scholarly journals The Clinical Outcome of the Reduction of the Patellar Inferior Pole Fracture with Wire Cerclage Through A Generated Bone hole, in Combination with Patellar Concentrator: A Retrospective Comparative Study

Author(s):  
Rong Chen ◽  
Hong Cao ◽  
Zhibo Sun ◽  
Liangbo Jiang ◽  
Xiangwei Li ◽  
...  

Abstract Objective: The patellar inferior pole fracture is typically comminuted. Hence, achieving firm fixation and early activity is highly challenging. In this article, we employed the method of wire cerclage through a generated bone hole to reduce the fracture. Our objective was to compare the clinical efficacy of patellar concentrator alone with a combination of cerclage and patellar concentrator in the treatment of patellar inferior pole fracture.Methods: We conducted a retrospective review of patients with patellar inferior pole fractures, who underwent patellar concentrator fixation only (the control group) or cerclage combined with patellar concentrator fixation (the experimental group), performed by a single surgeon, between July 2015 and October 2019. Our analysis included surgical indexes like7 aspects (fracture gap after operation, operation time, intra-operative blood loss,intra-operative number of C-arm fluoroscopies conducted, Insall-Salvati ratio calculated immediately after operation, initial range of motion on the 7th day after operation, and fracture healing time), as well as the Bostman score and complications recorded on 1-, 3-, 6-, and 12-month follow up post operation.Results:A total of 94 patients with patellar inferior pole fracture and a minimum 1-year followup were recruited. Following operation, the control group had 33(71.74%) patients with a fracture gap of 0-2 mm and 13(28.26%)patients with a fracture gapgreater than 2 mm(P=0.002). Conversely,the experimental grouphad46(95.83%)patients with a fracture gap of 0-2 mm and 2(4.17%) patients with a fracture gapgreater than 2 mm(P=0.002). Compared to the control group, the experimental group did not experience enhanced operation time or intra-operative blood loss (P=0.811, P=0.823). The Insall-Salvati ratio and initial range of motion in the experimental group were larger than the control group (P=0.037, P=0.000). Alternately, the number of intra-operative C-arm fluoroscopies conductedand fracture healing time of the experimental group were considerably less than the control group (P=0.003,P=0.000).Moreover, at 1-, 3-, 6-, and 12-month follow ups after operation, the Bostman scores of the experimental group were remarkably higher than the control group (P< 0.05).At 12 months post operation, 23 cases (50%) were classified as excellent, 22 cases (47.83%) were good, and 1 case (2.17%) was poor in the control group(P=0.005). In the meantime, in the experimental group, 38 cases (79.17%) were deemed as excellent and 10 cases (20.83%) were good (P=0.005).Lastly, complications were detected in 3 cases (6.52%;1 case of internal fixation loss,2 cases of hematoma) within the control group, and in 1 case(2.08%; marginal wound necrosis) within the experimental group. There was no wound infection, implant discomfort, or broken fixation in eithergroup.Conclusion: Managingthe patellar inferior pole fracture with wire cerclage through a generated bone hole is both simple and effective. Moreover, an additional step of patellar concentrator fixation facilitates early functional exercise, with satisfactory clinical outcome.

2021 ◽  
Author(s):  
Guanglei Zheng ◽  
Yingjie Qi

Abstract Background: This paper is to describe and evaluate the nail groove reconstruction method in removing slide wire screw on locking plate. Then compare the method with tungsten steel drilling nail method, to explore a new method of removing slide wire screw on locking plate.Method: A total of 1254 patients with removal fracture internal fixation devices were collected from the Affiliated Hospital of Hangzhou Normal University from July 2015 to September 2021, of which 62 cases met the inclusion and exclusion criteria. All patients were randomly divided into the experimental group and the control group. 31 people per group. There were 19 males and 12 females in the experimental group, the age of patients was 35.68±11.70years; while 18 males and 13 females in the control group, the age of patients was 36.27±10.37years. Nail groove reconstruction method was used in the experimental group, and the tungsten steel drilling nail method was used in the control group. Collect and count surgical-related indicators, the data of two groups were compared and analyzed from four aspects: intraoperative blood loss, operation time, incision healing time and limb function recovery time.Result: All slide wire screws were removed successfully, and all patients had no serious postoperative complications such as internal fixation retention and neurovascular injury. The experimental group was better than the control group in the following three aspects: the amount of intraoperative blood loss, the operative time, the recovery time of limb function, and the differences were statistically significant(p < 0.05). There was no significant difference in incision healing time between the two groups.Conclusion: The nail groove reconstruction method has less damage to the bone and soft tissue, less intraoperative blood loss, shorter operation time, and faster postoperative recovery of limb function. The nail groove reconstruction method is a simple and effective method, it has obvious advantages compared with the traditional method.


2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Jiechang Ju

Objective: To study the clinical effect of modified circumcision in the treatment of phimosis and excessive foreskin. Methods: 110 patients with overly long foreskin or phimosis were divided into experimental group and control group by random number table method, with 55 cases in each group. The experimental group was treated with modified circumcision, and the control group was treated with traditional manual cutting and suture. Then the clinical effects of the two treatments were compared. Results: Two different surgical procedures were performed. During the operation, the blood loss of the experimental group was less than that of the control group; the operation time and wound healing time were shorter than those of the control group; after the operation, the incidence of related complications in the experimental group was 14.55%, which was significantly lower than For 25.45% of the control group, the clinical treatment effect was obvious, and the difference was statistically significant (P<0.05). Conclusion: The clinical effect of modified circumcision in the treatment of patients with phimosis and excessive foreskin is good. Compared with the traditional manual cutting and suture treatment, it not only has the advantages of simple operation and clinical application, but also benefits the rehabilitation of patients. Rehabilitation time reduces the incidence of postoperative complications. It is an ideal treatment plan for this type of disease in the current clinic, and it is worthy of popularization and application in general surgery and reproductive surgery.


2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Liang Gao ◽  
Shuang Xu ◽  
Miao Zhang ◽  
Jing Chen ◽  
Li Ma

Objective: To explore the clinical efficacy of plastic surgery of asymmetric double eyelid. Methods: The clinical data of 70 patients with asymmetrical double eyelid who underwent plastic surgery in our hospital from April 2018 to December 2019 were retrospectively analyzed. The patients were divided into different groups based on different plastic surgery procedures. The control group (n=35 cases) were the patients who underwent double eyelid incision method, and the patients who used embedding double eyelid method were included in the observation group (n=35 cases). The operation time, intraoperative blood loss, incision size, healing time of incision, satisfaction of plastic surgery and occurrence of complications were compared between the two groups. Results: The operation time and incision healing time of the observation group were shorter than those of the control group. The intraoperative blood loss and incision were less than those of the control group, and the satisfaction was higher than that of the control group. The difference was statistically significant (P<0.05). The incidence of complications in the observation group was slightly lower than the control group, but the difference was not statistically significant (P>0.05). Conclusion: For asymmetric double eyelid, it should undergo embedding double eyelid plastic surgery, because the operation time and incision healing time are shorter. And intraoperative blood loss and incision size are smaller, which can improve patient satisfaction and reduce the incidence of complications.


2021 ◽  
pp. 155335062110624
Author(s):  
Jing Yang ◽  
Penghui Ni ◽  
Lina Zhang ◽  
Zhanxin Lu ◽  
Dapeng Liu ◽  
...  

Background This study aimed to evaluate a personalized 3D-printed percutaneous vertebroplasty positioning module and navigation template based on preoperative CT scan data that was designed to treat patients with vertebral compression fractures caused by osteoporosis. Methods A total of 22 patients with vertebral compression fractures admitted to our hospital were included in the study. Positioning was performed with the new 3D-printed positioning module, and the navigation template was used for patients in the experimental group, and the traditional perspective method was used for patients in the control group. The experimental group consisted of 11 patients, 2 males and 9 females, with a mean age of 67.27 ± 11.86 years (range: 48 to 80 years), and the control group consisted of 11 patients, 3 males and 8 females, with a mean age of 74.27 ± 7.24 years (range: 63 to 89 years). The puncture positioning duration, number of intraoperative fluoroscopy sessions, and preoperative and postoperative visual analog scale (VAS) scores were statistically analyzed in both groups. Results The experimental group had shorter puncture positioning durations and fewer intraoperative fluoroscopy sessions than the control group, and the differences were statistically significant (P < .05). There were no significant differences in age or preoperative or postoperative VAS scores between the two groups (P > .05). Conclusions The new 3D-printed vertebroplasty positioning module and navigation template shortened the operation time and reduced the number of intraoperative fluoroscopy sessions. It also reduced the difficulty in performing percutaneous vertebroplasty and influenced the learning curve of senior doctors learning this operation to a certain degree.


2020 ◽  
Author(s):  
Zhibin Xu ◽  
Zhenchi Li ◽  
Maomao Guo ◽  
Hao Bian ◽  
Tianli Niu ◽  
...  

Abstract We present here the three-dimensional (3D) visualization fused with ultrasound and to evaluate its clinical application effect preliminarily. One hundred and eighteen patients with renal calculi in our hospital from September 2017 to December 2019 were prospectively randomized into two groups. The experimental group was treated with percutaneous renal puncture guided by the 3D visualization fused with ultrasound. The control group was treated with percutaneous renal puncture guided by B-ultrasonography (B-US). The puncture time, operation time, and the loss of hemoglobin in the experimental group were lower than those in the control group, and the success rate of establishing the channel at one time, and the coincidence rate between the channel and the longitudinal axis of the target renal calyx were higher. The stone clearance rate in the experimental group was higher, while the postoperative blood transfusion rate and interventional embolization rate in the experimental group were significantly lower. The difference was statistically significant (P < 0.05). 3D visualization assisted ultrasound could preliminarily guide precise navigation to puncture tissues, reduced operation time and bleeding, improved stone clearance rate and operation safety.


2018 ◽  
Vol 2 (6) ◽  
Author(s):  
Ke Du ◽  
Zhenxing Wang

【Abstract】Objective: To compare the clinical effects of minimally invasive esophageal cancer radical resection and traditional esophageal cancer radical resection.Methods: 200 cases of esophageal cancer radical resection were performed from July 2014 to July 2017 in our hospital.The cases were divided into experimental group and control group, 82 cases in the experimental group and 118 cases in the control group.The experimental group was treated with minimally invasive esophageal cancer radical surgery, and the control group was treated with conventional thoracotomy.Record the comparison between the two groups (1) surgical conditions, including the time of surgery, intraoperative blood loss, hospitalization time; (2) the number of lymph nodes cleaned; (3) the postoperative control group used conventional thoracotomy, including lung lesions, anastomotic fistula / narrow.RESULTS: The parameters of operation time, intraoperative blood loss, hospitalization time, and number of lymph nodes cleaned in the experimental group were lower than those in the control group, and the difference was statistically significant (p<0.05). In addition to pulmonary infection (p<0.05), There was no significant difference in the incidence of other complications between the experimental group and the control group (p>0.05).Conclusion: Minimally invasive esophageal cancer radical resection and conventional thoracotomy have good clinical effects in the treatment of esophageal cancer. Minimally invasive esophageal cancer radical surgery can effectively reduce intraoperative trauma and postoperative reaction, which is worthy of popularization and application.


2019 ◽  
Vol 21 (2) ◽  
pp. 21-27
Author(s):  
N. S. Puzakov ◽  
V. Yu. Cherebillo ◽  
A. V. Polezhaev ◽  
G. V. Gavrilov ◽  
P. V. Ognev ◽  
...  

The study objective is to compare the outcomes of surgeries performed via the transciliary supraorbital approach and traditional lateral supraorbital approach in patients with suprasellar meningiomas. Material and methods. The experimental group included 17 patients (8 males and 9 females aged between 38 and 67 years (mean age 48.7 ± 5.9 years)) with meningotheliomatous meningiomas (size between 15 and 46 mm (mean size 24.5 ± 5.7 mm) that underwent surgery via the transciliary supraorbital approach. All surgeries were performed by one surgeon. The control group included 20 patients (10 males and 10 females) that underwent surgery via the lateral supraorbital approach. These surgeries were also performed by one surgeon. The 2 groups were matched for size and location of meningiomas. We compared the extent of surgery, frequency of complications, severity of cosmetic defects, and other parameters between the groups. Preoperative examination, microsurgical removal of the tumor, anesthesia, and postoperative management were the same in both groups. Results. We observed no differences in the extent of surgery, frequency of complaints, complications, and neurological status between participants in the experimental and control groups. There were no deaths in either group. Patients that underwent surgery via the transciliary supraorbital approach had lower blood loss than those who underwent surgery via the lateral supraorbital approach (145 ± 18 mL vs 186 ± 24 mL). The duration of surgery was also lower in the experimental group than in the control group (145 ± 24 min vs 167 ± 32 min). Cosmetic outcomes were evaluated using the Cosmetic Visual Analogue Scale. Participants in the experimental group had higher score (>90) than controls (2 patients reported scores of 70 and 80). Possible negative effects of the transciliary supraorbital approach include the risk of scarring in the eyebrow area, skin numbness in the frontal area, paralysis of the frontalis muscle, and the need for more accurate preoperative markings using neuronavigation. Conclusion. In general, the therapeutic effect of surgeries via the transciliary supraorbital and lateral supraorbital approaches do not differ. However, the use of the transciliary supraorbital approach allowed smaller incisions (in both skin and dura mater) and smaller trepanation holes (and as a result minimal displacement of brain structures during surgery). It also ensured lower blood loss and duration of surgery and improved the cosmetic effect. The decision on the surgical approach should be based on tumor characteristics with the consideration of patient’s opinion.


2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0029
Author(s):  
Jordan Fried ◽  
David Bloom ◽  
Samuel Baron ◽  
Eoghan Hurley ◽  
Jovan Popovic ◽  
...  

Objectives: Tranexamic acid (TXA) is a commonly used medication in orthopaedic procedures, reducing perioperative bleeding and need for transfusion. The purpose of this double-blind randomized controlled study was to evaluate if IV TXA for primary anterior cruciate ligament (ACL) reconstruction with bone-patella tendon-bone (BTB) could reduce perioperative blood loss or postoperative intra-articular hemarthrosis without postoperative drains. Methods: A controlled, randomized, double-blinded trial was conducted in 110 patients who underwent ACLR with BTB autograft. Patients were equally randomized to the control and experimental groups. The experimental group received two 1-gram boluses of IV TXA, one prior to tourniquet inflation and one prior to wound closure; the control group did not receive TXA. If a clinically significant hemarthrosis was evident, the knee was aspirated, and the volume of blood (ml) was recorded. Additionally, perioperative blood loss (ml); Visual Analog Scale (VAS) on postoperative days (POD) 1-7 and post-operative weeks (POW) 1, 6 and 12; postoperative opioid consumption POD 1-7; range of motion (ROM) and ability to straight leg raise (SLR) at POW 1, 6, 12; and pre and postoperative thigh circumference ratio (TCR). Results: There was no significant difference in perioperative blood loss between the experimental and control groups (32.5ml v. 35.6ml, p=0.47). The experimental group had 23 knees aspirated; control group had 26 knees aspirated (p=0.56). No significant difference seen in postoperative hemarthrosis volume with IV TXA (26.7ml v. 37.3ml, p=0.12). There was no significant difference in VAS score between the two groups (p=0.15), additionally, there was no difference in postoperative opioid consumption (p=0.33). There was no significant difference in ROM or ability to SLR, or pre- nor post-operative TCR (p > 0.05 for all). Conclusions: IV TXA in patients who undergo ACLR with BTB autograft does not significantly impact perioperative blood loss, postoperative hemarthrosis, or postoperative pain levels. Additionally, no significant differences were seen in early post-operative recovery regarding ROM or quadriceps reactivation.


2021 ◽  
Author(s):  
Xuede Guo ◽  
Guanjun Cui ◽  
Cishan Wang ◽  
Hongya Meng ◽  
Shujie Huang ◽  
...  

Abstract Objectives: Observe the efficacy of vancomycin-loaded calcium sulfate(VCS)in promoting the natural healing of bone transport's docking site.Methods: We retrospectively analyzed 48 patients who used bone transfer to treat the tibia's infectious bone defects from 2013 to 2018. The patients were randomly divided into an experimental group receiving VCS treatment or a control group not receiving VCS treatment. After treatment, the two groups of docking site healing time, skin incarceration rate, natural healing rate, external fixation index, bony results, and functional results were compared.Results: The experimental group achieved bone healing in the docking site union for an average of (15.30±6.32) months after the operation. Among them, 25 cases healed spontaneously, two patients healed after bone cleaning and grafting; the average external fixation index was (2.10 ± 0.28) months/cm; Bone results: excellent in 19 cases, right in 7 patients, low in 1 case, functional derivatives: excellent in 16 points, good in 9 cases, and fair in 2 cases. The control group achieved bone healing at the docking site for an average of (15.29±5.36) months after the operation. Among them, 11 cases healed spontaneously at the docking site, and 10 cases of non-natural healing (6 points of skin incarceration) healed after cleaning and bone grafting; the average external fixation index was (2.09±0.25) months/cm; Bone results: excellent in 15 cases, right in 5 patients, fair in 1 case, functional products: excellent in 12 points, good in 8 cases, and fitting in 1 case. There was no significant difference in the healing time, bony results, functional results, and external fixation index between the two groups at the docking site (P>0.05). The experimental group's skin incarceration rate was lower than that of the control group, and the natural healing rate was higher than that of the control group (P<0.05).Conclusion: In bone removal surgery, the implantation of VCS in the infected bone defect area helps prevent the docking site skin incarceration and promotes the docking site's natural healing.


2020 ◽  
Author(s):  
Xinhua Yin ◽  
Liang Yan ◽  
Baorong He ◽  
Ding Jun Hao ◽  
Zhongkai Liu

Abstract Background There was a controversy about surgery approach of severe rigid congenital kyphoscoliosis in adolescence treatment. Aim of the study is to compare the clinical efficacy of surgical treatement by hemivertebra resection (HR) and hemivertebra resection combined with wedge osteotomy (HRWO) for severe rigid congenital kyphoscoliosis in adolescence. Methods Twenty-five patients with severe rigid congenital kyphoscoliosis between Jan 2006 and Dec 2011 were studied in our center. The patients were divided into hemivertebra resection group (group HR) or hemivertebra resection combined with wedge osteotomy group (group HRWO). The clinical and radiographic evaluation in terms of operation time, blood loss, correction rate, fusion time, hospital stay, complications and SRS-24 questionnaire score were compared between Group A and Group B. Results It is obvious that group HR achieved much better results in time of operation time, intra-operative blood loss, and hospital stay than group HRWO (P < 0.05). But meanwhile, group HRWO was significantly better than group HR in the times of coronal Cobb angle, kyphosis, the sagittal imbalance, coronal imbalance and SRS-24 questionnaire score (P < 0.05). There were no significant differences between the two groups in the age, mean flexibility, follow-up time, fusion time, and complications in the last follow-up (P > 0.05). Conclusion The outcomes of follow-up showed that the hemivertebra resection combined with wedge osteotomy approach obtained better clinical outcomes hemivertebra resection surgery. It might be a better surgical treatment for severe rigid congenital kyphoscoliosis in adolescence patients, but it needs longer operation time, more intra-operative blood loss, and extended hospital stay.


Sign in / Sign up

Export Citation Format

Share Document