Humans ; Oral Surgical Procedures ; instrumentation ; methods ; Robotics ; instrumentation ; methods ; Surgery, Computer-Assisted ; instrumentation

OBJECTIVETo report the clinical outcome of arthroscopically assisted treatment for tibial plateau fractures.

METHODSA total of 39 patients with tibial plateau fractures were treated by arthroscopic fixation from February 2002 to December 2005, including 11 patients with bony avulsion of the anterior cruciate ligament and 19 with meniscal injury. There were 4 cases of type I fracture, 12 type II, 9 type III, 12 type IV and 2 type V according to Schatzker criteria. Firstly, the combined injuries were treated. Then the plateau fractures with the displacement over 3 mm or more were reduced and fixed. Finally, the internal fixation was observed by X-ray equipment. Postoperative management was early motion and delayed weight bearing.

RESULTSAll the fractures healed in 3 or 4 months. All patients were followed up for 1 to 5 years after operation. No case had severe complications, such as poor wound healing, infection, osteofascial compartment syndrome and osteoarthritis. According to the Rasmussen scoring system, 36 cases obtained excellent or good results and the other 3 cases had moderate clinical results. The average score was 26+/-3.

CONCLUSIONSAs an adjuvant treatment of intraarticular fractures such as tibial plateau fracture, arthroscopy has many advantages. It can treat associated intraarticular soft tissue components, visualize the chondral surface reduction, lavage the hematoma and smaller loose fragments, decrease soft tissue dissection, reduce the risk of scarring and promote rapid recovery.

Adolescent ; Adult ; Arthroscopy ; Female ; Fracture Fixation ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery ; Treatment Outcome

OBJECTIVETo retrospective study the results of arthroscopic resection of articular capsule valvular treated popliteal cysts and examined the incidence of complication.

METHODSFrom July 2007 to July 2010, 45 patients with symptomatic popliteal cysts such as knee pain and limitation of motion were treated with arthroscopic technique to resect the connecting valvular mechanism at posteromedial compartment of articular capsule. Through the posteromedial viewing portal and cyst resection working portal, resected the valvular mechanism by shaver and plasma cutter, associated intra-articular pathology was treated simultaneously. The functional outcome was evaluated by employed Rauschning and Lindgren score before the surgery and the last follow-up. By using of Wilcoxon rank sum test to statistics analyze the clinic outcome.

RESULTIn all cases, 40 patients were found the associated intra-articular pathology, the incidence was 88.9%.The intra-articular pathology was medial meniscus tear (27 cases, 60.0%), lateral meniscus tear (20 cases, 44.4%), cartilage lesion (28 cases, 62.2%), which composed with patellofemoral joint (12 cases, 26.7%),medial condyles of femur (10 cases, 22.2%),lateral condyles of femur (6 cases, 13.3%). The anterior cruciate ligment injury was found in 2 cases, the incidence was 4.4%. All the patients achieved symptoms relief postoperative, such as posterior knee discomfort and swelling after activities.The Rauschning and Lindgren score was improved 1-2 grade in average (Z = -6.092, P = 0.00). The recurrence rate was 2.2%. All the incision healed good. No major complications were encountered such as saphenous nerve, great saphenous vein, blood vessel in popliteal injury.

CONCLUSIONSArthroscopic resection of articular capsule valvular treatment of popliteal cyst and treatment of associated intra-articular pathology are effective and safe. This surgery technique has more minimally trauma and lower recurrence rate.The clinic results in short term are excellent.

Adolescent ; Adult ; Aged ; Arthroscopy ; methods ; Child ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Popliteal Cyst ; complications ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

BACKGROUNDImaging-guided thermal ablation using different energy sources continues to gain favor as a minimally invasive technique for the treatment of primary and metastatic hepatic malignant tumors. This study aimed to evaluate the performance of microwave ablation with 2450-MHz internally cooled-shaft antenna in ex vivo and in vivo porcine livers.

METHODSAll studies were animal care and ethics committee approved. Microwave ablation was performed using a noncooled or cooled-shaft antenna in 23 ex vivo (92 ablations) and eight in vivo (36 ablations) porcine livers. Diameters of the coagulation zone were observed on gross specimens. The coagulation diameters achieved in different microwave ablation parameter groups were compared. Curve estimation analysis was performed to characterize the relationship between applied power and treatment duration and coagulation diameter (including short-axis and long-axis diameter).

RESULTSCoagulation zones were elliptical and an arrowed-shaped carbonization zone around the shaft was observed in all groups. But the antenna track was also coagulated in the noncooled-shaft antenna groups. In ex vivo livers, the short-axis diameter correlated with the power output in a quadratic curve fashion (R(2) = 0.95) by fixing ablation duration to 10 minutes, and correlated with the ablation duration in a logarithmic curve fashion (R(2) = 0.98) by fixing power output to 80 W. The short-axis reached a relative plateau within 25 minutes. In in vivo livers, short-axis diameter correlated with the coagulation duration in a sigmoidal curve fashion (60 W group R(2) = 0.76, 80 W group R(2) = 0.87), with a relative plateau achieved within 10 minutes for power settings of 60 W and 80 W.

CONCLUSIONSThe internally cooled microwave antenna may be advantageous to minimize collateral damage. The short-axis diameter enlargement has a plateau by fixing power output.

Animals ; Catheter Ablation ; Liver ; surgery ; Microwaves ; Swine

OBJECTIVETo evaluate the clinical result of arthroscopic anterior cruciate ligament (ACL) reconstruction with either allo- or auto- bone-patellar tendon-bone (B-PT-B) grafts.

METHODSFrom February 2002 to January 2006, 142 of 187 cases of ACL ruptures who received ACL reconstruction with B-PT-B grafts were studied retrospectively. There were 93 male and 49 female whose age was from 15 to 57 years (mean 26 years). Patients were divided into 2 groups by graft selection: 38 patients with autograft and 104 with allograft. Clinical results were evaluated according to IKDC, Lysholm, Irgang and Larson scales. Sub-items of scales such as pain, swelling and laxity were specifically evaluated.

RESULTSAll of the patients were followed up with an average of 24 months (range from 6 to 43 months). All grafts were radiographically in good position at the time of follow-up. KT-1000 examination of affected knee showed less than 3 mm anterior translation difference compared with contralateral one's. Allograft group: 85 patients got normal IKDC score (81.7%). Lysholm score 82.8 +/- 8.5, Irgang score 79.2 +/- 7.3, Larson score 86.7 +/- 3.1. Autograft group: 29 patients got normal IKDC score (76.3%). Lysholm score 84.6 +/- 9.5, Irgang score 79.5 +/- 7.6, Larson score 88.9 +/- 6.8. No significant statistical difference was found between the 2 groups in the comprehend scale (P>0.05).

CONCLUSIONSBoth autograft and allograft group achieve good results, and the allograft B-PT-B could provide the similar clinical result as autograft, the preliminary result of allograft reconstruction might indicate predictable result in the future.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; Bone-Patellar Tendon-Bone Grafting ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Matched-Pair Analysis ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Transplantation, Autologous ; Transplantation, Homologous ; Treatment Outcome

OBJECTIVETo evaluate early clinical outcome after arthroscopic treatment of elbow dysfunction.

METHODSFrom September 2007 to December 2009, 21 patients with elbow dysfunction were treated with an arthroscopic procedure. All patients had chronic history of elbow dysfunction. Extension lag was 18.2° (10° - 25°) combined with pain. All patients underwent five-portals arthroscopic release and debridement. Postoperative care including anti-infection, rehabilitation and prophylaxis of myositis ossificans were prescribed. All elbows were assessed for increase in ROM and Mayo assessment before and after surgery. Mayo score assessment: ≥ 90 points, excellent; 75 - 89 points, good; 60 - 74 points, common; < 60, bad. Complications were evaluated.

RESULTSAt an average follow-up of 19.7 months (6 - 29 months), all patients had improvement of extension and relief of pain. The average lag of extension was 2.4° (0° - 5°). Pre-operative Mayo assessment: good, 13 patients; common, 5 patients; bad, 3 patients. Post-operation Mayo assessment: excellent, 17 patients; good, 4 patients; common, 0 patients; bad, 0 patient. There was no complication in this case serial.

CONCLUSIONSArthroscopic surgery can minimize trauma and bleeding, and reduce complications. Combined with reasonable rehabilitation, arthroscopic surgery can improve elbow function and appears to be satisfactory management.

Adult ; Arthroscopy ; methods ; Elbow Joint ; injuries ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Treatment Outcome

OBJECTIVETo retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA).

METHODSFrom September 2008 to March 2009, 35 senile patients with intertrochanteric fracture, aged from 65 to 92 years with an average age of 76.5 years, were treated with PFNA within 24 hours after injury. There were 10 type I fractures, 19 type II and 6 type III according to upgraded Evans-Jensen classification system. All patients were complicated with osteoporosis, and 19 patients had preexisting internal medical diseases. According to the rating scale of disease severity by the American Society of Anesthesiologists (ASA), there were 9 grade I, 14 grade II, 8 grade III, and 4 grade IV.

RESULTSThe duration for operation ranged from 45 to 73 minutes with an average of 57.6 minutes. The volume of blood loss during operation ranged from 50 to 120 ml with an average of 77.5 ml. Patients could ambulate 2-4 days after operation (mean 3.5 days). Hospital stay was 4-7 days (mean 5.3 days). Full weight bearing time was 10-14 weeks (mean 12.8 weeks). During hospitalization period, there was no regional or deep infection, hypostatic pneumonia, urinary tract infection and bedsore except for 2 cases of urine retention. All cases were followed up with an average period of 12.3 months, and bone healing achieved within 15-18 weeks (mean 16.6 weeks). No complications such as delayed union, coxa vara or coxa valga, screw breakage or backout occurred and only 2 cases had trochanter bursitis because of thin body and overlong end of the antirotated nail. According to the Harris grading scale, the results were defined as excellent in 21 cases, good in 9 cases and fair in 5 cases, with the excellent and good rates of 85.7%.

CONCLUSIONThe emergency treatment of senile intertrochanteric fracture with proximal femoral nail antirotation has the advantages of minimal invasion, easy manipulation, less blood loss, shorter length of stay, less complications, and the preliminary clinical effect is satisfactory.

Aged ; Aged, 80 and over ; Alzheimer Disease ; complications ; Bone Nails ; Emergency Treatment ; Female ; Fracture Fixation, Internal ; methods ; Hip Fractures ; complications ; surgery ; Humans ; Length of Stay ; Male ; Postoperative Complications

OBJECTIVETo explore the effects of surgical procedure combined with the intravascular minimal invasive technique for the treatment of deep vein thrombosis (DVT) of lower extremity.

METHODSAt the curse of disease from six hours to ninety days, one hundred and two patients with DVT including one hundred and three lower extremities had received surgical procedure and intravascular minimal invasive treatment.

RESULTSThere were not procedure-related morbidities in 102 cases, and symptoms disappeared, all procedures were successful based on angiography. The detecting head for the intravascular ultrasound ablation was entered to inferior vena cava (IVC) in 74 cases (78%), Forgarty catheter was entered to IVC in 21 cases (21%), the stenosis in the confluence of the common iliac vein and IVC was dilated by sacculus rotundus catheter in 89 cases (88%), including 9 patients underwent percutaneous transluminal stenting. One hundred and two patients followed up for twenty months, follow-up by angiography showed no restenosis in 91 cases, restenosis in ilio-femoral vein in 1 cases, and thrombus recontouring in 4 cases, as well as 6 cases died caused by primary disease.

CONCLUSIONSurgical procedure combined with the intravascular minimal invasive technique is a safe and effective therapeutic method for DVT.

Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon ; Catheter Ablation ; methods ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Stents ; Ultrasonic Therapy ; Venous Thrombosis ; surgery ; therapy

Traumatic brain injury (TBI) is a highly complex multi-factorial disorder. Animal models of TBI are used to elucidate primary and secondary injury mechanisms and pathophysiological changes and to provide the diagnostic and therapeutical basis for TBI. The choices of animal models depend upon the research objectives. However, various animal models have limitations. The models only can duplicate the pivotal injury mechanisms or a certain important pathophysiological course. The characteristics of human TBI can not fully be reflected by using these models. In the review, animal models of traumatic brain injury are classified as dynamic direct brain injury, indirect dynamic brain injury and combined neuro-traumatic models. Several common models are described for consideration.
Animals ; Biomechanical Phenomena ; Brain/physiopathology* ; Brain Injuries/physiopathology* ; Diffuse Axonal Injury/physiopathology* ; Disease Models, Animal ; Forensic Medicine ; Head Injuries, Closed/physiopathology* ; Head Injuries, Penetrating/physiopathology* ; Humans ; Mice ; Rats ; Reproducibility of Results

Therapeutic angiogenesis comes into sight as a new strategy for coronary atherosclerotic heart disease (CAHD). The therapeutic method of activating blood circulation to remove stasis has shown confirmative effect upon both fundamental researches and clinical trials of CAHD. Thus, the new proposition may provide a better treatment plan for CAHD to study on therapeutic angiogenesis with the therapeutic method of activating blood circulation to remove stasis. The author reviewed relevant theories and the latest researches, on the basis of combining diseases identification and syndrome typing, discussed the state quo and achievement of therapeutic angiogenesis in CAHD by Chinese herbal medicines (CHM) of activating blood circulation to remove stasis from fundamental and clinical researches and action mechanisms from standpoints of Chinese herbal compounds, single Chinese herb, effective herbal chemical composition, thus providing references for future researches.
Coronary Disease ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; methods ; Neovascularization, Physiologic ; Phytotherapy ; methods