Objective To introduce a modified method to correct type I and type II cup ear and to evaluate the effectiveness. Methods Between May 2006 and November 2011, 23 patients with type I or type II cup ear (27 ears, type I in 6 ears and type II in 21 ears according to Tanzer’s criteria) were treated. There were 14 males and 9 females with an average age of 10 years (range, 7-16 years). The unilateral ear was involved in 19 cases and bilateral ears in 4 cases. The main clinical manifestations included the flat helix and scapha and ptosis of upper 1/3 auricle. The arc incision was adopted in the auriculocephalic angle, elevation of the dis-clothing-like flap in the front and rear of the auricular cartilage, relocation of the craniofacial initiation site of the scapha and the cavity of auricular concha, correction of deformational auricular cartilage and reconstruction of smooth helix, antihelix, superior and inferior antihelix crus. Results All the incisions healed by first intention without any hematoma, postoperative infection, or flap necrosis. All patients were followed up 9 months-6 years (median, 36 months). No auricle ptosis, deformity contour, or atrophy was observed. The structure of the helix, scapha, and antihelix were clear, natural, and excellent. The scars at the local site were limited and unconspicuous. Conclusion Modified method can almost correct all the anatomic defects of cup ear. It is an ideal method to treat type I and type II cup ear.
Objective To explore the technique of the soft tissue balancing inthe total knee arthroplasty (TKA) for the patients with the knees of varus deformity and flexion contracture. Methods From January 2001 to December 2005, 86 patients (19 males, 67 females; age, 57-78 years;average, 66 years) with the knees of varus deformity and flexion contracture underwent primary TKA and the balancing of the soft tissues. All the patients had suffered from osteoarthritis. The unibilateral affection was found in 68 patients and the bilateral affection in 18. The varus deformity angle was averaged 12.3° (range, 6-34°). The soft tissue varus accounted for 56.7% and the bony varus accounted for 43.3%. The flexion contracture lt; 10° was found in 21 knees, 10-19° in 45 knees, 20-29° in 22 knees, and gt;30° in 16 knees, with an average angle of 18.9°. Results The flexion contractures were improved. Before operation the average angle ofthe flexion contracture was 18.9° but after operation only 4 patients had a residual flexion contracture of 5° and the remaining patients had a complete correction. The follow-up for 37 months (range, 6-72 months) in all the patients revealed that only 6 patients had a residual flexion contracture of 5-10° and the others had a full extension. Before operation the average varus angle was 12.3°(range, 6-34°) and the average tibiofemoral angle was 174.7° (range, 70.3-175.6°), but after operation the residual varus angle gt; 3° was only found in 2 patients. The complications occurring during operation and after operation were found in 6 patients, injuries to the attachment of the medial collateral ligaments in 2, patellar clunk syndromes in 2, cerebral embolism in 1, and lacunar infarction in 1, with no nerve disorders left after the medical treatment. No skin necrosis, the cut edge infection or deep infection occurred. Conclusion The balancing of the soft tissues is a major management for correction of the varus deformity and the flexion contracture. The proper balancing of the softtissues can achieve an obvious recovery of the function and correction of the varus deformity after TKA.
OBJECTIVE To evaluate the effect of tissue flap pedicled with the superficial temporal artery in repairing deformity of the head and face in children. METHODS From October 1986 to December 1996, 13 children with deformity of the head and face were repaired by this tissue flap. Among them, there were congenital deformity in 9 cases, burned scar in 3 cases and infection scar in 1 case. Among the flaps, 1 was temporal skin flap, 3 were temporal flap with hairbearing scalp, 1 was frontal skin flap, and 8 were posterio-uricular superficial fascia flap and skin flap. The area of tissue flap was ranged from 5.0 cm x 1.2 cm to 10.0 cm x 5.0 cm. The length of the pedicle was 5-8 cm. RESULTS All tissue flaps healed with first intention. Followed up for 6 months to 12 years, the appearance and function of tissue flaps were satisfactory. CONCLUSION The tissue flap pedicled with the superficial temporal artery is suitable to repair many kinds of deformities of the head and face in children. It has the advantages of good blood supply, closely acceptor area, easy operation and satisfactory appearance.
OBJECTIVE: To explore a method of reconstruction of hip joint function after deformed healing of the upper 1/3 of fractured femur as a complication of old fracture dislocation of hip joint. METHODS: A patient with loss of function in hip joint and fusion of knee joint was treated with lock for femur intra-medullary fixation in April 1997. RESULTS: Before operation, the diseased hip joint lost its most functions and the entire lower extremity was disabled because the knee joint had been fused. One year after operation, the follow-up examination revealed that the patient could walk by crutches without discomfort, his daily life and work recovered to normal. CONCLUSION: It is effective to treat a patient suffering old fracture-dislocation of hip joint complicated with deformed healing of the upper 1/3 of fractured femur by means of individualized artificial joint replacement and a prosthesis body with lock for femur intra-medullary fixation, and it is helpful for the development of a new clinical idea to reconstruct functions in the management of some particular cases.
Over a two year period, four patients of pectus carinatum received surgical correction at our hospital. All patients were followed up for 6 months to 1 year. The operative results were satisfactory but one required revision with additional resection of bilateral second cartilage for the persistent malformation. The clinical characteristics, operative techniques and indications for operative treatment were discussed.
ObjectiveTo study the causes and treatment of postoperative deviation secondary to thumb duplication resection. MethodsBetween February 2007 and June 2013,32 cases (33 thumbs) of postoperative deviation secondary to thumb duplication resection were treated,and the clinical data were retrospectively analyzed.There were 13 males and 19 females,aged 2-34 years (median,8 years).The left thumbs were involved in 7 cases,the right thumbs in 24 cases,and bilateral thumbs in 1 case.Of 33 thumbs,2 were rated as type Ⅱ,4 as type Ⅲ,10 as type IV,7 as type V,and 10 as type VⅡ according to Wassel classification.The average time between duplicated thumb resection and admission was 6.5 years (range,1-29 years).Nine thumbs only had ulnar deviation of the metacarpophalangeal (MP) joint;8 thumbs only had radial deviation of the interphalangeal (IP) joint;10 thumbs only had ulnar deviation of the IP joint;and 6 thumbs had ulnar deviation of the MP joint combined with radial deviation of the IP joint.The mean deviation degree of the MP joint was 32.3°(range,20-40°),and the mean deviation degree of the IP joint was 42.5°(range,30-110°).Operation methods were chosen specially according to the deformity,including remnant bone or cartilage resection,restoring normal alignment,and soft tissue balance. ResultsAll wounds got first stage healing and there was no complication associated with operation.Postoperative follow-up period ranged from 6 to 70 months (mean,34 months).The skeleton alignment of the thumbs was improved on the X-ray images;all osteotomy got union at 5-10 weeks (mean,6 weeks).Deviation was completely corrected in 31 thumbs;the preoperative deviation degree was too large to correct completely in 2 thumbs with a postoperative deviation degree of 10°.The motion degree was similar to that at preoperation in 13 thumbs;the motion degree decreased in 20 thumbs,which did not affect the function of the thumbs.Nineteen cases (20 thumbs) were followed more than 2 years,there was no recurrence of deviation and all thumbs developed well,but the size of affected thumb was smaller than that of the contralateral side in 14 cases (14 thumbs). ConclusionGetting good result and preventing postoperative deviation for thumb duplication resection acquires appropriate preoperative design,reconstruction of the insertion of the abductor pollicis brevis,transposition of the flexor and extensor pollicis longus insertion,and essential osteotomy play important roles in preventing postoperative deviation after thumb duplication resection.Individualized treatment plan for deviation should be made according to the degree and the cause of deviation.