Humans ; Osteotomy ; adverse effects ; methods ; Scoliosis ; surgery

Humans ; Osteotomy ; adverse effects ; methods ; Scoliosis ; surgery

How to remove the well fixed cement or cementless prosthesis and get a completely distal cement removal in the rTHR are critical to the outcome of revision. Because of higher rate of union, excellent intraoperative exposure, and adjustment of abductor tension, ETO has been widely applied to rTHR and complicated primary THR by foreign scholars. Furthermore, this technology has wide indications, very few contraindications, high cure rates,and low complications rate. ETO turns out to be a safe and effective revision technology. In the article, the indication, contraindication, complications and advantages of this technique were reviewed.
Arthroplasty, Replacement, Hip ; methods ; Humans ; Osteotomy ; adverse effects ; methods

Humans ; Kyphosis ; surgery ; Lumbar Vertebrae ; surgery ; Osteotomy ; adverse effects ; methods ; Thoracic Vertebrae ; surgery

Humans ; Intraoperative Complications ; Osteotomy ; adverse effects ; methods ; Postoperative Complications ; Spine ; surgery

BACKGROUND: Standard treatments may provide adequate containment in mild to moderate Legg-Calve-Perthes disease (LCPD), but they can be problematic in more severe cases. The purpose of this study was to report the results of combined shelf acetabuloplasty with femoral varus osteotomy in severe LCPD. METHODS: We reviewed 12 patients who had undergone combined shelf acetabuloplasty with femoral varus osteotomy. The indications for this type of operation were: (1) above 8 years of age at clinical onset; (2) massive femoral epiphysis involvement (Catterall group 4, lateral pillar C); (3) femoral head lateral subluxation on the anteroposterior radiograph; and (4) impending hinged abduction on preoperative magnetic resonance imaging or arthrography. The mean age was 9.3 years (range, 8 to 10.8 years). The patients were clinically evaluated with Iowa hip score and leg length discrepancy at the final follow-up. Radiographic outcome was assessed using the Stulberg classification to evaluate femoral head sphericity. The presence of osteoarthritis was evaluated by the Tonnis classification. Correlation analysis was conducted to analyze the preoperative factors that were strongly associated with patients' outcomes. RESULTS: The mean follow-up period was 10.1 years (range, 7.1 to 13.2 years). Functional grade was excellent in all patients at last follow-up (mean, 92; range, 82 to 99). The mean leg length discrepancy after skeletal maturity was 0.9 cm (range, 0 to 1.7 cm). There were no significant complications or need for additional surgery. Radiographically, 92% of patients reached satisfactory outcomes: Stulberg grade I, 0 cases; Stulberg grade II, 4 cases (34%); Stulberg III, 7 cases (58%), Stulberg IV, 1 case (8%); and Stulberg V, 0 cases. There was no osteoarthritis by Tonnis classification. CONCLUSIONS: The surgical outcomes for combined shelf acetabuloplasty with femoral varus osteotomy in severe LCPD patients over 8 years old are comparable with other advanced surgical methods. In the cases of severe disease that match our inclusion criteria, our containment method could be another treatment option.
Acetabuloplasty/adverse effects/*methods ; Child ; Female ; Humans ; Leg Length Inequality ; Legg-Calve-Perthes Disease/radiography/*surgery ; Male ; Osteotomy/adverse effects/*methods ; Pain ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo explore the therapeutic effects of posterior osteotomy and long-segment internal fixation in the treatment of senile thoracolumbar kyphotic deformity and provide the reference for operative treatment.

METHODSFrom April 2007 to April 2010, 19 older patients with thoracolumbar kyphotic deformity were respectively analyzed. There were 12 males and 7 females with an average age of 62 years (ranged, 58 to 74 years). Among patients, 11 cases were old fracture, 3 cases were ankylosing spondylitis, and 5 cases were old spinal tuberculosis. According to preoperative Frankel classification, 12 cases were grade E, 4 cases were grade D, 2 cases were C and 1 case was grade B. All patients were treated by posterior osteotomy and long-segment internal fixation and followed up above 1 year. VAS score preoperative, 2 weeks and 1 year after operation, Cobb's angle,n erve function and complication were observed.

RESULTSVAS score preoperative, 2 weeks and 1 year after operation separately was (7.0 +/- 1.2),(1.1 +/= .7) and (1.3 +/- .8); while Cobb's angle separately was (44.1 +/- .9), (10.9 +/- .1) and (11.5 +/- .8); there was significant difference in VAS score and Cobb's angle between preoperative and 2 weeks after operation (P < 0.05) w hile no significant difference between 2 weeks and 1 year after operation (P > 0.05). Eighteen cases met the standard of osseous fusion, 1 case occurred nonunion, but not looseness 1 year after operation. Nerve function: 3 cases changed grade E from 4 cases with grade D, 2 cases with grade C changed to grade D, 1 case with grade B changed to grade

CONCLUSIONPosterior osteotomy and long-segment internal fixation for the treatment of senile thoracolumbar kyphotic deformity can receive a good short-time effects.

Aged ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Kyphosis ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Osteotomy ; adverse effects ; methods ; Retrospective Studies ; Thoracic Vertebrae ; surgery

OBJECTIVEThe purpose of this study was to determine the incidence of temporary and permanent sensory disturbance of the inferior alveolar nerve (IAN) after bilateral sagittal split osteotomy (BSSO) of the mandible.

METHODS14 patients were selected for this study. Before BSSO and at 1 week, 1, 3, 6 and 12 months after BSSO, the sensibility of bilateral inferior alveolar nerves were examined using sharp-blunt testing, 2-point discrimination, electronic pain response test (ZGK-1 electrometer).

RESULTSWith conventional sharp-blunt and 2-point discrimination test, electronic pain response test, the incidence of temporary impairment of IAN after BSSO was 78% (22/28). Obvious sensory recovery of IAN was found 6 to 12 months postoperatively. Permanent sensory disturbance of unilateral inferior alveolar nerve occurred in 2 patients.

CONCLUSIONSSensory recovery of the inferior alveolar nerve after bilateral sagittal split osteotomy of the mandible would take 6 to 12 months. Serious injury of the IAN would cause permanent neurosensory deficits.

Adolescent ; Adult ; Female ; Humans ; Male ; Mandible ; surgery ; Mandibular Nerve ; physiopathology ; Oral Surgical Procedures ; adverse effects ; Osteotomy ; adverse effects ; methods ; Sensory Thresholds ; Trigeminal Nerve Injuries

OBJECTIVETo discuss the treatment and prevention of the complications resulted from intraoral mandibular angle reduction.

METHODSFrom July 2002 to August 2008, 672 cases underwent intraoral mandibular angle reduction. The 59 cases with postoperative complications were treated and followed up.

RESULTSNo severe complication happened. In 18 cases with asymmetry, 13 cases improved through soft tissue adjustment, 5 cases were reoperated with good results. Intraoperative precise osteotomy was needed to prevent asymmetry. 3 cases with infection healed with drainage and anti-inflammatory treatment. Intraoperative aseptic manipulation and adequate drainage were necessary to prevent infection. 20 cases with labial numbness recovered 3 - 6 weeks later. 5 cases with temporary facial nerve injury recovered 2 - 3 months later. 12 cases with bleeding and hematoma were treated by dressing with pressure and drainage and healed 3 weeks later. Skin necrosis resulted from tight dressing occurred in one case, which were treated with skin graft. Intraoperative protection of nerve and vessels, as well as the dressing were very important.

CONCLUSIONSMost of the complications can be treated and recovered well. Preoperative design, precise manipulation and postoperative reliable dressing are the key points to prevent complications.

Adolescent ; Adult ; Female ; Humans ; Male ; Mandible ; abnormalities ; surgery ; Osteotomy ; adverse effects ; methods ; Postoperative Complications ; prevention & control ; Young Adult

OBJECTIVETo investigate the result of zygomatic reduction with midface L-shaped osteotomy through intraoral approach.

METHODSFrom June 2006 to Aug. 2009, 67 cases received zygomatic reduction with midface L-shaped osteotomy through intraoral approach. 52 cases underwent CT scan before operation and 12 months after operation. The images were analyzed by software GE AW 4.1 for evaluation of clinical effect, maxillary sinus change and complication. SAS 6.12 software was applied for one-way ANOVA.

RESULTSSatisfactory results were achieved in all the patients. The volume of maxillary sinus at left and right side was (21233.96 +/- 4455.04) mm3, and (22020.64 +/- 3663.82) mm3, respectively before operation: (17840.91 +/- 4381.03) mm3 and (18511.85 +/- 3466.24) mm3 respectively 12 months after operation, showing a significant difference between them (P<0.05). No infection or dental pulp necrosis happened.

CONCLUSIONSGood results can be achieved with intraoral L-shaped osteotomy for zygomatic reduction. Exposure of maxillary sinus would not cause any complication.

Adult ; Female ; Humans ; Male ; Maxillary Sinus ; Osteotomy, Le Fort ; adverse effects ; methods ; Postoperative Complications ; epidemiology ; Reconstructive Surgical Procedures ; methods ; Young Adult