in eight cases at 3 months and in 0 case at 6 months. The difference of calf circumference on the rupture surface between the affected side and healthy side at 6 months was (1.64 ±2.34) cm. There were no significant differences between the two groups in operation time, hospitalization time, the AOFAS score at 6 months, and the results of single foot heel raise at 6 months(P >0.05). Treatment group had better results than control group in terms of the difference of calf circumference on the rupture surface between the affected side and healthy side at 6 months as well as the result of single foot heel raise at 3 months (P < 0.05). No infection and sural nerve injury were found in either group. Conclusion The repair of Achilles tendon rupture by percutaneous minimally invasive anchor technique can help patients achieve heel raise early, obtain better muscle capacity, and return to work earlier.
2.Clinical observation of"three modulation acupuncture"combined with repeated functional magnetic stimulation in the treatment of neurogenic bladder with detrusor muscle weakness after spinal cord injury
Yongqiang PANG ; Xiumei XU ; Yanlong XU ; Zixiao CHENG ; Chunxuan DONG ; Yanqin ZHANG ; Xi ZHANG ; Han MA
Journal of Beijing University of Traditional Chinese Medicine 2024;47(6):826-834
Objective To observe the clinical efficacy of"three modulation acupuncture"combined with repeated functional magnetic stimulation(rFMS)in the treatment of neurogenic bladder with detrusor muscle weakness after spinal cord injury.Methods A total of 120 patients with neurogenic bladder with detrusor muscle weakness after spinal cord injury were divided into conventional treatment group,"three modulation acupuncture"treatment group,rFMS treatment group and comprehensive treatment group according to the random number table method,with 30 patients per group.The conventional treatment group was given conventional rehabilitation treatment,the"three modulation acupuncture"treatment group was treated with"three modulation acupuncture"(modulating spirit,modulating reflex arc,and modulating lower jiao and waterway)based on conventional rehabilitation treatment,the rFMS treatment group was treated with rFMS based on conventional rehabilitation treatment,and the comprehensive treatment group was treated with"three modulation acupuncture"and rFMS based on conventional rehabilitation treatment.The first desire to void(FDV),maximum cystometric capacity(MCC),maximum detrusor pressure of urine storage period(Pdet.max),maximum intravesical pressure of urine storage period(Pves.max),average daily urination frequency,average daily urine leakage,residual urine volume,and neurogenic bladder symptom scores of the patients were compared before and after treatment,and the clinical effectiveness of each group was evaluated.Results After treatment,the FDV,MCC,and Pdet.max of the four groups were all increased compared with those before treatment,and Pves.max,the average daily urination frequency,the average daily frequency of urine leakage,the residual urine volume,and the neurogenic bladder symptom scores were all decreased(P<0.05).After treatment,the FDV,MCC,and Pdet.max of the"three modulation acupuncture"treatment group,the rFMS treatment group and the comprehensive treatment group were all higher than those of the conventional treatment group,and Pves.max,the average daily urination frequency,the average daily frequency of urine leakage,the residual urine volume,and the neurogenic bladder symptom scores were all lower(P<0.05).After treatment,the comprehensive treatment group had a higher FDV,MCC,and Pdet.max than the"three modulation acupuncture"treatment group and rFMS treatment group,and Pves.max,the average daily urination frequency,the average daily frequency of urine leakage,the residual urine volume,and the neurogenic bladder symptom scores were lower(P<0.05).The curative efficiency rates were 86.2%(25/29)in the"three modulation acupuncture"treatment group,85.7%(24/28)in the rFMS treatment group,and 92.6%(25/27)in the comprehensive treatment group,which was higher than that of the conventional treatment group,which was 75.9%(22/29).Conclusion"Three modulation acupuncture"and rFMS can effectively improve the functional status of the bladder in patients of neurogenic bladder with detrusor muscle weakness after spinal cord injury,and their combined application has a synergistic effect.