OBJECTIVETo introduce the clinical features of a rare malignant soft tissue tumor.

METHODSReview the clinical findings, pathologic features and results of the treatment of 16 cases of the epithelioid sarcoma in extremities, which were treated in our hospital from 1992 to 2004. Analyze the follow-up results of 14 cases.

RESULTSThe tumors occurred chiefly in young adults (mean age 30 years) and commonly involved soft tissue of the hand. Follow-up (average 25 months, from 1 to 112 months) information on 14 patients revealed relentless clinical course with frequent recurrence (71%). There was a significant difference between those patients in whom had a marginal and radical resection, both in recurrence rate and disease-free survival rate.

CONCLUSIONIt is safe to choose the radical resection of this disease after the tumor reoccurs.

Adolescent ; Adult ; Extremities ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Sarcoma ; diagnosis ; pathology ; surgery ; Soft Tissue Neoplasms ; diagnosis ; pathology ; surgery

Objective To improve the effect of clinical diagnosis and treatment of acetabular fracture with a femoral nerve injury by analyzing the causes of femoral nerve injury following acetabular fractures.Methods From January 1996 to November 2004,146 cases of acetabular fractures were treated operatively.Six cases of them were complicated with femoral nerve injury.The causes of femoral nerve injury were analyzed on the basis of clinical manifestations,CT scan and 3-dimensional reconstruc- tion.All the cases were classified according to Letournel and Judet classification.Three cases had hema- toma compression (2 cases with double column fractures and 1 with transverse-posterior wall fractures);2 cases had femoral nerve injury caused by fracture fragments (1 case with anterior wall fracture following anterior hip dislocation,the another with old fracture of anterior column combined with fracture of superior ramus of pubis);and one case had anterior column fracture combined with fracture of wing of ilium,and the femoral nerve was injured by traction in operation.Clearance of hematoma,nerve tract decompression and epineuria solution were performed in 5 cases,and 1 case was treated conservatively.Results The average follow-up period was 1.8 years(ranging from 1 to 3 years).The muscle power of quadriceps fem- oris recovered from 1-2 grade before operation to 4-5 grade after operation in 5 cases.The function of ex- tensor knee and gait was normal.The function of sensory completely recovered in 4 cases.One case was followed up for 2 years,which showed the patient still suffered from hypoesthesia in the lower 2/3 of the thigh and the medial of the leg.One ease of traction injury was followed up for 1.2 years,showing the muscle power recovered to normal,but still presented with sensory disability.Conclusion Acetabular fractures associated with femoral nerve injury are rare.For complex acetabular fractures and severe trau- ma,attention should be given to the possibility of femoral nerve injury.Fragment stabbing and compres- sion of hematoma around iliopsoas muscle are the common causes of femoral nerve injury following ace- tabular fractures.Iatrogenic injury should not be ignored.

AIM: To discuss the clinical applications of methods to localize nasal cut ends and the effects of Z-plasty in the surgeries for lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption.
METHODS: From September, 2010 to October, 2013, a total of 37 patients ( 37 eyes ) with lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption were operated for anastomosis of lacrimal canaliculi disruption and suture of lower eyelid longitudinal. Different methods to search for the nasal cut ends of lacerated lacrimal canaliculi, such as “under a microscope directly”, “guided by probing needle” and“pigtail curved probe”. Then, to repair lower eyelid longitudinal laceration with Z-plasty transposition flaps. Follow up was 3mo~2a after operation.
RESULTS: All nasal cut ends could be found successfully on 37 patients;Lacrimal duct unobstructed in 31 patients (83. 8%), improved in 5 patients (13. 5%), invalid in 1 patient (2. 7%),the overall successful rate was 97. 3%; the eyelids repair was satisfactory, small scars, the appearance and function was normal.
CONCLUSION: The nasal cut ends can be found successfully by “directly under a microscope”, “guided by probing needle” and“pigtail curved probe”;the effect of silicone drainage tube used as lacrimal canaliculi bracket is satisfactory; most patients gained excellent recovery for both appearance and function after Z-plasty.

BACKGROUNDSymbrachydactyly is defined as a combination of short fingers with syndactyly. There are few published reports estimating the incidence of symbrachydactyly. The aim of this study was to investigate the clinical features and the outcome of surgical treatment for congenital symbrachydactyly.

METHODSOne hundred and twenty webs of thirty-four patients of symbrachydactyly were involved in the study. The sex ratio was 21 males/13 females. The age ranged from 1 year to 8 years, average 2.6 years. Four cases had both hands involved and 30 patients had one hand involvement. Release of the syndactylous digits webs were completed by one surgical procedure in 14 cases and more than one surgical procedure in 20 cases; 3 to 6 months between the procedures. In the meantime, some of the associated hand deformities were treated.

RESULTSPostoperative follow-up time was 10 to 18 months, average 12 months. All the fingers involved in this study were separated successfully. However, 6 fingers had scar tissue contracture and 8 had web scar adhesion. All complications needed further surgical treatment. Parents of 94.1% of the patients were satisfied with the overall function of the hand, and 76.5% were satisfied with the cosmetic appearance of hand.

CONCLUSIONSThe combination of syndactyly and brachydactyly is the main clinical feature in symbrachydactyly. Separation of the digital webs can greatly improve the function of the hand. However, more work needs to be done to improve the cosmetic appearance of the hand.

Abnormalities, Multiple ; Brachydactyly ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Syndactyly ; surgery ; Treatment Outcome

OBJECTIVETo summarize the clinical characteristic and outcome of digital gigantism of the foot.

METHODSRetrospectively analyze the clinical documents of cases of digital gigantism of the foot. Twelve 12 cases with 13 feet in this study included 8 male and 4 female with an average 4.6-years-old. All the deformities were found at birth. Multiple toes involved were more than single toe, and tibial toe involved more than fibular. Forefoot was enlarged. All the phalanges involved and partial metatarsal bones were enlarged. Marked increase in subcutaneous fat was found in all cases in the operation which infiltrated interossei and articular capsules. The appearance of the nerves and its branches in the foot were normal and fat infiltrating was not discovered. The operation types included debulking, epiphyseal arrest, amputation, nerve stripping and anastomosis.

RESULTSSeven cases were followed up with mean periods 25.6 months. Functional evaluation according to a criterion formulated by author revealed a result of 2 excellent, 2 good and 3 fair.

CONCLUSIONSDigital gigantism of the foot is an uncommon congenital deformity of the foot characterized by overgrowth of both the soft-tissue and the osseous elements of the enlarged toe and forefoot. Surgical treatment is the unique method, and the goal is to reduce the size of the foot to allow fitting regular shoes and walking readily. There are several types of operations which to be chosen. The indication, the timing of operative intervention and the selection of operation type should be paid more attention.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Foot Deformities, Congenital ; surgery ; Forefoot, Human ; surgery ; Humans ; Infant ; Male ; Retrospective Studies ; Toes ; abnormalities ; Treatment Outcome

OBJECTIVETo study composition, distribution and causes of acute occupational hand injuries in Beijing Jishuitan Hospital.

METHODSFrom April 1st 2005 to September 30th 2005, all patients with acute hand injuries were investigated by questionnaire focusing on all related epidemiological elements.

RESULTSTwo thousand six hundred fifty eight cases with acute hand injuries were about 17.3 % of patients with acute orthopedic injuries. Their mean age was (30.4 +/- 10.8) years old. The radio of males to females in cases with acute hand injuries was 57:1. The cutting and crushing injuries were the main causes of acute hand injuries. Most of cases with acute hand injuries were engaged in work related to machines. The acute hand injuries were mainly involved in index and middle figures of both hands, 94.9 % of acute hand injuries were opening, and 87.6% of acute hand injuries were involved in the deep tissues.

CONCLUSIONAcute hand injuries are the common occupational severe injuries for young male workers. The acute hand injuries occur in patients engaged in work related to machines. The prevention of acute hand injuries should be emphasized.

Adolescent ; Adult ; China ; epidemiology ; Emergency Service, Hospital ; Female ; Hand Injuries ; epidemiology ; Humans ; Male ; Middle Aged ; Occupational Injuries ; epidemiology ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo introduce the experience of management of inverted papilloma in frontal sinus in hospital.

METHODSSix patients with inverted papilloma in frontal sinus treated between 1999 and 2006 were reported, with special emphasis on the clinical symptoms, surgical technique and prognosis.

RESULTSAmong 6 patients with frontal sinus involvement, there were 5 males and 1 female, aged between 24 and 66 years. All 6 patients were managed with endoscopic resection and additional open approach (glabellar nasal keyhole approach). Follow-up ranged from 2 -8 years. Five patients treated with this protocol remained disease free, and 1 patient died of tumor recurrence and malignant degeneration 16 years after the first surgical management of sinonasal inverted papilloma.

CONCLUSIONSThe appropriate management of inverted papilloma involving the frontal sinus is combined open/endoscopic approach. The tumor extended into the lateral, far superior, and anterior aspects of the frontal sinus is truly at the limits of current endoscopic instrumentation. In order to avoid recurrence, the tumor must be resected completely during the operation. Postoperative radiotherapy is not absolutely necessary.

Adult ; Aged ; Endoscopy ; Female ; Frontal Sinus ; pathology ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Papilloma, Inverted ; surgery ; Paranasal Sinus Neoplasms ; surgery ; Treatment Outcome

OBJECTIVETo discuss the diagnosis and treatment of the diseases originated in the olfactory cleft.

METHODSEight consecutive patients with the diagnosis of olfactory cleft diseases, encountered between December, 2003 and May, 2006, were included in this retrospective study. On the basis of case reports, the related anatomy, diagnosis and treatment of olfactory cleft diseases were discussed.

RESULTSFor the 8 patients with olfactory cleft diseases, the clinical and pathological diagnosis were as follows: adenocarcinoma, squamous cell carcinoma, inverted papilloma, glioma with cerebrospinal fluid (CSF) rhinorrhea, pyocyst of the superior turbinate, angiofibrosteoma, neurofibroma and hemangioma. All patients were treated by endoscopic surgery. Postoperative radiotherapy was given to two patients with malignant tumour.

CONCLUSIONSThe diseases in the olfactory cleft are not uncommon, which are often overlooked. In order to avoid misdiagnosis, (1) it is important to pay attention to this specific anatomic area; (2) the particularity of olfactory cleft diseases should be emphasized, especially in the cases of huge tumors. In that cases, the primary sites of olfactory cleft tumors can not be correctly judged preoperatively by CT scans, which can only be found during endoscopic surgery. For the treatment of olfactory cleft diseases, surgery under endoscope is the treatment of choice. If the tumor is malignant, postoperative radiotherapy should be added.

Adenocarcinoma ; diagnosis ; therapy ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; pathology ; Neurofibroma ; diagnosis ; therapy ; Nose Neoplasms ; diagnosis ; therapy ; Retrospective Studies ; Smell ; Young Adult

OBJECTIVESubtrochanteric femoral fractures are severe injuries. Although many treatment methods have been developed, controversy exists regarding the optimal management of these fractures. This study evaluated the clinical outcome of subtrochanteric femoral fractures fixed with long proximal femoral nail antirotation (PFNA-long).

METHODSBetween October 2006 and February 2008, 25 patients with traumatic subtrochanteric fractures of the femur were treated with PFNA-long. Closed reduction and fixation were performed in 20 cases. In the remaining 5 cases, closed reduction was difficult, so limited open reduction was performed, with bone grafting in 4 cases and circumferential wiring in 4 cases.

RESULTSThe average follow-up time was 16.1 months. All subtrochanteric femoral fractures healed uneventfully except one case of delayed union. The mean union time was 26.2 weeks. Technical difficulties with nail insertion were encountered in 3 cases. No implant failure was observed.

CONCLUSIONPFNA-long is effective in treatment of subtrochanteric femoral fractures, with a high rate of bone union, minor soft tissue damage, early return to functional exercise and few implant-related complications.

Adult ; Biomechanical Phenomena ; Bone Nails ; Female ; Fracture Fixation, Internal ; instrumentation ; Fracture Healing ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies