OBJECTIVETo compare the hemodynamic responses to orotracheal intubation via Upsher-scope (USSP) or Macintosh direct laryngoscope (MDLS) under general anesthesia.

METHODSFifty patients with ASA grade I-II and undergoing the elective plastic surgery and requiring orotracheal intubation were randomly allocated to either the USSP (U group) (n=25) or MDLS (M group) (n=25). After standard intravenous anesthetic induction, orotracheal intubation was performed using a USSP or a MDLS. Noninvasive systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded before and after anesthetic induction, at intubation and every minute thereafter for 5 minutes. The time spent in tracheal intubation was recorded. The mean blood pressure (MBP) and rate-pressure product (RPP) were calculated.

RESULTSThe intubation time was not significantly different between these two groups (P > 0.05). After anesthetic induction, SBP, DBP, MAP, and RPP in these two groups decreased significantly as compared with preinduction values. The orotracheal intubation caused significant increases in SBP, DBP, MAP, and RPP in these two groups in comparision with postinduction values (P < 0.05), but these hemodynamic changes lasted only 1 to 2 minutes and then decreased gradually to the postinduction level. The blood pressure changes caused by orotracheal intubation did not exceed the preinduction values (P > 0.05). As compared to, the maximal HR values in these two groups during observation (from the beginning of intravenous anesthetic induction to 5 min after intubation) were significantly higher than their preinduction values (P < 0.05). The maximal RPP values in M group during observation were significantly higher than their preinduction values (P < 0.05), but no such significant difference was observed in U group (P > 0.05). The hemodynamic data at each time point during the observation had no significant differences between these two groups. (P > 0.05).

CONCLUSIONSOrotracheal intubation using the USSP and MDLS may result in similar hemodynamic responses. The standard general anaesthesia can effectively inhibit the pressor, but not the tachycardiac responses caused by orotracheal intubation via USSP or MDLS. USSP is not superior than MDLS in palliating the adverse cardiovascular stress responses to orotracheal intubation.

Adult ; Anesthesia, General ; Female ; Hemodynamics ; Humans ; Intubation, Intratracheal ; instrumentation ; methods ; Laryngoscopes ; Male ; Reconstructive Surgical Procedures

OBJECTIVETo explore the therapeutic efficacy of a modified method with splints in correction of cryptotia.

METHODSFrom Oct. 2012 to Jan. 2014, 3 cases with unilateral cryptotia were treated with the modified method with splints. The muscles attached to the periosteum of cartilage were dissected. The muscles between the ear and temper were cut off. Then one silicon tube was put around the ear through cranioauricular sulcus. The other tube was placed within the cavum conchae and fixed with the tube around the ear.

RESULTSNo flap necrosis happened. The patients were followed up for six months to one year with satisfied and stable results.

CONCLUSIONSThe modified method is easy to perform with less morbidity. It is one of the ideal correction for cryptotia.

Ear Auricle ; abnormalities ; surgery ; Ear Cartilage ; abnormalities ; surgery ; Humans ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Splints

Medial patellofemoral ligament (MPFL) is the major static structure to restrain lateral patellar dislocation. There are always MPFL injuries in patellar dislocations. The medial ligamentous deficiency will lead to recurrent patellar dislocation or patellar instability. Surgeon used to suture all those structures in the medial knee compartment before MPFL is recognized. Reconstruction of MPFL becomes an important method to treat patellar dislocation since it is anatomically recognized. Many techniques have invented MPFL reconstruction. The goal of this article is to develop a current understanding of MPFL and its clinical significance, especially MPFL reconstruction. The anatomical double bundle reconstruction of MPFL by bone anchors is a safe, easy and effective way to treat patellar dislocations.
Humans ; Patellar Dislocation ; physiopathology ; surgery ; Patellar Ligament ; injuries ; physiopathology ; surgery ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Suture Anchors ; Suture Techniques ; instrumentation

We evaluated the safety and stability of the less-invasive submuscular bar fixation method in the Nuss procedure. One hundred and thirteen patients undergoing the Nuss procedure were divided into three groups according to the bar fixation technique employed. Group 1 consisted of 25 patients who had undergone bilateral pericostal bar fixation, group 2 consisted of 39 patients with unilateral pericostal one, and group 3 included 49 patients with bilateral submuscular one. The patients' age ranged from 2 to 25 yr, with an average of 7.2+/-5.67 yr. Bar dislocation occurred in 1 patient (4%) in Group 1, 2 patients (5.1%) in Group 2, and 1 patient (2.0%) in Group 3 (p=0.46). Hemothorax was noted in 2 patients (8%) in Group 1, 2 (5.1%) in Group 2, and none (0%) in Group 3 (Group 1 vs. Group 3, p=0.028). The mean operation time was shorter in Group 3 than Group 1 (50.1+/-21.00 in Group 3 vs. 67.2+/-33.07 min in Group 1, p=0.041). The submuscular bar fixation results in a decrease in technique-related complications and operation time and is associated with favorable results with regard to the prevention of bar dislodgement.
Treatment Outcome ; Thoracic Surgical Procedures/*instrumentation/*methods ; Surgical Procedures, Minimally Invasive/instrumentation/methods ; Ribs/surgery ; Reconstructive Surgical Procedures/*instrumentation/*methods ; *Prostheses and Implants ; Male ; Humans ; Funnel Chest/*surgery ; Female ; Child, Preschool ; Child ; Adult ; Adolescent ; Abdominal Muscles/surgery

OBJECTIVETo analyze the clinical effect and related risk factors of Gartland type II-III supracondylar fractures of humerus in children in the emergency closed reduction and percutaneous Kirschner wire fixation.

METHODSFrom January 2008 to June 2013,112 children of Gartland type II to III supracondylar humeral fractures were treated in children in emergency closed reduction and percutaneous K-wire fixation, including 72 males and 40 females with an average age of 6.2 years old ranging from 2 to 11 years old. Among them,74 cases were in Gartland type II fractures,38 cases were in type III; The duration from injury to surgery time was 2.5 to 8 hours (averaged 4.6 hours). Elbow cast was applied after operation with the elbow extended of 100 degrees for 4 to 6 weeks, then the gypsum and Kirschner wires were removed.

RESULTSAll patients were follow-up from 6 to 60 months (averaged 12 months). All fractures reached clinical healing. The final follow-up was assessed by Flynn criteria, the result was excellent in 86 cases, good in 23 cases, general in 3 cases, excellent and good rate was 97.3%. Three patients had mild cubitus varus deformity without orthopedic treatment. No pin tract infections, iatrogenic ulnar nerve injury, compartment syndrome, and complications such as Volkmann ischemic contracture occurred.

CONCLUSIONClosed reduction and percutaneous Kirschner wire fixation had advantages of exact reduction, firm fixation, fewer complications ,less pain in children undergoing emergency surgery, and.high success rate, so it is a safe and efficient treatment for humeral supracondylar fracture in children.

Bone Wires ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Reconstructive Surgical Procedures

Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; Biomedical Research ; methods ; trends ; Humans ; Minimally Invasive Surgical Procedures ; Orthopedic Procedures ; instrumentation ; methods ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Tendons ; transplantation ; Transplantation, Autologous ; Transplantation, Homologous

OBJECTIVETo comparatively study the difference of the skin expansion rate and instantly expanded skin retraction rate between implantation of double overlapping expanders and implantation of one single expander.

METHODSFrom Mar. 2009 to Mar. 2012, 22 cases with 39 sites for skin expansion, received double overlapping expanders in 24 sites, single expander in 15 sites. The area of original skin and expanded skin was measured by "wet-cloth sampling". Then the skin expansion rate was calculated. A distance of 5 cm at the center of expanded skin was re-measured after taking out the expanders. Then the instantly skin retraction rate was calculated.

RESULTSDuring the same expansion period, the skin expansion rate was (3.5 +/- 0.9)% with the double overlapping expanders and (2.6 +/-0.6)% with one single expander, showing a significant difference between the two groups (P = 0. 002), while the instantly skin retraction rate was not statistically different [(30.3 +/- 0.8)% vs (32.3 +/- 0.9)%; P = 0.47)]. There was a negative relationship between the instantly skin retraction rate and the expansion period (r = -0.768).

CONCLUSIONSThe skin expansion rate can be increased with double overlapping expanders, while the instantly skin retraction rate doesn' t decrease. So the skin expansion efficiency is increased to reduce the re-expansion times for the patients with large lesions.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Tissue Expansion ; instrumentation ; methods ; Tissue Expansion Devices ; Young Adult

OBJECTIVETo study the application of dental implant distractor (DID) in mandibular functional reconstruction.

METHODSWe designed a new device named DID, which includes the permanent dental implant and the temporary distractor in itself. It is specially designed for fibula wider distraction in mandible reconstruction. Twenty-five sets of DID devices were put into 8 patients (6 men and 2 women) during operation. Two patients suffered from ameloblastoma of the mandible, 2 from odontogenic cyst of the mandible, 1 from fibrous dysplasia, and the other 3 from malignant tumor of the mandible. The age of 8 patients ranged from 19 to 67 (mean 46.8) years.

RESULTSDuring postoperative 2 - 15 months follow up, 7 patients were found to be successful. The clinical examination and X-ray film showed the normal shape of the mandible and the osteointegration of the implants were solid enough to withstand the denture force. Others had the DID removed because of inflammation. Two of the patients successfully worn the fixed dental prosthesis. The outcomes was satisfying.

CONCLUSIONThe DID device specially designed for mandibular reconstruction with fibular flap can help to simplify convenient procedures to a single surgery.

Adult ; Aged ; Dental Implantation, Endosseous ; instrumentation ; Female ; Fibula ; transplantation ; Humans ; Male ; Mandible ; surgery ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

OBJECTIVETo assess the effect of preformed orbital titanium mesh in the reconstruction of orbital fracture.

METHODTwenty-seven cases of blow-out orbital fracture were diagnosed in the period from January 2012 to July 2012, all with serious defect of the orbital wall and herniation of the orbital soft tissues. Preformed orbital titanium mesh was grafted to the traumatic orbital walls. Orbital axial and coronal CT and three-dimension CT scan examination were performed routinely in all cases preoperatively and postoperatively to evaluate the postoperative exophthalmos and orbital wall reconstruction.

RESULTSAll the patients were followed up for 3 months. Orbital wall reconstruction was successfully performed in all cases without serious complications. The postoperative enophthalmos was less than 3 mm in 23 of the 27 cases.

CONCLUSIONPreformed orbital titanium mesh allows accurate reconstruction of orbital wall fracture.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Orbital Fractures ; surgery ; Prosthesis Design ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Surgical Mesh ; Titanium ; Young Adult

OBJECTIVEThe purpose of this study is to evaluate the possibility and surgical principle of titanium mesh used for the reconstruction of skull base bone defect.

METHODSThe clinical data of 11 patients with defect of skull base bone repaired with titanium mesh were retrospectively analysed.

RESULTSAmong 11 patients, there were 6 patients with skull base tumor, 3 patients with fibrosis hyperplasia, 2 patients with encephalomeningocele. The surgical approach included craniofacial approach in 7 patients, transfrontal and extended transfrontal approach in 3 patients, trans-midface approach in 1 patient. The anterior and lateral skull base was repaired in 2 patients, anterior and middle skull base and sellar repaired in 6 patients, anterior skull base and orbital floor repaired in 3 patients. In early postoperative period, there were 3 patients with intracranial pneumatosis, but without symptom, and 1 patient with transient cerebrospinal leakage. Following-up for average 14.4 months, there was no titanium mesh displacement and intracranial infection in all patients.

CONCLUSIONSThe titanium mesh used for the repair of skull base bone defect was both possible and safe.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Retrospective Studies ; Skull Base ; pathology ; surgery ; Surgical Mesh ; Titanium ; Young Adult