ObjectiveTo explore the effectiveness of Ilizarov technique in improving bone transport axial offset. MethodsBetween January 2010 and December 2014, 14 patients with tibial fracture were treated by using Ilizarov technique. Of 14 cases, 11 were male and 3 were female, aged 18-70 years (mean, 38.8 years); there were 10 cases of infective bone defect and 4 cases of non-infective bone defect. According to Paley typing, 7 cases were rated as type B1(bone defect without shortening) and 7 cases as type B3(bone defect with shortening). The injury to operation time was 1 to 72 months (mean, 11.9 months). Ilizarov fixation was used for type architecture and adjusting fixed bone removal of half the distance between the needle and the ring, changing the auadrilateral edges, adjusting the convolution relationship between the bone removal section and bone segment involution, and adjusting the two force lines of bone segment involution end so as to make the limb lines of force satisfactory. ResultsThe patients were followed up 9-31 months (mean, 19.1 months). Four cases achieved natural bone healing at last follow-up, bone healing was obtained in 10 cases after bone graft. At 1 week after operation, X-ray films showed angulation in the coronal plane in 10 cases (3-12°, 4.9° on average) and in the sagittal plane in 9 cases (2-12°, 3.8° on average); axial offset was observed in 6 cases (43%), which was corrected in 5 cases except 1 case. At last followup, angulation in the coronal plane was observed in 5 cases (2-4°, 2.6° on average), angulation in the sagittal plane in 6 cases (2-6°, 4.1° on average), and axial offset in 1 case (7%), which were significantly improved when compared with ones at 1 week. According to Paley evaluation criteria, the osseous results were excellent in 12 cases and good in 2 cases; the functional results were excellent in 12 cases and good in 2 cases at last follow-up. ConclusionAxial offset in the Ilizarov bone transport relatively common. By adjusting fixed bone removal of half the distance between the needle and the ring, the axial offset can be improved.
ObjectiveBy applying the mutual corroboration in the diagnosis, we aimed to improve the accuracy of preoperative imaging diagnosis, select the appropriate timing of operation and guide the follow-up time for patients with pulmonary nodules.MethodsClinical data of 1 368 patients with pulmonary nodules undergoing surgical treatment in our department from July 2016 to October 2019 were summarized. There were 531 males and 837 females at age of 44 (21-67) years. The intraoperative findings, images and pathology were classified and analyzed. The imaging pathology and pathological changes of pulmonary nodules were shown as a dynamic process through mutual collaboration and interaction.ResultsOf 1 368 patients with pulmonary nodules, 376 (27.5%) were pure ground-glass nodules, 729 (53.3%) were mixed ground-glass nodules and 263 (19.2%) were solid nodules. Among the pure ground-glass nodules, adenocarcinoma in situ (AIS) accounted for the highest proportion (156 patients), followed by microinvasive adenocarcinoma (MIA, 90 patients), atypical adenomatous hyperplasia (AAH, 85 patients), and benign tumors (20 patients). Among mixed ground-glass nodules, 495 patients were invasive adenocarcinoma (IA) and 207 patients of MIA. In solid nodules, patients were characterized by pathology of either IA (213 patients) or benign tumors (50 patients), and no patient was featured by AAH, AIS or MIA.ConclusionThe mutual collaboration and interaction can improve the accuracy of preoperative diagnosis of pulmonary nodules, and it supports the choice of operation timing and the judgment of follow-up time.