BACKGROUND: The purpose of this study was to investigate the clinical and radiological outcomes of locking plate fixation with fibular strut allograft to manage unstable osteoporotic proximal humerus fractures. METHODS: We retrospectively reviewed 15 patients who underwent open reduction and locking plate fixation with fibular strut allograft for osteoporotic proximal humerus fracture between July 2011 and June 2015. For functional evaluation, we evaluated visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion. For radiological evaluation, shoulder true anteroposterior (AP) and AP in 20° external rotation, as well as the axillary view were taken at two weeks, six weeks, three months, six months, and one year. And the neck-shaft angle was measured on the AP view in 20° external rotation view. RESULTS: At the one-year follow-up, mean VAS pain score and all shoulder scores, including ASES score and UCLA shoulder score, exhibited satisfactory clinical outcomes. All patients obtained bone union between three and six months post-procedure. Moreover, the mean immediate postoperative neck-shaft angle was 138°± 4°, and at one-year follow-up, the neck shaft angle was 137°± 5°. There was no significant difference between the preoperative and postoperative values (p=0.105). CONCLUSIONS: For the unstable two-part and three-part osteoporotic proximal humerus fractures with medial calcar comminution, the use of fibular strut allograft with locking plate fixation was effective in maintaining the initial status of reduction and exhibiting the satisfactory functional and radiological outcomes.

BACKGROUND: The purpose of this study is to compare clinical and radiological outcomes between trans-acromial fixation with Kirschner's wire (K-wire) and AO locking hook plate fixation for acute acromioclavicular (AC) joint dislocation. METHODS: This study included 61 patients who underwent either closed reduction and trans-acromial fixation with K-wire (group A, 23 patients) or open reduction and internal fixation with AO locking hook plate (group B, 38 patients). Pain on a visual analogue scale (VAS) score, the University of California Los Angeles (UCLA) shoulder score, the American Shoulder and Elbow Surgeons (ASES) score, and active range of motion (ROM) were used in the functional evaluation. For radiological evaluation, coracoclavicular distance (CCD) was measured on both clavicular anteroposterior view and compared between groups. RESULTS: At one-year follow-up, no significant differences in VAS pain score, UCLA shoulder score, ASES score, and active ROM were observed between groups, despite five cases (22.7%, 5/23) of complication in group A. The side-to-side difference between normal and affected CCD was 2.4 ± 2.2 mm in group A and 0.2 ± 0.7 mm in group B. This difference showed a statistical significance between groups (p<0.001). CONCLUSIONS: For the treatment of acute AC joint dislocation, the K-wire trans-acromial fixation group showed a significantly greater CCD than the AO locking hook plate group. In addition, during the follow-up period, much higher incidence of complication related to implant was observed in the trans-acromial fixation group. Although clinical outcomes between groups were not significantly different, these results should be interpreted carefully.
Acromioclavicular Joint* ; California ; Dislocations* ; Elbow ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Range of Motion, Articular ; Shoulder ; Surgeons

AlM: To study the trabeculectomy clinical effect of use tunnel knife to make double - deck scleral flap and to cut off the layer scleral flap of glaucoma.METHODS: Using the random grouping method to divide 46 cases (60 eyes) of glaucoma into the treatment group of 24 cases (32 eyes) and control group of 22 cases (28 eyes). The treatment group, tunnel knife was used to make double- deck sclera flap and superficial scleral flap about the size of 5mm×5. 5mm, 1/3 scleral thickness, under the sclera flap made another one about the size of 3. 5mm× 4mm, 1/3 scleral thickness, resected the middle layer of the sclera flap, removed 2mm×2mm trabecular tissue, underwent routine peripheral iridectomy, could adjust suture the superficial scleral flap, sutured Ball fascia and bulbar conjunctiva. ln control group, routine glaucoma trabeculectomy was undergone.RESULTS:Patients were followed up for 1a, the vision in treatment group was obviously better than that in the control group, with a statistically significant difference (P< 0. 05). The postoperative intraocular pressure of the two groups of patients were significantly lower than that of the preoperative one. Postoperative 1 and 3mo, no statistical significant difference of intraocular pressure in two group(P>0. 05). But after 6 and 12mo, the intraocular pressure of the treatment group were significantly lower than that of the control group, with statistically significant difference (P<0. 05). Postopeartive 1a, the cumulative complete success rate and conditions for successful rate were 90. 63% and 96. 88% in the treatment group, and those were 75% and 89. 29% in control group. There was significant difference between two groups(P<0. 05).CONCLUSlON:The trabeculectomy have a good effect to lower the intraocular pressure by use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap. The scleral flap have uniform thickness, smooth surface, and the function of the filtering bleb maintained for a long time, less postoperative complications, suitable for various types of glaucoma, so it is worthy of clinical promotion.

Animals ; Cocaine ; pharmacology ; Habenula ; drug effects ; physiology ; Neurons ; drug effects ; physiology ; Pain Threshold ; drug effects ; Rats

Humans ; Microcirculation ; Sepsis ; physiopathology

Objective To explore the importance of gene diagnosis and prenatal diagnosis of spinal muscular atrophy(SMA),and improve the clinical diagnosis of SMA by analyzing the electrophysiological and gene characteristics of SMA.Methods Fifteen cases with SMA including 9 male and 6 female were enrolled in this study.The age was 5 months to 12 years.The 15 cases were subdivided into 3 clinical types,5 cases of type Ⅰ including 3 male and 2 female aging 5-18 months;7 cases of type Ⅱ including 4 males and 3 females aging 5 months-3 years;3 cases of type Ⅲ including 2 male and 1 female aging 3-12 years.They were all characterized by symmetric muscle weakness(more proximal than distal)associated with atrophy,absence or marked decrease of deep tendon reflexes,loss of voluntary movement and inability to sit or stand.The clinical characteristics and changes of electromyography(EMG)and nerve conduction velocity were assessed in all cases by using Danish Medoc Keypoint myoelectricity and evoked potentials inducer.The survival of motor neuron(SMN)gene was detected by PCR and restriction endonuclease spectrum analysis in 10 cases.Results EMG analysis found 94% patients had spontaneous potential,90% patients had increased duration of motor unit,and amplitude increased in 89% patients.Motor nerve conduction velocity was determined in 78 nerves.Motor nerve compound action potential wave amplitude decreased in 52 nerves,among them,distal latent period prolonged and motor conduction velocity reduced slightly in 36 nerves.Sensory nerve conduction velocity was determined in 45 nerves and remained normal.The SMN gene detection revealed deletion of exon 7 and 8 in 9 cases,deletion exon 7 in 1 case.The SMN gene detection in 10 patients and their parents didn't find any deletion of exon 7 and 8.Conclusions The definite diagnosis of SMA will rely on the typical clinical characteristics,changes of EMG and gene deletion analysis.Gene diagnosis of SMA lays a basis for prenatal diagnosis.

No abstract available.
Ascites* ; Pancreatitis, Chronic* ; Pleural Effusion*

BACKGROUND: Few studies have investigated magnetic resonance (MR) characteristics of traumatic posterosuperior rotator cuff tears involving the supraspinatus and infraspinatus. We hypothesized that traumatic rotator cuff tears may have MR characteristics distinguishable from those of non-traumatic tears. METHODS: Preoperative MR arthrography and intraoperative tear size measurements were compared in 302 patients who underwent MR arthrography and subsequent arthroscopic rotator cuff repairs for traumatic (group T, 61 patients) or non-traumatic (group NT, 241 patients) tears. The inclusion criteria for both groups were posterosuperior full-thickness rotator cuff tear and age between 40 and 60 years. For group T, traumas were limited to accidental falls or slips, or sports injuries, motor vehicle accidents; injuries were associated with acute onset of pain followed by functional shoulder impairment; and time between injury and magnetic resonance imaging (MRI) was 6 weeks or less. RESULTS: In group T, 72.1% of shoulders (44 patients) had tendon tears with blunt edges while 27.9% of shoulders (17 patients) had tears with tapering edges. In contrast, 21.2% of patients in group NT (51 patients) had blunt-edge tears, while 78.8% (190 patients) of tears had tapering edges. These results were statistically significant (p<0.001) and estimated odds ratio was 9.6. The size of tear did not vary significantly between groups. CONCLUSIONS: We found no exclusive MR characteristic to define traumatic tears. However, oblique coronal MRI of traumatic tears showed a significant tendency for abrupt and rough torn tendon edges and relatively consistent tendon thicknesses (without lateral tapering) compared to non-traumatic cuff tears.
Accidental Falls ; Arthrography* ; Arthroscopy ; Athletic Injuries ; Humans ; Magnetic Resonance Imaging ; Motor Vehicles ; Odds Ratio ; Rotator Cuff* ; Shoulder ; Tears* ; Tendons

OBJECTIVETo search for an optimum method for testicular prothesis implantation in the treatment of testis loss.

METHODSWe retrospectively analyzed the surgical methods and outcomes of 53 cases of terminal prostate cancer and 4 cases of unilateral testicular torsion treated by implantation of testicular prothesis with the polypropylene mesh.

RESULTSThe 57 male patients all received testicular prothesis with the polypropylene mesh. All the patients were satisfied with the appearance and size of the scrotum after surgery. No scrotal hematoma, prosthesis infection, or autoimmune disease occurred postoperatively.

CONCLUSIONTestis loss is not a rare condition clinically, for the treatment of which surgical implantation of testicular prothesis with the polypropylene mesh can achieve both a fine tissue compatibility and a desirable scrotal appearance.

Humans ; Male ; Polypropylenes ; Prostatic Neoplasms ; surgery ; Prostheses and Implants ; Retrospective Studies ; Scrotum ; Spermatic Cord Torsion ; surgery ; Surgical Mesh ; Testis

OBJECTIVETo study mechanical affect of knee joint of reasonable positioning of femoral tunnel during knee posterior cruciate ligament (PCL) double-bundle reconstruction and graft fixation after reconstruction by virtual reality interactive technology and evaluate the biomechanical response of knee after reconstruction by finite element analysis.

METHODSKnee specimens from five fresh frozen cadavers were used. Computer simulations and biomechanical experiments were used in this study. Experiments on flexion and extension movements of the knee joint were performed on specimens of fresh human knee joint. Laser three dimensional scanning was used to record and calculate the indexes of movements. Three-dimensional models of knee joint bone structure were then reconstructed on computer with the experimental data. Simulations of flexion and extension movements were carried out on the models to show the spatial positions of femur and tibia and label the attachment sites of PCL. Ten test points in the anterior,posterior, proximal, distal at the femoral attachment area of anterior and lateral bundle (ALB) and postoperior medial bundle (PMB) were selected and the central points of tibial en attachment areat anchored. The distance btween each two points of two article surface was calculated and contacted by software of Geomagic. Model was import software Ansys, adopting the tetrahedron unit a finite element model of complex tibial and femoral was set up to simulat human walking in one leg,on this condition the the joint surface force of model under weight impact load were analyzed.

RESULTSThe three-dimensional models could demonstrate the spatial positions of the bone structure of the knee in different flexions and extensions. The models could be used to measure the spatial distance between 2 points on the femoral and tibial planes by software Geomagic. There was significantly difference among the length changes of anterolateral bundle and posteromedial bundle at every fixed point with different flexion angles (P<0.05), so the fixed angle with different points. The length changes of anterior lateral bundle's A2, A1 and posterior medial bundle's B3, B1 points were (1.35±0.19) mm, (5.41±1.22) mm, (1.95±0.04) mm and (5.23±2.21) mm, respectively. The A2 and B3 points' length changes were the less, and that of the Al and B1 points were the more. It had no significant difference between the length changes of anterior lanteral bundle's A2 and A3 point (P=0.913>0.05). All of the maximal length changes of anterior lateral bundle's A2, A3 and postterior medial bundle's B3 points were less than 2 mm.

CONCLUSIONThe models of knee joint were builded through computer technology and it can be measure the lenth of cruciate ligament with software Geomagic exactly. The femoral tunnel for the PCL double-bundle reconstruction should be located as follows: ALB at the middle point of upper edge of femoral attachment site (proximal point),while PMB at the middle point of femoral attachment site (proximal point). This model provides a satisfactory method for the evaluation of the biomechanical response of knee after cruciate ligament reconstruction.

Adult ; Aged ; Biomechanical Phenomena ; Computer-Aided Design ; Female ; Femur ; surgery ; Humans ; Knee Joint ; physiology ; Male ; Middle Aged ; Posterior Cruciate Ligament ; surgery ; Reconstructive Surgical Procedures ; methods