At present, treatment for chronic radial head dislocation mainly focus on open reduction, and conservative treatment is invalid. While the surgical procedure generally applies to extend ulnar, short radial, reset radial head. Repair or reconstruction of annular ligament is the focus of study. For the dysfunction, radial head resection served as the final choice. Early diagnosis is the key to the treatment of chronic radial head dislocation. While ulnar or radial osteotomy and non-reconstruction of annular ligament is still the main trend of today.
Humans ; Joint Dislocations ; surgery ; Ligaments, Articular ; surgery ; Radius ; injuries ; surgery

Penile augmentation is an important part of penile surgery, the demand for and supply of which has increased because of mens desire for a larger penis. There is some controversy about the rationality of this operation, because the surgical indications and standardization of surgical techniques are not confirmed. Nevertheless, the clinical necessity for penile augmentation is beginning to be accepted as is aesthetic surgery in women. Penile augmentation is performed mainly by using dermal fat grafting for girth enhancement and skin reconstruction or ligament release for lengthening. Several new techniques and modification have been introduced. This review describes recent advances in the field of penile augmentation surgery.
Female ; Humans ; Ligaments ; Male ; Penis ; Skin ; Surgery, Plastic ; Transplants

The usefulness and accuracy of computer-assisted surgery have been evaluated clinically in many orthopedic fields, including joint replacement arthroplasty, pedicle screw placement, and cruciate ligament reconstruction of the knee joint. Since several preliminary reports on application of navigation to bone tumor resection and reconstruction surgery have recently been issued, navigation-assisted surgery for bone tumors has received significant attention with regard to its usefulness. In particular, navigation can be helpful during surgery for musculoskeletal tumors, because it can maximize the accuracy of resection and minimize the unnecessary sacrifice of normal tissue by providing precise intraoperative three-dimensional radiological information. In addition, it is helpful in prosthetic reconstruction, because preoperative virtual simulation makes it possible to estimate size and location of bone defect to be left after tumor resection. Surgeons should recognize that use of navigation systems in bone tumor surgery has some hidden pitfalls. Here, based on our clinical results, we describe the surgical techniques that we have used and include some cautionary notes.
Arthroplasty, Replacement ; Joints ; Knee Joint ; Ligaments ; Orthopedics* ; Surgery, Computer-Assisted

Deltoid ligament injury is common in the daily activities, unlike some other diseases, mechanism of deltoid ligament injury is relatively clear with less controversies, but the consistent standard for its diagnosis and treatment has not yet formed. Whether the stress X-ray as the main basis for diagnosis, MRI check for early application, and the indications of surgical exploration and so on, these are not unified. In the international, especially the conservative treatment and surgical treatment has been existing two major differences. In the choice of surgical treatment, domestic and foreign experts have respective preference. In recent years, domestic researchers emphasis to repair with suture anchors, while abroad it has been mainly to reconstruct the deltoid ligament.
Ankle Injuries ; diagnosis ; surgery ; Arthroscopy ; Humans ; Ligaments, Articular ; injuries

Anterior Cruciate Ligament ; surgery ; Humans ; Knee Joint ; surgery ; Ligaments, Articular ; surgery ; Reconstructive Surgical Procedures ; methods

OBJECTIVETo investigate the approach and efficacy of dealing the rectal ligament in resection of rectal cancer in obese male patients.

METHODSA total of 92 patients (BMI>25 kg/m(2)) undergoing resection of rectal cancer from December 2008 to December 2010 in Henan Tumor hospital were assigned into 2 groups according to the surgical technique, the modified group (paralleled clipping of rectal ligament, 48 patients) and traditional group (44 patients). Operative time, intra-operational bleeding, rectal ulceration, ureteral injury, mesorectal integrity, and positive rate of lateral margin of pelvic wall were compared between two groups.

RESULTSThe operative time was (66.9±99.8) min in modified group, which was significantly shorter than that in traditional group [(125.4±12.2) min, P=0.000]. Intra-operative bleeding was (160.3±27.2) ml in modified group and (150.5±28.5) ml in traditional group (P=0.093). Rectal ulceration rated were 0 and 18.2% (8/44), mesorectal disintegrity rates were 6.2% and 22.7%, pelvic infection rates were 2.1% (1/48) and 20.4 (9/44) in modified and traditional groups respectively, whose differences were all significant (all P<0.05). No ureteral injury and positive margin were found in both two groups.

CONCLUSIONThe approach of paralleled clipping of rectal ligament around the rectum meets the principle of TME, which is simple, safe and effective.

Adult ; Aged ; Humans ; Ligaments ; surgery ; Male ; Middle Aged ; Obesity ; complications ; Rectal Neoplasms ; complications ; surgery ; Rectum ; surgery

Acromioclavicular Joint ; injuries ; surgery ; Endoscopy ; Humans ; Joint Dislocations ; surgery ; Ligaments ; surgery ; Reconstructive Surgical Procedures

OBJECTIVE: To evaluate the operability and effectiveness of a self-developed patellar bone canal locator (hereinafter referred to as "locator") in the reconstruction of the medial patellofemoral ligament (MPFL). METHODS: A total of 38 patients with recurrent patellar dislocation who met the selection criteria admitted between January 2022 and December 2022 were randomly divided into study group (the patellar canal was established with a locator during MPFL reconstruction) and control group (no locator was used in MPFL reconstruction), with 19 cases in each group. There was no significant difference in baseline data between the two groups ( P>0.05), such as gender, age, body mass index, disease duration, patella Wiberg classification, constituent ratio of cartilage injury, Caton index, tibia tubercle-trochlear groove, and preoperative Lysholm score, Kujal score, Tegner score, visual analogue scale (VAS) score, and so on. The Lysholm score, Kujal score, Tegner score, and VAS score were used to evaluate knee joint function before operation and at 3 days,1 month, 3 months, and 6 months after operation. The ideal prepatellar cortical thickness and canal length were measured before operation, and the actual prepatellar cortical thickness and canal length after operation were also measured, and D1 (the distance between the ideal entrance and the actual entrance), D2 (the ideal canal length minus the actual canal length), D3 (the ideal prepatellar cortical thickness minus the actual prepatellar cortical thickness) were calculated. RESULTS: Patients in both groups were followed up 6-8 months (mean, 6.7 months). The incision length and intraoperative blood loss in the study group were smaller than those in the control group, but the operation time was longer than that in the control group, the differences were significant ( P<0.05). There was no complication such as incision infection, effusion, and delayed healing in both groups, and no further dislocation occurred during follow-up. One patient in the study group had persistent pain in the anserine area after operation, and the symptoms were relieved after physiotherapy. The VAS score of the two groups increased significantly at 3 days after operation, and gradually decreased with the extension of time; the change trends of Lysholm score, Kujal score, and Tegner score were opposite to VAS score. Except that the Lysholm score and Kujal score of the study group were higher than those of the control group at 3 days after operation, and the VAS score of the study group was lower than that of the control group at 3 days and 1 month after operation, the differences were significant ( P<0.05), there was no significant difference in the scores between the two groups at other time points ( P>0.05). Patellar bone canal evaluation showed that there was no significant difference in preoperative simulated ideal canal length, prepatellar cortical thickness, and postoperative actual canal length between the two groups ( P>0.05). The postoperative actual prepatellar cortical thickness of the study group was significantly smaller than that of the control group ( P<0.05). D1 and D3 in the study group were significantly higher than those in control group ( P<0.05), but there was no significant difference in D2 between the two groups ( P>0.05). CONCLUSION The locator can improve the accuracy of MPFL reconstruction surgery, reduce the possibility of intraoperative damage to the articular surface of patella and postoperative patellar fractures.
Humans ; Patella/surgery* ; Patellar Dislocation/surgery* ; Patellofemoral Joint/surgery* ; Knee Joint/surgery* ; Joint Dislocations ; Ligaments, Articular/surgery*

OBJECTIVE: This study aims to examine the biomechanical effects of different reconstruction methods, including single-bundle, double-bundle anatomical reconstruction, and double-bundle truly anatomical reconstruction of the coracoclavicular ligament on the acromioclavicular joint using finite element analysis, to provide a theoretical basis for the clinical application of truly anatomical coracoclavicular ligament reconstruction. METHODS: One volunteer, aged 27 years old, with a height of 178 cm and a weight of 75 kg, was selected for CT scanning of the shoulder joint. Three-dimensional finite element models of single-bundle reconstruction, double-bundle anatomical reconstruction, and double-bundle truly anatomical reconstruction of coracoclavicular ligament were established by using Mimics17.0, Geomagic studio 2012, UG NX 10.0, HyperMesh 14.0 and ABAQUS 6.14 software. The maximum displacement of the middle point of the distal clavicle in the main loading direction and the maximum equivalent stress of the reconstruction device under different loading conditions were recorded and compared. RESULTS: The maximum forward displacement and the maximum backward displacement of the middle point of the distal clavicle in the double-bundle truly anatomic reconstruction were the lowest, which were 7.76 mm and 7.27 mm respectively. When an upward load was applied, the maximum displacement of the distal clavicle midpoint in the double-beam anatomic reconstruction was the lowest, which was 5.12 mm. Applying three different loads forward, backward, and upward, the maximum equivalent stress of the reconstruction devices in the double-beam reconstruction was lower than that in the single-beam reconstruction. The maximum equivalent stress of the trapezoid ligament reconstruction device in the double-bundle truly anatomical reconstruction was lower than that in the double-bundle anatomical reconstruction, which was 73.29 MPa, but the maximum equivalent stress of the conoid ligament reconstruction device was higher than that of the double-bundle anatomical reconstruction. CONCLUSION The truly anatomical reconstruction of coracoclavicular ligament can improve the horizontal stability of acromioclavicular joint and reduce the stress of the trapezoid ligament reconstruction device. It can be a good method for the treatment of acromioclavicular joint dislocation.
Humans ; Adult ; Acromioclavicular Joint/surgery* ; Finite Element Analysis ; Ligaments, Articular/surgery* ; Shoulder Joint/surgery* ; Plastic Surgery Procedures ; Joint Dislocations/surgery*

OBJECTIVE: To study the effectiveness of TightRope elastic fixation combined with functional total repair of the inferior tibiofibular ligament in the treatment of distal tibiofibular syndesmosis injury. METHODS: The clinical data of 34 patients with distal tibiofibular syndesmosis injury who met the selection criteria between January 2020 and January 2022 were retrospectively analyzed, and they were divided into improved group (TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament) and control group (distal tibiofibular screw fixation) according to the surgical methods, with 17 cases in each group. There was no significant difference in age, gender, body mass index, fracture type, and other baseline data between the two groups (P>0.05). The operation time, intraoperative blood loss, and complications were recorded in the two groups. The American Orthopaedic Foot and Ankle Society (AOFAS) score, ankle metatarsal flexion and dorsal extension range of motion were used to evaluate the ankle function. The patient satisfaction survey was conducted at last follow-up. RESULTS: All 34 patients were followed up 8-20 months, with a median of 13 months. The operation time and intraoperative blood loss in the improved group were significantly longer than that in the control group (P<0.05). In the improved group, no infection or poor reduction occurred, and only 1 patient had TightRope knot reaction at 6 months after operation. In the control group, there were 2 cases of poor reduction, 1 case of lower tibiofibular screw rupture, and 1 case of subcutaneous infection (cured after anti-infection treatment). There was no significant difference in the incidence of complications between the two groups (P>0.05). At last follow-up, the AOFAS score and ankle metatarsal flexion and dorsal extension range of motion of the improved group were significantly better than those of the control group (P<0.05). The satisfaction rates of patients in the improved group and the control group were 94.1% and 82.4%, respectively, showing significant difference (P<0.05). CONCLUSION TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament in the treatment of distal tibiofibular syndesmosis injury has sufficient fixation strength, and can achieve better effectiveness and joint function compared with traditional screw fixation.
Humans ; Ankle Joint/surgery* ; Blood Loss, Surgical ; Ligaments/surgery* ; Plastic Surgery Procedures ; Retrospective Studies ; Ankle Injuries/surgery*