目的:探讨医源性隐睾的病因,预防和治疗特点。方法:回顾分析我院治疗的16 例医源性隐睾患儿,其中睾丸鞘膜积液术后7 例,腹股沟斜疝术后8 例,尿道下裂术后1 例。结果:16 例均接受手术治疗,10 例睾丸存在不同程度的萎缩,其中1 例睾丸完全萎缩,行睾丸切除。术后随访12 例,睾丸均在阴囊内,但发育较健侧差。结论:降低医源性隐睾发病率的根本措施是防止其发生,尽量减少不正确的医疗行为,并做到早期发现,早期行手术治疗。
Objective To investigate the method and the short term cl inical effectiveness of in situ suture repair procedure of knee dislocation with multi ple-l igament injury at acute stage. Methods From February 2006 to November 2007, 9 patients suffering from single knee closed dislocation with multi ple-ligament injury underwent open in situ suture repairprocedure with non-absorbable thread and managements of other combined injuries simultaneously. Nine patients included 6 males and 3 females, aged 34-52 years old. The injured knees were left side in 4 cases and right side in 5 cases. Injuries were caused by traffic accident in 8 cases and heavy-weight crushing in 1 case. EMRI and arthroscopic examination showed that all patients suffered from the avulsion injuries of anterior cruciate l igament and posterior cruciate l igament. The time from injury to operation was 4 to 7 days with an average of 5.1 days. Results No bacterial arthritis occurred after operation. Subcutaneous liquated fat occurred and cured after symptomatic treatment in 2 cases, other incisions healed by first intension. All patients were followed up 12 months. At 12 months postoperatively, 2 patients’ flexion range of the suffering knees lost 10° when to compared with normal knees, and the range of motion was from 0 to 125°. The Lysholm knee scores were 83-92 (average 86.3), the results were excellent in 3 cases and good in 6 cases. The posterior drawer test and anterior drawer test were one-degree positive in 3 cases respectively; the Lachman tests were one-degree positive in 5 cases, lateral stress tests were negative in all cases. Conclusion In situ suture repair procedure of knee dislocation with multi ple-ligament injury at acute stage has the advantages such as rel iable fixation, simultaneous management of other combined injuries and satisfactory short term effect.
【摘要】 目的 探讨关节镜治疗膝关节滑膜软骨瘤病的疗效。 方法 2005年1月—2009年10月，对23例（28膝）滑膜软骨瘤病患者入院行X线片、关节活动度检查、视觉模拟评分以及Lysholm膝关节功能评分。根据镜下所见分为表浅型6例，游离体型17例。结合病理学检查行Milgram 分期，Ⅱ期16例，Ⅲ期7例。所有患者均行关节镜下病变滑膜切除及游离体取出治疗。 结果 所有患者均随访13~57个月，平均（32.3±6.7）个月，术后伤口均甲级愈合。术后（5.05±2.43） d恢复正常生活或工作。症状明显改善21例（91.30%），部分改善2例（8.70%），对疗效满意23例（100%）。膝关节关节活动度由术前的伸膝（14.29±16.34）°以及屈膝（106.07±35.83）°提高到术后的伸膝（1.79±2.79）°及屈膝（132.64±35.64）°，差异具有统计学意义（Plt;0.05）。负重行走时疼痛视觉模拟评分由术前的（3.81±2.02）分降低到术后的（0.37±0.65）分（Plt;0.05）。Lysholm评分由术前的（43.20±8.24）分升至术后6个月的（86.72±5.40）分（Plt;0.05）；术后1年复诊并检查膝关节正侧位X线片，均未见滑膜软骨瘤体，所有患者无复发。 结论 关节镜下游离体取出术联合病变滑膜切除术疗效满意，关节疼痛明显减轻，功能恢复，是一种治疗膝关节滑膜软骨瘤病确切有效的方法。【Abstract】 Objective To investigate the therapeutic effect of arthroscopic treatment on synovial chondromatosis. Methods A total of 23 patients (28 knees) with synovial chondromatosis were diagnosed and treated in our hospital from January 2005 to October 2009. All of the patients underwent radiographic imaging examination, knee joint range of motion (ROM), visual analogue scale (VAS) and Lysholm score. According to distinct arthroscopic appearance, superficial pattern was found in 6 patients and loose body lesion pattern was in 17. Additionally, combined with pathological examination, according to the Milgram staging，Stage Ⅱ was in 6 patients and Stage Ⅲ was in 7. Arthroscopic limited synovectomy and removal of loose bodies were performed on all the patients. Results The patients were followed up for 13-57 months with the mean of (32.3±6.7) months. The wound of all patients healed up. The time of returning to normal work and life was (5.05±2.43) days for average. The postoperative symptom was markedly alleviated in 21 patietns and partly alleviated in 2. All patients were satisfied with the therapeutic effect. The mean activity of knee joint was significantly different befoe and after the surgery (Plt;0.05) preoperative extension and flexion degrees were (14.29±16.34) and (106.07±35.83) degrees, respectively; postoperative extension and flexion degrees were (1.79±2.79) and (132.64±35.64) degrees (flexion) , respectively. The mean VAS score of weight bearing walking was 0.37±0.65 after theoperation and 3.81±2.02 before the peration; the difference was significantly different (Plt;0.05). The preoperative Lysholm knee score was 34-67 with the mean of 43.20±8.24, and the post-operative score was 71-99 with the mean of 86.72±5.40. There were differences in preoperative and post-operative scores (Plt;0.05) . Radiographic imaging examination of knee joint was performed 1 year after the opertation, no loose bodies was seen and no patients recurred. Conclusion The therapeutic effect of arthroscopic limited synovectomy and removal of loose bodies is good on synovial chondromatosis.
Objective To compare the effect of proximal femoral nail anti-rotation (PFNA) and dynamic hip screw (DHS) in the treatment of intertrochanteric fracture in elderly patients with osteoporosis. Methods A total of 72 elderly patients with intertrochanteric fractures were enrolled between December 2011 and December 2014. According to the different surgical methods, the patients were divided into PFNA group (38 cases) and DHS group (34 cases). The operation time, perioperative blood loss, postoperative weight-bearing time, Harris score were compared between the two groups. Results All cases were followed up for 5–24 months (mean, 13.5 months). The operation time in PFNA group was shorter than that in DHS group [(40.25±24.23) vs. (72.65±34.65) minutes], the perioperative blood loss in PFNA group was less than that in DHS group [(136±56) vs. (256±102) mL], the postoperative weight-bearing time in PFNA group was earlier than that in DHS group [(5.24±4.52) vs. (15.69±6.78) days], and the Harris score in PFNA group was higher than that in DHS group (80.23±10.26 vs. 54.75±12.37) ; the differences above were all statistically significant (P<0.05). Conclusion Elderly patients with intertrochanteric fracture and osteoporosis treated with PFNA have shorter operation time, less wounds, better hip function, and earlier weight-bearing than the patients treated with DHS; the surgical method can improve the patient′ life quality.
The overlap of literature in umbrella reviews can affect the reliability and accuracy of research conclusions, leading to results with a higher risk of bias. Therefore, it becomes crucial to assess the degree of overlapping and how to handle it. In order to avoid redundant calculations and reduce the risk of bias, researchers need to quantify the degree of literature overlap and adopt corresponding processing strategies. This paper provides a detailed introduction to the calculation methods of overlapping and different strategies for handling overlapping, aiming to provide a reference and guidance for domestic scholars' understanding and application of this method.