Abstract:Objective To compare the efficacy between unilateral transpedicular lateral approach and bilateral transpedicular approach for percutaneous kyphoplasty(PKP)in the treatment of stage Ⅰ and Ⅱ Kümmell's disease.Methods Clinical data of 67 patients with Kümmell's disease treated by PKP in First Affiliated Hospital of Guangdong Pharmaceutical University from January 2019 to January 2022 were analyzed retrospectively.According to different surgical approaches,patients were divided into two groups,unilateral group and bilateral group.Thirty-one patients in unilateral group were performed PKP by unilateral transpedicular external approach,and 36 patients in bilateral group were performed PKP by bilateral transpedicular approach.Operation time,postoperative hospital stay,visual analogue scale(VAS)score,Cobb angle,bone cement injection volume,and bone cement leakage rate were compared between the two groups.Results There were no statistical differences in postoperative hospital stay,preoperative and postoperative VAS score and Cobb angle between the two groups(P>0.05).The operation time and the amount of bone cement in the unilateral group were significantly less than those in the bilateral group(P<0.05).Both groups showed significant improvement in VAS scores and Cobb angle at 1 day and 12 months postoperatively when compared with preoperative ones(P<0.05).There was no significant difference in the incidence of bone cement leakage between the two groups(29.03％in unilateral goup vs 13.89％in bilateral group,P>0.05).No signs of nerve damage was found in patients with bone cement leakage.Conclusions PKP by unilateral transpedicular lateral approach and bilateral transpedicular approach could both achieve satisfactory effects for the treatment of stage Ⅰ and Ⅱ Kümmell's disease,and the former approach has the advantages of less operative time,lower bone cement injection volume,and good operation security.
Abstract:Adhesive capsulitis of the shoulder is a common disease that causes pain of shoulder joint pain,characterized by shoulder pain accompanied by restricted movement and functional impairment.Conservative treatment includes oral medication,physical therapy,local injection of drugs,etc.In most cases,symptoms will be improved to some extent after conservative treatment,otherwise it is a general indication for surgical treatment.Surgical treatment mainly includes manual release under anesthesia and arthroscopic release surgery.In this paper,progress in the influence factors,disease classification,clinical staging,as well as the treatment development of adhesive capsulitis of the shoulder in recent years are reviewed,so as to provide reference for clinical strategy.
Abstract:Objective To investigate the effect of specialized nurse-led doctor-nurse collaborative model in patients during acute edema period after atlantoaxial surgery.Methods A total of 112 patients with atlantoaxial spine surgery admitted to General Hospital of Southern Theater Command from April 2023 to June 2024,were randomly divided into control group and observation group,with 56 patients in each group.Patients in control group were given nursing intervention with routine nursing model for patients during acute edema period after surgery,while patients in observation group were given additional doctor-nurse collaborative model led by specialized nurses.Differences in length of hospital stay,visual analogue scale(VAS)score,Japanese Orthopaedic Association(JOA)score,postoperative complication rate and hospital satisfaction were compared between the two groups.Results The length of hospital stay in the observation group were shorter than those in the control group,the VAS score and JOA score at one week after surgery,and hospitalization satisfaction at discharge from the hospital were better than those in the control group,and the complication rate was lower than that in the control group,the differences between the two groups had statistical significance(P<0.05).Conclusion The doctor-nurse collaborative model led by specialized nurses could speed up the rehabilitation process of patients in the acute edema stage after atlantoaxial spine surgery,reduce the incidence of complications,and improve patients'satisfaction with nursing work.
Abstract:Objective To evaluate the application and validity of the simplified Chinese version of functional rating index (SC-FRI) for patients with low back pain (LBP) in China. Methods The translation and cross-cultural adaptation were performed according to the international guidelines. The SC-FRI was administered to 115 patients with LBP diagnosed in Orthopaedic Clinic in Changhai Hospital from December 2010 to March 2011 along with the simplified Chinese version of Oswestry disability index (SC-ODI), 36-item short form health survey (SF-36), and visual analogue scale (VAS), to self-evaluate their pain and functional health status. Psychometric testing included internal consistency, test-retest reliability, concurrent criterion validity and construct validity. Results A high completion rate of 96% and no floor or ceiling effects were noted for SC-FRI. The internal consistency was good (Cronbach'sα = 0.897 for the overall SC-FRI; range, 0.851-0.890 if an item was deleted). Test-retest reliability was excellent, with an intraclass correlation coefficient of 0.948 (95% confidence interval, 0.917-0.968). Concurrent criterion validity assessment demonstrated that SC-FRI significantly correlated with SC-ODI (r = 0.958) and VAS (r = 0.852). Construct validity was confirmed by the significant Pearson correlation between SC-FRI and physical functioning, bodily pain, social functioning, role-physical and general health domains of SF-36 respectively (r = -0.802,-0.698,-0.573, -0.565, -0.435). Conclusions SC-FRI has excellent reliability and validity for evaluating of pain and functional health status of Chinese-speaking patients with LBP. Being simple and easy to use, SC-FRI should be recommended in clinical and research practice in China.
Abstract:Objective To compare the difference of clinical effects of internal fixation via sinus tarsi approach versus traditional lateral L-type approach for treatment of calcaneal fractures. Methods A total of 116 patients with calcaneal fractures treated in People's Hospital of Sanshui District from January 2013 to June 2015, were randomly divided into observation and control groups using a random numerical table. Patients in control group underwent plate internal fixation through traditional lateral L-type approach, while patients in observation group were treated by plate internal fixation through sinus tarsi approach. Incision length, operation time, intraoperative estimate blood loss and fracture healing time were recorded in two groups, American Orthopaedic Foot and Ankle Society (AOFAS) score, Kofoed score, Maryland score, radiographic Gissane angle and Bohler angle at preoperation and postoperation, as well as postoperative complications were compared between two groups. Results Incision length, operation time, intraoperative estimate blood loss, fracture healing time and incidence of postoperative complications in observation group were better than those in control group, there were statistical differences between two groups (P <0.05). The above joint function scores and radiological parameters at 1 year after operation were all improved compared with preoperative ones (P <0.05), while there were no statistical differences between two groups at postoperation (P >0.05); But postoperative excellent and good rate of AOFAS score in observation group was higher than that in control group (P <0.05). Conclusions Clinical effect of either sinus tarsi approach or traditional lateral L-type approach is satisfactory; Plate internal fixation through sinus tarsi approach has the advantages of alleviating surgical injury, shortening fracture healing time, reducing postoperative complications and promoting early function rehabilitation.
Abstract:Objective To discuss clinical effects of lower extremity biomechanics correction with spinal core muscle groups training for the treatment of patients with chronic non-specific low back pain (LBP). Methods Thirty-two chronic non-specific LBP patients treated by lower extremity biomechanics correction were randomly divided into observation group and control group, with 16 patients in each group. They were all configured biomechanics orthopedic insole, and treated by conventional physical therapy and manipulation therapy at the same time. In addition, patients in observation group performed spinal core muscle group training. Before and after treatment, pain visual analogue scale (VAS) and LBP Oswestry disability index (ODI) scores in two groups were recorded and compared. Results At 1, 6 months after the treatment, VAS and ODI scores improved, the differences between pre- and post-treatment had statistical significance (P <0.05). Before the treatment, VAS, ODI scores between 2 groups had no statistical difference (P >0.05), while there was statistical difference between two groups after the treatment (P <0.05). Conclusion For non-specific LBP patients, spinal core muscle groups training strengthens the efficacy of lower extremity biomechanics correction, as a result, could relieve lumbar pain and improve the quality of life.
Abstract:Porous tantalum, with high porosity, low elastic modulus, high friction coefficient, and combined with tissue ingrowth characteristic and chondroconductive potential, is considered as a perfect implant material in orthopaedic surgery. Recently, there are exciting outcomes reported in researches of manufacture technique and diversified implant devices of porous tantalum. Therefore, in this paper, the manufacture technique, biological characteristics of porous tantalum as biomaterials, and the clinical application of its implant devices in orthopaedic surgery are summarized.
Abstract:Objective To analyze the epidemiological features of adult patients with ankle injuries, including age-sex distribution, causes of injury as well as classifications. Methods The data of 714 ankle injuries (705 adult patients) treated in 5 hospitals in Xinjiang districts from January 2011 to December 2011 were collected through PACS system and medical record query system. Gender, age, injuried sites and AO or Lauge-Hansen classification were recorded and analyzed. Results There were 67.5% of men and 32.5% of women in 705 patients. Ankle injuries were most common in patients who were 31 to 40 years old (27.0%, 190/705). Most injuries (68.1%, 480/705) belonged to low-energy trauma including falling or spraining. About 10.1%of ankle injuries could not been classified by Lauge-Hansen classification, while all ankle injuries could been classified by AO classification. Conclusion Most of adult patients with ankle injuries were young men, and low-energy injury was the most common cause. Not all injuries could been claissified by Lauge-Hansen classification.
Abstract:Objective To explore the clinical effect of bridge combined internal fixation system in the treatment of comminuted femoral shaft fracture. Methods From March 2008 to March 2012, 45 patients with comminuted femoral shaft fracture were treated by bridge combined fracture internal fixation system in Yan'an Hospital Affiliated to Kunming Medical University. Operative time, estimate blood loss, healing time of fracture, as well as limb function recovery were evaluated. Results All patients were followed up from 12 to 24 months (average, 18 months), operative time was 1.0-2.5 h (average, 1.5 h), estimate blood loss was 100-400 mL (average, 200 mL), healing time of fracture was from 4.0 to 6.0 months (average, 4.5 months). During the follow-up, no serious complications such as wound infection, bone nonunion, internal fixation loosening or breakage had happened. According to Sanders limb function assessment, there were excellent in 40 cases, good in 2 cases, and fair in 3 cases, with the excellent and good rate was 93% (42/45). Conclusion Bridge combined internal fixation system is a new choice for comminuted femoral shaft fracture due to its advantages of relative simple operation and satisfactory clinical results.
Abstract:Objective To compare the differences of clinical efficacy between modified Stoppa and ilioinguinal approaches in the treatment of pelvic and acetabular fractures. Methods Clinical data of 98 patients with pelvic and acetabular fractures treated in Guangzhou General Hospital of Guangzhou Military Command from January 2010 to December 2014 with complete follow-up were retrospectively analyzed, in which 48 cases were treated by modified Stoppa approach, and other 50 cases treated by ilioinguinal approach. Clinical evaluation involved incision length, operative time, estimate blood loss volume, reduction of fractures, postoperative hip function scores, as well as postoperative complications. Results All patients were followed up for 6 months to 5 years (average, 12 months). The group of Stoppa approach was significantly superior to the ilioinguinal approach group in incision length [(9.2 ± 2.7) cm vs (15.1 ± 4.3) cm], operative time [(1.7 ± 0.7) h vs (2.0 ± 0.5) h] and estimate blood loss volume [(545 ± 230) mL vs (721 ± 156) mL], the difference between two groups had statistically significance (P <0.05). There were no statistically differences in reduction of fractures [the excellent and good rate of 94% (45/48) vs 92% (46/50), P >0.05] and hip function score [Matta standard, the excellent and good rate of 96% (46/48) vs 96% (48/50), P >0.05] at final follow-up. In modified Stoppa group, there were 2 cases of postoperative deep venous thrombosis; In ilioinguinal approach group, there were 1 case of superficial incision infection, 1 case of deep venous thrombosis, 3 cases of lateral femoral cutaneous nerve paralysis, and 1 case of inguinal hernia. The difference of complication rate between two groups had statistically significance (P <0.05). Conclusions Compared to ilioinguinal approach, the efficacy of procedure for pelvic and acetabular fractures by modified Stoppa approach is reliable, which has advantages of minimal invasiveness, short operation time, less blood loss, less complications, and sufficient exposure of quadrilateral surface, high superior ramus of pubis and bilateral pelvic and acetabular fractures.
Abstract:Objective To investigate a reasonable treatment for femoral shaft fracture by comparison of therapeuctic effects between interlocking intramedullary nail (IMN) and locking compression plate (LCP). Methods Clinical data of 126 adult patients with femoral shaft fracture treated by the above two kinds of internal fixation methods from March 2009 to May 2013 in Chancheng Hospital of Foshan First People's Hospital were analyzed retrospectively. According to different kinds of internal fixation, the patients were divided into interlocking IMN group (n = 70) and LCP group ( n = 56). The estimate blood loss, length of hospital stay, fracture healing time, excellent and good rate for clinical effect at the last follow-up, as well as complication incidence in two groups were compared and analyzed. Results Estimate blood loss, length of hospital stay in interlocking IMN group and LCP group was (386 ± 53) mL, (41 ± 4) d and (419 ± 66) mL, (49 ± 6) d respectively, the differences were statistically significant (P <0.05). All patients were followed-up with the average time of 11.6 months (ranged, 9-27 months). In interlocking IMN group and LCP group, fracture healing time was (4.5 ± 1.1) months and (5.6 ± 1.3) months; excellent and good rates evaluated at the last follow-up were 97%(68/70) and 86%(48/56), complication rates were 6% (4/70) and 18% (10/56). The differences had statistical significance between the above data in two groups (P <0.05). Conclusion Compared with LCP, treatment of interlocking IMN for adult femoral shaft fracture could achieve comparable curative effect with less estimate blood loss, shorter length of hospital stay, less fracture healing time and lower complication incidence.
Abstract:Objective To observe the therapeutic effect of extracorporeal shockwave for the treatment of scapulohumeral periarthritis. Methods A total of 168 patients with scapulohumeral periarthritis treated in the First Affiliated Hospital of Xiamen University from January 2013 to December 2014 were randomly divided into observation group and control group, 84 cases for each group. With the pain points as the focus, patients in observation group were treated by extracorporeal shockwave therapy, and patients in control group were given Celecoxib with functional exercise therapy. Visual analogue scale (VAS) scores before and after the treatment in two groups were evaluated respectively, and the therapeutic effects were accessed. Adverse reactions in two groups were also observed. Results The difference of VAS score before the treatment between two groups had no statistical significance (P >0.05). After the treatment, VAS scores in two groups improved significantly compared with those measured before the treatment; After the treatment, VAS score in observation group was lower than that in control group, the assessment of therapeutic effect, as well as the abduction, retro-extension and internal rotation range of motion (ROM) of shoulder joint were also better than those in control group (P <0.05). No serious adverse reaction was found. Conclusion Extracorporeal shockwave therapy is an effective treatment technique for scapulohumeral periarthritis, which could relieve pain effectively, improve ROM of shoulder joint, and thus obtain satisfied short-term efficacy.