OBJECTIVE: To review the experience with Wang procedure for treatment of pectus excavatum in young children. METHODS: The clinical data of 21 children with a mean age of 3.3 ± 1.1 years (ranging from 1.5-6 years) undergoing Wang procedure for pectus excavatum were analyzed. A longitudinal incision (1 to 2 cm) was made in the front of the xiphoid, and two tunnels were created using steel bars beneath the muscles on two sides of the chest wall. The fibrous tissue between the diaphragm and the sternum was dissociated, and the steel wires were sutured through the deformed chest wall. After the steel bar was placed in the tunnels, the wires were pulled and fixed in the middle of the bar, and the incision was sutured. RESULTS: All the operations were performed using 3 wires and 1 steel bar. The operation time was 25 to 51 (38.1 ± 9.6) min with an intraoperative bleeding volume of 5 to 10 (7.1±1.5) mL. The time of hospitalization of the patients ranged from 6 to 10 days (mean 8.1±1.3 days). In all the patients, the incision healed smoothly without serious pain or obvious complications. All the patients were followed up for 1 to 13 months after the operation. During the follow- up, no recess recurred and no such complications as bar displacement or transposition occurred. According to the evaluation criteria after pectus excavatum operation, 13 cases had a total score of 9, and 8 had a total score of 8. The overall effect was satisfactory, and there were no cases rated as basically satisfactory or unsatisfactory. CONCLUSIONS Wang procedure is a good option for treatment of pectus excavatum in young children.
Bone Wires ; Child ; Child, Preschool ; Diaphragm ; Funnel Chest ; surgery ; Humans ; Internal Fixators ; Operative Time ; Orthopedic Procedures ; instrumentation ; methods ; Retrospective Studies ; Thoracic Wall ; Treatment Outcome ; Xiphoid Bone ; surgery

OBJECTIVETo study therapeutic effects between hook plate fixation and modified Weaver-Dunn surgery for the treatment of acromioclavicular joint dislocation.

METHODSForty patients with fresh acromioclavicular joint dislocations of type III according to Rockwood classification were reviewed. All the patients were divided into two groups: hook plate fixation group and modified surgery group. There were 20 patients in hook plate fixation group, including 13 males and 7 females, with an average age of (37.45 +/- 14.29) years old; 12 patients had injuries in the left and 8 patients had injuries in the right; preoperative Constant-Murley score was 40.75 +/- 10.40. And there were 20 patients in modified surgery group,including 11 males and 9 females, with an average age of (41.65 +/- 14.83) years old; 11 patients had injuries in the left and 9 patients had injuries in the right; preoperative Constant-Murley score was 42.75 +/- 8.18. The Lazzcano standard, Constant-Murley score and imaging changes were used to evaluate shoulder joint function before and after surgery.

RESULTSAll the patients were followed up,and the duration ranged from 7 to 32 months,with an average of 24 months. According to Lazzcano evaluation, 16 patients got an excellent result,3 good and 1 poor in modified surgery group with no re-dislocation, and 1 patient had pain more than middle degree; while in hook plate fixation group, 9 patients got an excellent result, 7 good and 4 poor, 1 patient had re-dislocation, and 3 patients got pain more than middle degree. The therapeutic effects of modified surgery group were better than those of hook plate fixation group. Constant-Murley scores:preoperative 42.75 +/- 8.18 vs 93.40 +/- 4.04 at the latest follow-up in modified surgery group; preoperative 40.75 +/- 10.40 vs postoperative 88.40 +/- 4.81 and 92.05 +/- 4.49 at the latest follow-up in hook plate fixation group. The postoperative scores all improved compared to preoperative scores in two groups. And there was no statistical difference of scores at the latest follow-up between two groups.

CONCLUSIONThe surgery of allograft tendon transplantation combined with anchor fixation to strengthen coracoclavicular ligament, as well as part transposition of acromiocoracoid ligament and resection at the distal part of clavicle may got safety fixation and less postoperative complications compared with hook plate internal fixation.

Acromioclavicular Joint ; injuries ; Adolescent ; Adult ; Bone Plates ; Case-Control Studies ; Clavicle ; surgery ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; instrumentation ; Treatment Outcome ; Young Adult

No abstract available.
Bone Neoplasms/*surgery ; Femur/surgery ; Humans ; Orthopedic Procedures/instrumentation ; Osteochondroma/*surgery

Joints involved in deep burn often result in joint contracture, limb dysfunction, psychological disorder, or even loss of living and working abilities. The management of post-burn joint contracture will directly orientate the functional recovery of the patients. Comprehensive intervention may prevent the contracture process of the affected joints. Orthoses application is an important measure and should be maintained throughout the whole process of burn care, from positioning the joints at the early stage to maintaining the range of joint motion at the late stage. Orthoses should be used on the premise of protecting the joint functions. In order to maintain the tissue tension while enhancing the joint mobility and muscle strength, the static orthoses and the dynamic orthoses are often alternately used. It is showed in clinical practice that orthoses are designed and applied on the basis that biomechanics will lead to a better outcome.
Burns ; complications ; rehabilitation ; Cicatrix ; etiology ; rehabilitation ; Contracture ; etiology ; rehabilitation ; Humans ; Orthopedic Procedures ; instrumentation ; Orthotic Devices

BACKGROUND: Due to the anatomical nature of the radial nerve, dissection and attainment of an adequate operative field in mid to distal humerus fracture is dangerous and limited. We devised a combined anterolateral and lateral approach that ensures protection of the radial nerve. This is achieved by performing bimodal dissection of the proximal humerus anteriorly and the distal humerus laterally. METHODS: Thirty-five consecutive patients were treated using a combined anterolateral and lateral approach for a minimum follow-up period of 24 months. We analyzed time to bony union, time to return to daily work, range of motion, elbow joint function as assessed by the Mayo elbow performance index and complications. RESULTS: Radiologic bony union was observed at 11.2 weeks (range, 8 to 20 weeks) on average. Four cases of incomplete radial nerve palsy before surgery all recovered. Time to return to work was 10.2 weeks (range, 2 to 32 weeks) on average. The average range of motion of the elbow was 3.3degrees (range, 0degrees to 10degrees) of extension and 135.9degrees (range, 125degrees to 145degrees) of flexion. There were 21 cases of excellent and 13 cases of good or better recovery, comprising over 97.1% on the Mayo elbow performance index. There were no complications of radial nerve palsy, non-union, mal-union, or infection. CONCLUSIONS: Our a modified combined anterolateral and lateral approach is a clinically effective surgical method of achieving protection of the radial nerve and securing easy and firm internal fixation.
Adolescent ; Adult ; Aged ; Female ; Humans ; Humeral Fractures/radiography/*surgery ; Male ; Middle Aged ; Orthopedic Fixation Devices ; Orthopedic Procedures/adverse effects/instrumentation/*methods ; Pain, Postoperative ; Prospective Studies ; Range of Motion, Articular ; Return to Work ; Treatment Outcome

The design principle and application of an adjustable spine prone frame are introduced. Adjustable spine prone frame is used in posterior lumbar surgery, during operation, X-ray can shoot fast and internal fixation implants can fix accurately, the vacant abdominal ensure normal respiratory and circulatory function, and the lumbar curvature can adjust conveniently. It meets the surgical position and care requirements, can prevent the complications effectively.
Equipment Design ; Humans ; Lumbar Vertebrae ; surgery ; Orthopedic Procedures ; instrumentation ; Prone Position

The orthopedics implants failure management system has been put forward according to the present status. The function of the system and typical failure case reasoning route also have been described. Furthermore, the analysis process has been presented by illustrating a typical failure case analysis.
Medical Records Systems, Computerized ; Orthopedic Procedures ; instrumentation ; Prosthesis Design ; Prosthesis Failure ; Software Design

OBJECTIVETo explore the best entry point and trajectory of anterior cervical screw in the cervical screw by radiological studies, and provide reference for clincal application.

METHODSFrom January 2008 to December 2010,50 patients were scanned by cervical CT and confirmed no obvious defect of lower cervical spine. Of them, 27 cases were males and 23 were females, ranged the age from 38 to 83 years ( mean 58.5 years). On horizontal axis, the camber angle of C3-C7 anterior lower cervical pedicle of vertebral arch axis (alpha) and distance between (axial length, AL) of anterior cervical pedicle axial line was measured from C3 to C7. Vertebral were divided into four areas, and from measured side of pedicle of vertebral began to record, orderly 1 to 4, the area of pedicle vertebral arch intersert into vertebral were recorded. On sagittal view, the head or tail angle (beta) and length (sagittal length, SL) of anterior cervical pedicle axial line was also measured from C3 to C7. Vertebral were divided into four areas, and from measured side of pedicle of vertebral began to record, orderly 1 to 4, the area of pedicle vertebral arch arch intersert into vertebral were recorded. The above data were statistically analyzed to find the best entry point and trajectory of anterior cervical screw in the cervical screw and insert pedicle screw.

RESULTSThe lateral angle of lower cervical spine was 38 degrees to 45 degrees on transverse plane, C3 to C5 increasing gradually, C5 to C7 decreasing. On sagittal view, C3,C4 pedicle were head tulting, C5 were basic level, C6,C7 were tail. C3 to C5 decreasing gradually, C5 to C7 increasing gradually. C3 to C7 in AL and SL increased gradually. On horizontal axis, the intersection of C3,C4 and C5 were in the second area, the number of C6 in the second and third area were the same, but C7 were in the third area. The intersection in the first and forth area were less. On sagittal view,the intersection of C3,C4 and C5 were in the first area,the number of C6 in third and forth area were less. Six pedicle screws of 3 cases were insert into lower cervical spine, and obtained good effects, no complications occurred.

CONCLUSIONThe best entry point of C3,C4 and C5 were located in the center line and slightly to opposite vertebral body side and upper 1/4 area; C7 were located the vertebral body side and upper 2/4 area; C6 were located between them. The best insertion point were extraversion 38 degrees to 45 degrees, C3 to C5 increased graduallly, C5 to C7 decreased on horizontal axis; On sagittal view, C3,C4 for head 5 degrees to 10 degrees, C5 were basic level, C6,C7 for tail 5 degrees to 10 degrees. The anterior cervical pedicle screw for lower cervial spine is a good and feasible internal fixation.

Adult ; Aged ; Aged, 80 and over ; Bone Screws ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; instrumentation ; Radiography ; Treatment Outcome

The innovative research on the platform of the guided-navigating surgery of bone and joints consists of four basic function modules and three technical-related systems. Through this research the functional modules will be constructed by orthopedic specialists and software experts who have made jointly efforts based on the transitional medicine to develop a new software for guided-navigating surgery of bone and joints suitable for people in Asia and for its application in medical treatment.
Equipment Design ; Humans ; Orthopedic Procedures ; instrumentation ; methods ; Software ; Surgery, Computer-Assisted ; instrumentation ; methods

Noise problem is encountered in many types of surgery, especially in orthopaedic surgery, where the cutting tool and its actuation part such as motor always generates big noise. This work is dedicated to developing a novel and promising solution based on the active noise control (ANC) technology to solve the noise problem in an orthopaedic theatre. The development process began with building an engineering evaluation model (EEM) to analyze the specifics of sound interactions and sound field involved in the noise problem. This model can describe the acoustic problem in a straightforward way, help to design a good control system and furthermore to assess the result and to optimize the control structure. Then the "auto position tracking near head space ANC" strategy was proposed from the model study. Furthermore, the real sound field measurement experiment proved the possibility of proposed design.
Humans ; Models, Theoretical ; Noise ; prevention & control ; Operating Rooms ; Orthopedic Procedures ; instrumentation ; Surgical Instruments