OBJECTIVETo investigate the safety and efficacy of close reduction and percutaneous needle fixation for the treatment of anterior dislocation of sternoclavicular joint.

METHODSA retrospective analysis was performed with 6 cases of anterior sternoclavicular dislocation by close reduction and percutaneous needle fixation with Kirschner wire treated from January 2001 to February 2009, including 5 males and 1 female aged from 19 to 45 with an average of 28.8 years old. Among the 6 cases, 4 were on right lateral and 2 were on left lateral. The time from injured to treatment was from 6 hours to 12 days (averaged 4.5 days). The clinical effects were evaluated according to Rockwood scoring and the complications were observed.

RESULTSAll 6 patients were followed-up for 3 to 13 months (averaged 6 months). According to Rockwood scoring,the preoperative score was (7.00 +/- 0.89) points, postoperative score was (13.17 +/- 1.72) points; the results showed excellent in 5 cases and good in 1 case. No local infection, postoperative pain,recurrent dislocation,broken needle, and other complications were observed in this study.

CONCLUSIONThe treatment of anterior sternoclavicular joint dislocation with Kirschner wire minimally invasive fixation is an easy, reliable fixation with less complications.

Adult ; Bone Wires ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Radiography ; Sternoclavicular Joint ; injuries ; surgery

OBJECTIVETo investigate the safety and efficacy of minimally invasive achilles tendon lengthening and system rehabilitation for the treatment of contracture of achilles tendon.

METHODSFrom January 2002 to December 2010, 27 patients (31 feet) with contracture of achilles tendon were treated with minimally invasive achilles tendon lengthening and system rehabilitation. There were 11 males and 16 females with an average age of 35.5 years (ranged 3 to 65 years). Right foot was in 13 cases, left foot was in 10 cases, both feet were in 4 cases. Course of disease was from 1 to 5 years with an average of 2.3 years. The cause of contracture included postoperative complication of tibia fractures treated with intramedullary nailing in 7 feet, sequelae of lower leg compartment syndrome in 11 feet, congenital talipes equinovarus in 13 feet (both feet in 4). Before operation, all the patients walked with limping, plantar flexion anomaly was from 15 degrees to 50 degrees with an average of 35.5 degrees. The strength of quadriceps muscle of thigh was grade V in 27 feet, grade IV in 4 feet, the strength of musculus triceps surae was grade V in 24 feet, grade IV in 7 feet.

RESULTSAll the patients were followed-up for 6-24 months with an average of 11.3 months. According to standard of Arner-Lindholm to evaluate function of ankle joint, 29 feet obtained excellent results and 2 feet good. No infection, re-rupture or re-contracture was found.

CONCLUSIONMinimally invasive achilles tendon lengthening and system rehabilitation in treating contracture of achilles tendon has advantage such as simple operation, less complication, lower recurrence rate, which is favourable for thoroughly rehabilitation of patients. But, the case in which the strength of quadriceps muscle of thigh or musculus triceps surae still less than grade III after preoperative rehabilitation care should not choose the method.

Achilles Tendon ; surgery ; Adolescent ; Adult ; Aged ; Bone Lengthening ; methods ; Child ; Child, Preschool ; Contracture ; rehabilitation ; surgery ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods

Objective:To explore the relationship between residual collateral vessels in uterine arterial embolization (UAE) and the risk of bleeding during the operation of curettage for cesarean scar pregnancy.Methods:A total of 499 patients who underwent preventive UAE before curettage for scar pregnancy in Shandong Provincial Hospital from January 2012 to June 2019 were included. Clinical data of the patients were retrospectively collected and analyzed. In patients with uterine collateral circulation, collateral vessels were embolized as much as possible. Angiography was performed after UAE. All the cases were divided into 3 grades according to residual staining in middle and lower part of corpus uteri as follows, grade A: no or mild staining, grade B: moderate staining, grade C: intense staining. Blood loss of the patients during curettage was recorded, and the incidence rate of minor hemorrhage (<50 ml) and massive hemorrhage (>500 ml) of the 3 grades were calculated respectively. The results of three grades groups were compared with those of control group (patients without collateral circulation) by using Chi-square test or Fischer exact probability.Results:According to angiogram acquired after UAE, collateral vessels were found in 53 patients, with 25 cases in grade A group, 15 cases in grade B group, and 13 cases in grade C group, respectively. Thirty-six patients underwent transcatheter embolization of collateral vessels. The incidence rate of minor hemorrhage in type B and C [60.0% (9/15), 46.2% (6/13)] was lower than that in control group (87.9%, 392/446), with significant difference found (χ2=9.972, P=0.002, χ2=19.090, P<0.001). Significant difference was found in the incidence rate of massive haemorrhage between group C (23.1%, 3/13) and control group (2.2%, 9/446) (χ2=14.480, P=0.001). Conclusion:As for cesarean scar pregnancy cases with uterine collateral vessels, embolization of collateral vessels may reduce the amounts of bleeding during curettage. Residual staining of middle and lower part of corpus uteri may be helpful in predicting the risk of massive haemorrhage during curettage.