Quick Search
  Office Online
  Journal Online
Current Issue
Archive
Advanced Search
Read Articles
Download Articles
2019 Vol. 25, No. 3
Published: 2019-03-25
 
193 Application of Targeted Puncture Technique in Percutaneous Transforaminal Endoscopic Discectomy for Adolescent Lumbar Disc Herniation
Zhang Xin，SongYuke，Ren Dongjie，et al
Objective  To investigate the clinical efficacy of targeted puncture technique in percutaneous transforaminalendoscopic discectomy (PTED) for Adolescent Lumbar Disc Herniation (ALDH).Methods  A retrospective study was performed between Jun 2014 and September 2017，which included 30 adolescent patients who underwent PETD for lumbar disc herniation.2 females and 28 males were included，with a meanage of (18.50±2.13)years and a mean BMI of (22.04±3.71)kg／m2.The pre-andpostoperative visual analogue scale (VAS)，Oswestry disability index (ODI)，and modified MacNab scores，as well as perioperative data，were collected.Results  The mean follow-up period was (25.63±14.14)months.The average operation time and hospital stay were (118.23±31.57)minutes and (6.13±2.03)days.Besides，the average bleeding were (8.30±6.17)mL.During the follow-up period，the VAS for back and leg pain decreased significantly，and ODI scoresgreatly increased (P＜0.05).In terms of modified MacNab criteria，86.87% of patients showed excellent or good results.After surgery，one patients complained of leg numbnessand underwent a second surgery.Conclusion  The targeted puncture technique percutaneous transforaminalendoscopic discectomy is a safe and effectiveminimally invasive technique for ALDH.
2019 Vol. 25 (3): 193-196 [Abstract] ( 487 ) HTML (1 KB)  PDF (1947 KB)  ( 477 )
197 Intraoperative Elbow Joint Arthrography in the Treatment of Radial Neck Fracture of Young Children
Jiang Hai 1，Wu Yongtao 2，Wang Bing 2，et al
Objective  To observe the effect of intraoperative elbow arthrography in reduction of radial neck fractures of the young children and solve the problem caused by the nonvisulization of radial head ossified nucleus.Methods  Intraoperative elbow arthrographies were performed in 16 cases of radial neck fractures whose radial head nuclei were not clear in X ray image and then the reductions were performed by leverage of percutaneous Kirschner wire.There were 7 males and 9 females.The average age was 5 years and 1 month old. According to O’brien classification，there were 9 cases of type Ⅱ and 7 cases of type Ⅲ.The approach of lateral of the elbow joint was chosen to perform the arthrography.Iohexol was the contrast agent.After satisfactory reduction，two Kirschner needles were fixed through the fracture site or the proximal fracture site.The occurrence of postoperative complications and the clinical effects were observed.Results  Intraoperative elbow arthrography could clearly show the articular surface of the radial head，assistpercutaneous leveragereduction.According to the reduction criterion of Metaizeau，14 cases were excellent，2 cases were good，and the excellent and good rate was 100%.From follow up of average 21months(range 9 months to 30 months)，16 cases were excellent according to the effect criterion of Metaizeau，and the excellent and good rate was 100%.There was no proximal osseous junction and no ischemic necrosis of the radial head.No needle infection or injury to the deep branch of the radial nerve occurred.There was no postoperative complications.Conclusion  Closed reduction assisted by intraoperative elbow arthrography through percutaneous reduction by leverage and internal fixation can effectively improve the excellent and good rate of reduction of radial neck fracture in children without visulization of radial head ossified nucleus in young children.
2019 Vol. 25 (3): 197-204 [Abstract] ( 304 ) HTML (1 KB)  PDF (2061 KB)  ( 352 )
201 Clinical Classification and Treatment of Somatic Referred Pain of Osteoporotic Vertebral Compression Fracture
Shi Rongmao，Chen Taibang，Liang Jinlong，et al
Objective  To analyze the clinical characteristics and clinical treatment effect of somatic referred pain of osteoporotic vertebral compression fracture(OVCF).Methods  The clinical data of patients with OVCF hospitalized in our department from June 2013 to June 2017 were retrospectively analyzed.41 patients with somatic referred pain were enrolled this study.There were 8 males and 33 females，with an average age of (75.5±5.5)(range 64~91).The Type of somatic referred pain were classified into A~E types according to the pain distribution patterns.All patients underwent percutaneous kyphoplasty(PKP) ，the visual analog scale (VAS) and the Oswestry disability index (ODI) were recorded preoperatively and postoperatively to assess the pain and disability degree of patients.Results  41 patients were analyzed and types distribution were 20 cases of Type A，7 cases of Type B，6 cases of Type C，3 cases of Type D and 5 cases of Type E.The VAS and ODI significantly improved postoperatively and final follow-up in all patients(P＜0.05).There was no significant difference in VAS and ODI score preoperatively between the different types (P＞0.05)，but significant differences was found in VAS and ODI score during postoperative and final follow-up (P＜0.01).Conclusion  Somatic referred pain is more common in patients with OVCF，Type A is the most common type，and Type D and Type E are relatively rare.PKP is an effective treatment for OCVF with somatic referred pain.
2019 Vol. 25 (3): 201-204 [Abstract] ( 457 ) HTML (1 KB)  PDF (625 KB)  ( 361 )
205 Outcomes and Complication Analysis of Surgical Treatment of Tibial Plateau Fractures with Posterior Column Involvement
Chen Changsheng 1，Qi Xiaoyang 2，Xu Mingyong 1，et al
Objective  To explore the clinical outcomes and complications of surgical treatment of tibial plateau fractures with posterior column involvement.Methods  Forty one patients with tibial plateau fractures with posterior column involvement were retrospectively analyzed.There were 22 men and 19 women，with an average age of 42 years.According to the three column classification system，there were 26 three-column fractures，8 lateral and posterior column fractures，1 medial and posterior column fracture，6 posterior column fractures.The fracture reduction and fixation order was posterior column，medial column and lateral column.Firstly，the patient was placed in prone position，the posterior column fracture was reduced and fixed with postmedial approach，then other column fractures were reduced and fixed with patient in supine position.Patients’ knee pain and range of motion were recorded during follow-up，and knee function was evaluated by hospital for special surgery knee score (HSS) at last follow-up.Results  All patients were followed up satisfactorily，with an average follow-up of 12.5 months.At 6 months follow-up，all fractures were healed clinically and radiologically，no loose or broken was seen.The pain was reduced and the range of motion was improved at 6 months and last follow-up compare to 3 months follow-up.The good and excellent rate of HSS score was 81% at last follow-up.Superficial infections occurred in 3 patients，foot numbness occurred in 1 patient，and one patient had less than 90° flexion.Conclusion  The postmedial approach combine with other approachesiseffectivein the treatment of tibial plateau fractures with posterior column involvement.The complication rate is low.The three-column concept isuseful in guiding surgical treatment of tibial plateau fractures.
2019 Vol. 25 (3): 205-208 [Abstract] ( 350 ) HTML (1 KB)  PDF (1273 KB)  ( 617 )
209 Clinical Study on Postoperative Infection of Open Tibial Fracture with Different Debridement Timing
Li Jie 1，2，Wang Qian 1，Lu Yao 1，et al
Objective  To investigate the relationship between the time of first debridement and postoperative infection in open tibial fractures.Methods  The clinical data of 215 patients with open fracture of tibia admitted from January 2012 to January 2017 were analyzed retrospectively.According to the time from the injury to the operation，the patients were divided into four groups：group A (T≤6 h)，group B (6 h＜T≤12 h)，group C (12 h＜T≤24 h) and group D (T＞24 h) respectively，to analyze the difference of infection rate between early debridement and delayed debridement after the first debridement.Results  6 cases of 65 cases in group A were infected，and the infection rate was 9.2%；9 cases in 95 cases in group B were infected，and the infection rate was 9.5%；4 cases of 36 cases in group C were infected，and the infection rate was 11.1%；2 cases of 19 case in group D were infected，and the infection rate was 10.5%.There was no statistical significance between any of the four groups.Accroding to fracture (GustiloAnderson) classification，there were 62 cases of type Ⅰ with 2 cases infected，and the infection rate was 3.2%；8 cases of type Ⅱ cases，and the infection rate was 8.2%；26 cases of type Ⅲ A with 3 cases infected，and the infection rate was 11.5%，25 cases of type Ⅲ B with 7 cases infected，and the infection rate was 28%，4 cases of type Ⅲ C type with 1 case infected，and the infection rate was 25%.There was statistically significant difference between the five groups.Conclusion  The prolonged time from injury to debridement of open tibial fractures does not increase the postoperative infection rate.And the postoperative infection of open tibial fractures is mainly related to the severity of fractures.
2019 Vol. 25 (3): 209-219 [Abstract] ( 314 ) HTML (1 KB)  PDF (505 KB)  ( 453 )
213 Analysis of Curative Effect of Treatment of Distal Lateral Malleolus Fracture with Lateral Malleolar Anatomical Hookplate
Zhang Ruyi，Yun Cai，You Xidong，et al
Objective  To evaluate the curative effect of lateral malleolar anatomical hookplate in the treatment of lateral malleolus fractures.Methods  During the period from January 2013 to January 2017，27 patients were treated at our institute using lateral malleolar anatomical hookplate for repair of distal lateral malleolus fracture，the average age was (38±9)years old(range 25 to 55).There were sixteen males and eleven females.The functional rehabilitation of the patients’anklejoints were assessed by the range of motion (ROM)and the Mazurscore retrospectively.Results  There were 25 patients were followedup for (31±9)months (range from 19 months to 47 months).At the last followup，the range of motion(ROM)between the healthy sideand the injured side，including flexion，extension，varus and valgus，had no statisticalsignificance(P＞0.05).According to the Mazur ankle scores，there were 17 excellent cases，6 good cases，1 fair case，1poor case，the excellent-good rate was 92.00％，and the scores were (88.64±3.41).Conclusion  he treatment of lateral malleolus distal fracture with fibula hook plate has anatomic reduction，firm fixation，easy operation，little stimulation to soft tissue and satisfy early functional exercise，which is helpful to the rehabilitation of ankle function.
2019 Vol. 25 (3): 213-215 [Abstract] ( 327 ) HTML (1 KB)  PDF (858 KB)  ( 364 )
216 Descriptive Study on Wound Infection Pathogens of Hand Injuries of Different Degrees of Damage
Liu Shibo，Sun Bo，Li Xiaodong，et al
Objective  To explore the the relationship of bacterial infection，injury mechanism and extent of injury of hand trauma to guide the treatmentthrough the retrospective study.Methods  The 239 cases of infection after hand injury from The Hand-Foot surgery of the Affiliated Hospital of Chengde Medical University were collected in 2011—2016.There were 181 males and 58 females，aged 4~77，with an average age of (42.96±12.60).Correlation analysis was performed on the injury mechanism，the injury degree，and the type of bacteria infected.Results  From the 239 cases，rolling cutter and avulsion with severe hand injuriesaccounted for 21.8%，crush injury and bruise accounted for-23.4%.There were different types of bacteria after different grades，Gram-positive bacteriaaccountedfor 38.3% in Grade I.The Gram-positive and Gram-negative bacteria accounted for 36.7% and 40.8% in Grade Ⅱ.Infections were mainly Gram-negative bacteria，and accountedfor 65.8% and 71.9% in Grade Ⅲ and Ⅳ.There were significant differencesin between grade I~Ⅳ.The pathogenic bacteria Pseudomonas aeruginosa accountedfor 20.6%，and Staphylococcus aureus accounted for 14.7%.The bacteria were mainly Gram-negative.Conclusion  The type ofbacterial changes with the severity of the injury.Gram-positive bacteria are the mainly type of patients with grade Ⅰ trauma.Gram-negative bacteria were the mainly type of patients with grade Ⅲ and Ⅳ trauma.In order to reduce the incidence of infection，the clinicians should choose antibiotics according to different grades of hand injuries.
2019 Vol. 25 (3): 216-219 [Abstract] ( 265 ) HTML (1 KB)  PDF (446 KB)  ( 335 )
220 Effects of Simvastatin on Bone Mineral Density and Fracture Healing in Postmenopausal Women with Abnormal Blood Lipid Metabolism
Liu Xiaoning，Ju Yang，Kong Deming，et al
Objective  To investigate the effects of simvastatin (20 mg/d) on bone mineral density and fracture healing in dyslipidemia diabetes patients with upper extremity fractures.Methods  86 cases of postmenopausal women with diabetes mellitus with abnormal blood lipid metabolism were followed up.According to whether the patients took the lipid-lowering drug simvastatin (20mg/d)，they were divided into the control group and the treatment group.The difference of bone mineral density and fracture healing in the distal tibia of the healthy side in the last 3 months.Results  During the hospital，there was no significant difference in bone mineral density of the radius between the treatment group and the control group (P＞0.05).After 3 months of treatment，the treatment group bone density compared with before treatment showed no significant difference(P＞0.05)；the control group mean bone density increased，but no significant difference before and after treatment (P＞0.05).After 3 months of treatment，there was no significant difference in bone mineral density (P＞0.05) between the treatment group and the control group.There were no significant differences in the number of fracture healing between the treatment group and the control group.Simvastatin(20 mg/d) does not promote the healing of fracture in postmenopausal diabetes women with hyperlipidemia.Conclusion  Simvastatin(20mg/d) has no effect on bone mineral density in the distal radius and fracture healing in hyperlipidemia postmenopausal diabetes mellitus patients with upper extremity fractures.
2019 Vol. 25 (3): 220-222 [Abstract] ( 308 ) HTML (1 KB)  PDF (411 KB)  ( 367 )
223 Bearing Surfaces of Ceramic-on-Ceramic(Delta ceramic) Versusceramic-on-Highly Cross-Linked Polyethylene in Total Hiparthroplasty：A Short-term Comparative Study
Chen Yuxuan，Zhang Zhiqiang，Shi Junjun，et al
Objective  To compare the short-term clinical efficacy between ceramic-on-ceramic and ceramic-on-highly cross-linked polyethylene bearing surfaces in total hiparthroplasty.Methods  65 patients(73 hips) who accepted the ceramic-on-ceramic andceramic-on-highly cross-linked polyethyleneprimarytotal hiparthroplasty (THA) from July 2015 to July 2016 were retrospectively analyzed.Patients were divided into 2 groups：ceramic-on-ceramic group(CC group) and ceramic-on-highly cross-linked polyethylene group(CP group).X-ray film was measured to observe osteolysisandprosthesis loosening，and to measurelinear wear rate and the abduction angle of the acetabular cup.Harris score were used to evaluatethe hip function.Results  Sixty-onepatients(69 hips)were followed up.The mean follow-up period was 26 months(ranged 24～30 months).There was no significant differencein gender，age，body weight，and preoperative Harris score between the two groups (P＞0.05).The wear rate in CC group could not be measured due to the occlusion of the acetabular cup.The mean displacement value of the first two months in CP group was (0.08±0.011)mm.The mean displacement value from 2 to 24 months after surgery was (0.017±0.012)mm.The mean Harris score of CC group increased from (46.18±7.31)(preoperative) to (89.70±6.44)(postoperative) (P＜0.001).The mean Harris score of CP group increased from (43.92±8.94)(preoperative) to (92.61±6.23)(postoperative) (P＜0.001).There was no significant difference in Harris score between the two groups at the last follow-up (P＞0.05).No radiological signs of osteolysis orprosthesis loosening were detected at follow-up.Conclusion  Both ceramic-on-ceramic(Delta ceramic)and ceramic-on-highly cross-linked polyethylene bearing surfaces have good effect in the total hip arthroplasty.There is no significant difference between the two prostheses in the early postoperative period.
2019 Vol. 25 (3): 223-236 [Abstract] ( 337 ) HTML (1 KB)  PDF (559 KB)  ( 302 )
227 Comparative Study on the Wound Healing of Diabetic Rats after Perioperative Period and Long-term Blood Glucose Control
Xiang Chuan，Cai Long，Liang Zhiyong，et al
Objective  To observe the serum tumor necrosis factor alpha (TNF-α)，interleukin 6 (IL-6) and local macrophage infiltration degree and number of fibroblast in diabetic rats during wound healing and，discuss whether long-term blood sugar control can obviously improve the wound healing of diabetic rats.Methods  a) Wound models of diabetic mice were divided into 4 groups.Including B：Preoperative blood glucose control 1 day，C：Preoperative blood glucose control 3 days，D：preoperative blood glucose control 7 days，E：preoperative blood glucose control 1 month.The normal rats were group A，which used the same procedure to produce the same size of wound as the control group.On the 1st day，3th day，7th day and 14th day after the surgery (3 rats each time)，we collected the heart blood and wound tissue.ELISA was used to detect serum level of TNF-α，IL-6，and immunohistochemistry was used to observe the macrophages and the number of fibroblasts.b) Intermediate-acting insulin was used to lower blood glucose levels before and after the modeling.Results  a) Compared with the control group，there was a delay in the wound healing of the experimental diabetes group.In the early stage after surgery，the number of local macrophages in the control blood glucose groups (B、C、D) were significantly lower in the perioperative period (P＜0.05)，but the macrophages in the later stage were significantly increased (P＜0.05).b) Compared with group B、C、D，it was found that group E could significantly improve wound healing.c) Compared with A，the level of TNF-α and the IL-6 was higher in experimental groups，but with the extension of preoperative blood glucose control，in early and middle stage of wound healing，TNF-α and the IL-6 of E were lower compared with B、C group，but higher compared with A(P＜0.05).Conclusion  In the process of wound healing，diabetic rats are prone to delayed inflammatory response and are not easy to subside.Preoperative long-term control of blood glucose can further improve the rate of wound healing，but compared with normal rats，there is still a risk of non healing wounds.
2019 Vol. 25 (3): 227-231 [Abstract] ( 268 ) HTML (1 KB)  PDF (2202 KB)  ( 226 )
Copyright © Editorial Board of sygkzz
     ���������� 14010702070875��
Supported by:Beijing Magtech