west china medical publishers
Author
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Author "张忠杰" 10 results
  • REPAIR OF COMPLICATED DEGLOVING INJURIES OF OPPOSITE FINGER WITH AKIN UNITED FLAPS PEDICLED WITH DORSAL CARPAL BRANCH OF ULNAR ARTERY

    Objective To evaluate the cl inical efficacy of akin united flaps pedicled with dorsal carpal branch of ulnar artery in repairing compl icated degloving injuries of the opposite fingers. Methods Between August 2005 and August 2009, 11 cases of compl icated degloving injuries of single finger were treated, including 8 males and 3 females with an average age of 26 years (range, 19-55 years). The defect locations were thumb in 1 case, index finger in 7 cases, and middle finger in 3 cases, including 9 cases of mechanical injury and 2 cases of traffic accident injury. The extent of skin avulsion was the proximal segments or beyond the middle segment of finger with a defect range from 5.0 cm × 4.5 cm to 8.0 cm × 5.5 cm. Compl icated injuries included phalangeal fracture in 2 cases, extensor tendon injury in 3 cases, flexor and extensor tendon injuries in 1 case, digital vascular injury in 9 cases, and digital nerve injury in 6 cases. The time from injury to operation was 2-18 hours (mean, 4.8 hours). The akin united flaps were designed on the basis of anatomical distribution of the dorsal carpal branch of ulnar artery. The proximally pedicled flaps enclosed palmar finger, and the distally pedicled flaps enclosed dorsal finger. The size of flaps ranged from 10 cm × 3 cm to 16 cm × 3 cm. The donor sites were sutured directly. After 3 weeks, the pedicle was cut. Results Light yellow secretion and eczema on the flap were observed in 1 case at 3 days, were cured after 2 weeks of dressing change; other flaps survived and healing of incisions by first intention was achieved. The incisions at donor sites healed by first intention. The secondary plastic operation was performed in 2 cases because of bulky flaps at 3 months after operation. Eleven patients were followed up postoperatively 6-12 months (8 months on average). The texture and appearance of all the flaps were satisfactory. The two-point discrimination was 12-20 mm with satisfactory recovery of finger function at 6 months after operation. According to Jebsen standard, the results were excellent in 8 cases, good in 2 cases, and poor in 1 case. Conclusion With rel iable blood supply, easy dissection, less injury at donor site, and good repair results, the akin united flaps pedicled with dorsal carpal branch ofulnar artery is a good method to repair complicated degloving injuries of the opposite fingers.

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • Posteriol Fixation and Fusion for Treatment of Tuberculosis of Spine

    目的:探讨后路内固定治疗脊柱结核的必要性及适应证。方法:2002年1月~2008年12月采用后路器械固定、融合结合前路彻底病灶清除、植骨治疗脊柱结核17例。病变位于胸椎3例,胸腰段2例,腰椎4例,腰骶椎8例;累及2个节段7例,3个节段7例,4个节段3例;有3例伴窦道形成;9例伴不同程度的脊髓和(或)神经根受压症状;术前后凸成角10°~72°,平均31°。所有患者均一期手术。结果:术后随访6个月~5年,平均3.1年,术后切口均Ⅰ期愈合,后凸成角7°~58°,平均16°,椎间植骨平均在5个月融合,植骨融合率95.6%,优良率达89.6%,无一例复发。结论:后路器械固定结合前路彻底病灶清除、植骨治疗脊柱结核主要适用于多个节段受累、腰骶段及伴窦道者,利于恢复脊柱的稳定性、提高植骨融合率、纠正和预防后凸畸形。

    Release date:2016-09-08 09:56 Export PDF Favorites Scan
  • TUMOR-SEGMENTAL RESECTION OF HAND-FOOT-GIANT CELL TUMOR OF BONE AND AUTOLOGOUS ILIAC BONE GRAFT RECONSTRUCTION

    To evaluate the effectiveness of tumor-segmental resection and autologous il iac bone graft reconstruction combined with internal fixation in treating hand-foot-giant cell tumor of bone. Methods Between August 1997 and April 2008, 8 cases of hand-foot-giant cell tumor of bone were treated, including 3 males and 5 females with an average age of 28.5 years (range, 16-42 years). The locations were metacarpal bones in 3 cases, metatarsal bones in 4 cases, and phalanges of toes in 1 case. According to Campanacci’s gradation of X-ray films, there were 1 case of grade I and 7 cases of gradeII; according to pathological examination before opration, there were 3 cases of grade I to II, 4 cases of grade II, and 1 case of grade II to III; and according to TNM staging, there were 1 case of TisN0M0, 4 cases of T1N0M0, and 3 cases of T2N0M0. There were 2 cases of recurrence, the time from the first operation to recurrence were 11 and 14 months, respectively. The tumor size was 1.8 cm × 1.0 cm to 6.0 cm × 2.0 cm, the cortical bone became thinner, and the boundary between tumor and periosteum was clear. All patients underwent tumor-segmental resection combined with autologous il iac bone graft reconstruction, and miniplate internal fixation by lumbar anesthesia or trachea cannula anesthesia. Results All incision healed by first intention. Eight patients were followed up 10 to 84 months with an average of 46 months. Radiographs showed that fracture union was achieved at 3 to 9 months (mean, 5 months). No significant rotation, angular, and shortening deformity occurred in il iac bone graft. The function of il iac bone donor site recovered excellently. The pathological examination showed giant cell tumor of bone in all cases, including 2 case of grade I-II, 5 cases of grade II, and 1 case of grade II-III. The hand or foot function recovered excellently. No tumor recurrence or lung metastasis occurred during follow-up. Conclusion Tumor-segmental resection combined with autologous il iac bone graft reconstruction plus internal fixation has excellent effectiveness for hand-foot-gaint cell tumor of bone.

    Release date:2016-08-31 05:48 Export PDF Favorites Scan
  • EVALUATION ON CURATIVE EFFECT OF THREE OPERATIVE METHODS IN TREATMENT OF SENILE INTERTROCHANTERIC FRACTURE

    Objective To analyze the cl inical appl ication and effect of three operation methods in treatment of senile intertrochanteric fracture. Methods From July 2004 to February 2007, 73 patients with intertrochanteric fracture were treated. Of 73 patients, 33 patients were treated by artificial bipolar femoral head (ABFH group), 18 patients by dynamic hip screw (DHS group) and 22 by proximal femoral nail anti-rotation (PFNA group). In ABFH group, there were 19 males and 14 females with age of (72.5 ± 3.8) years. The injury was by tumbl ing in 19 cases, by accident traffic in 7 cases, fall ing from height in 4 cases and others in 3 cases, including 6 cases of type I, 9 cases of type II, 11 cases of type III and 7 cases of type IV accordingto Evans classification. The Harris hip score was 16.8 ± 4.8, and the disease course was (21.2 ± 7.8) hours. In DHS group, there were 10 males and 8 females with age of (69.5 ± 3.2) years. The injury was by tumbl ing in 11 cases, by accident traffic in 5 cases, fall ing from height in 1 case and other in 1 case, including 6 cases of type I, 3 cases of type II, 5 cases of type III and 4 cases of type IV according to Evans classification. The Harris hip score of was 18.6 ± 5.5, and the disease course was (19.8 ± 6.5) hours. In PFNA group, there were 13 males and 9 females with age of (70.3 ± 3.5) years. The injury was by tumbl ing in 11 cases, by accident traffic in 6 cases, fall ing from height in 3 cases and others in 2 cases, including 5 cases of type I, 6 cases of type II, 6 cases of type III and 5 cases of type IV according to Evans classification. The Harris hip score was 20.4 ± 6.6, and the disease course was (20.0 ± 5.8) hours. All fractures were fresh. There were no significant difference in general data between three groups (P gt; 0.05). Results In ABFH group, all incisions healed by first intention, but deep vein thrombosis occurred in 1 case on the postoperative third day. In DHS group, incisions healed by first intention in 16 cases and by second intention in 2 cases, coxa adducta occurred in 2 cases after operation. In PFNA group, all incisions healed by first intention. Cacothesis in pate occurred in 1 case after operation. There were significant differences in operation time, blood loss, and out-of-bed time (P lt; 0.05). The patients were followed up (30.5 ± 6.5) months in ABFH group, (27.6 ± 6.2) months in DHS group, and (24.8 ± 5.4) months inPFNA group. The union time of fracture was (7.5 ± 2.5) months in ABFH group, (8.4 ± 2.2) months in DHS group and (7.2 ± 2.4) months in PFNA group. There were significant differences in Harris score between before operation and after operation and between different time after operation in three groups (P lt; 0.05). Conculsion The three operative methods have some their superiority, but the replacement of artificial bipolar femoral head is more suitable for the senile unstable intertrochanteric fracture because of simply procedure, short operation time, less blood loss and early ambulation.

    Release date:2016-09-01 09:06 Export PDF Favorites Scan
  • 手部屈指肌腱损伤的治疗

    Release date:2016-09-01 11:44 Export PDF Favorites Scan
  • EFFECTIVENESS ANALYSIS OF ARTIFICIAL HUMERAL HEAD REPLACEMENT FOR 18 CASES OFCOMPLICATED FRACTURES OF THE PROXIMAL HUMERUS

    【Abstract】 Objective To evaluate the effectiveness of artifical humeral head replacement in treatment of complicatedfractures of the proximal humerus. Method Between January 2005 and January 2011, 18 patients with proximal humerusfracture were treated with artifical humeral head replacement. There were 8 males and 10 females with a mean age of 71 years (range, 52-84 years). Fractures were caused by falling in 11 cases, by traffic accident in 3 cases, and by bruise in 4 cases. The time between injury and admission was 2 hours to 3 days (mean, 1.5 days). According to Neer classification, 8 cases had three-part fracture, 7 four-part fracture, and 3 cleavage fracture of humeral head; 5 cases complicated by shoulder joint subluxation, 2 cases by femoral fracture, 1 case by radial fracture, and 11 cases by osteoporosis. All the patients were treated with modular cemented prostheses. Results The operation time was 60-180 minutes with an average of 80 minutes; the blood loss was 100-400 mL with an average of 200 mL. All incisions healed by first intention without infection or neurovascular injury. Sixteen patients were followed up 3 years on average (range, 1-6 years). No loosening, dislocation of prothesis or heterotopic ossification occurred. According to the Neer scores, the results were excellent in 5 cases, good in 8 cases, moderate in 2 cases, and poor in 1 case at 1 year after operation. The excellent and good rate was 81.2%. Conclusion Artificial humeral head replacement is a good therapy for patients with complicated fractures of the proximal humerus, especially for elderly patients.

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • COMPREHENSIVE MANAGEMENT OF EARLY STAGE AVASCULAR NECROSIS OF FEMORAL HEAD BY ARTHROSCOPIC MINIMALLY INVASIVE SURGERY

    ObjectiveTo evaluate the effectiveness of comprehensive management for early stage avascular necrosis of the femoral head (ANFH) by arthroscopic minimally invasive surgery by comparing with closed core decompression. MethodsBetween January 2007 and March 2010, 28 patients (33 hips) with early stage ANFH were treated with the procedure of arthroscopic core decompression combined with autogenous cancellous bone graft and bone morphogenetic protein (BMP) in 18 cases (21 hips, trial group) or with simple closed core decompression in 10 cases (12 hips, control group). No significant difference was found in gender, age, disease duration, etiology, and staging between 2 groups (P gt; 0.05). ResultsIncision healed primarily in all patients, and no infection occurred. All patients were followed up 2.5 years on average (range, 1-3 years). Pain relief and improvement of hip function were obtained in all patients at 6 months after operation. At last follow-up, the Harris scores were 85.67 ± 4.78 in trial group and 81.33 ± 7.03 in control group, showing significant difference between 2 groups (t= —2.10, P=0.04). Collapse of the femoral head was observed in 1 hip (Ficat stage II) of trial group, and in 2 hips (Ficat stage I ) and 2 hips (Ficat stage II) of control group; hip arthroplasty was performed. Significant difference in total effective rate was found between trial group and control group (95.24% vs. 66.67%; χ2=4.85, P=0.03). ConclusionArthroscopic core decompression combined with autogenous cancellous bone graft and BMP is more effective than traditional closed core decompression for treatment of early stage ANFH in pain relief, improvement of hip function, slowing-down the process of femoral head necrosis, reduction of hip joint replacement by accurate location of the lesions, and thoroughly debridement of necrotic bone.

    Release date:2016-08-31 05:39 Export PDF Favorites Scan
  • 肩关节周围损伤合并腋神经损伤的诊治

    目的 总结肩关节周围损伤合并腋神经损伤的诊断和治疗方法。 方法 2005 年6 月- 2009 年3 月,收治6 例肩关节周围损伤患者,经体检结合肌电图确诊合并腋神经损伤。其中男4 例,女2 例;年龄21 ~ 56 岁,平均39 岁。锁骨远端骨折2 例,肩胛颈骨折、锁骨中段骨折、肩锁关节脱位及肩部挤压伤各1 例。术前三角肌肌力0 ~ 1 级。受伤至入院时间0.5 ~ 96.0 h。行切开复位内固定术或保守治疗,腋神经损伤均采用理疗、药物等非手术治疗。 结果 术后患者切口均Ⅰ期愈合。术后6 例均获随访,随访时间5 ~ 18 个月,平均8 个月。骨折均愈合,愈合时间6 ~10 个月。4 例三角肌肌力恢复至5 级,2 例恢复至4 级。患侧肩关节功能按照改良Mallett 评分标准评价,优4 例,良1 例,中1 例。无并发症发生。肌电图检查5 例恢复正常,1 例腋神经运动传导波幅稍低。 结 论 肩关节周围损伤时体检结合肌电图检查即可确诊是否合并腋神经损伤,采用保守治疗腋神经损伤可获得较好疗效。

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
  • CLINGING LESSER TROCHANTER OSTEOTOMY WITH WAGNER CONE IN TREATMENT OF CROWE TYPE IV DEVELOPMENTAL DYSPLASIA OF THE HIP IN ADULT

    ObjectiveTo investigate the effectivness of the clinging lesser trochanter osteotomy with the Wagner cone in total hip arthroplasty (THA) for Crowe type ⅠV developmental dysplasia of the hip (DDH) in adult. MethodsBetween November 2009 and September 2012, 7 female patients (9 hips) with Crowe type ⅠV DDH were treated by THA procedures of clinging lesser trochanter osteotomy with Wagner cone, aged 24-62 years (mean, 42 years). All patients experienced severe pain and claudication. The left hip was involved in 2 cases, the right hip in 3 cases, and bilateral hips in 2 cases. The Harris score of involved hip was 50.00±7.04. The both limps were discrepancy with an average length difference of 3.4 cm (range, 3-4 cm). The results of Trendelenburg sign were positive. X-ray films showed high complete dislocation of the involved hips. ResultsThe incisions healed by first intention. There was no complication such as infection, dislocation, prosthesis loosening, neurovascular injury. The average follow-up was 36.4 months (range, 25-48 months). Pain and claudication were improved and all patients could restore to work. The Harris score was improved to 83.42±6.47, showing significant difference when compared with preoperative score (t=8.90, P=0.00). The results of Trendelenburg sign were negative. X-ray films showed that all patients got a bony union at osteotomy site of greater trochanter at 3-6 months after operation. And the interface between prosthesis and bone was stable. There was no prosthesis loosening or sinking during the follow-up. ConclusionClinging lesser trochanter osteotomy with Wagner cone could be an option to shorten the femur in THA for patients with Crowe type ⅠV DDH. It is effective in decreasing the risk of neurovascular injury.

    Release date: Export PDF Favorites Scan
  • 多孔钽杯联合钽金属垫块翻修Paprosky Ⅲ型髋臼骨缺损的近期疗效

    目的总结多孔钽杯联合钽金属垫块翻修Paprosky Ⅲ型髋臼骨缺损的近期疗效。 方法回顾分析2011年3月-2014年10月,在髋关节翻修术中采用多孔钽杯联合钽金属垫块修复Paprosky Ⅲ型髋臼骨缺损的8例(8髋)患者临床资料。男3例,女5例;年龄45~78岁,平均64岁。关节置换术后1个月~12年,平均5.94年行翻修术。其中髋臼假体周围骨溶解及假体松动翻修5例,髋关节置换术后感染二期翻修3例。术前Harris评分为41~54分,平均46.25分。 结果术后患者切口均Ⅰ期愈合。8例患者均获随访,随访时间1~45个月,平均16.25个月;其中获随访1年以上3例,2年以上2例。患者术前患髋疼痛、跛行均明显改善。末次随访时,Harris评分为79~89分,平均83.75分。X线片复查示,随访期间臼杯及垫块周围未见进行性透亮线,无1例出现臼杯松动、移位及螺钉断裂,且臼杯及垫块周围有骨密度增强,骨长入良好。 结论多孔钽杯联合钽金属垫块翻修Paprosky Ⅲ型髋臼骨缺损,可保证假体良好初始稳定性及覆盖,且能实现早期骨长入,获得满意近期疗效。

    Release date: Export PDF Favorites Scan
1 pages Previous 1 Next

Format

Content