scholarly journals Treatment of Volar Defects of the Finger using Dorsal Digital–metacarpal Flap Versus Free Medial Plantar Artery Flap: A Comparative Study

2020 ◽  
Author(s):  
Quanzhe Liu ◽  
Wenlai Guo ◽  
Wenrui Qu ◽  
Xiaolan Ou ◽  
Rui Li ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Nerve Injury ◽  
Donor Site ◽  
Graft Loss ◽  
Operation Time ◽  
Plantar Artery ◽  
Significant Difference ◽  
Medial Plantar Artery ◽  
Volar Surface

Abstract Background: The treatment of defects on the volar surface of the finger has been scarcely reported, and its utility for digital resurfacing remains unclear. This study compared the outcomes of free medial plantar artery flap (MPAF) and dorsal digital–metacarpal flap (DDMF) in finger reconstruction.Methods: This retrospective cohort study included 24 patients with soft-tissue defects on the volar surface of the finger from March 2014 to March 2017. The patients were divided into two groups: the MPAF group and the DDMF group. The operation time, complications, such as flap necrosis, graft loss, infection, paresthesia, and donor-site morbidity, as well as two-point discrimination (2-PD) were carefully recorded. The Michigan Hand Outcomes Questionnaire was used for conduct follow-up assessment.Results: After more than 12 months of follow-up, the MPAF group had a longer operative time compared with DDMF group, but there was no significant difference between postoperative complications and 2-PD test result in patients without nerve injury. And in terms of overall function, Modified VSS score and 2-PD test (the patients with nerve injury), There were relatively obvious statistical differences, MPAF was superior to DDMF (p < 0.005).Conclusion: MPAF and DDMF are reliable for reconstruction of the volar surface of the finger; however, MPAF offers better functional outcomes and is associated with a lower incidence of postoperative complications.

scholarly journals Treatment of Volar Defects of the Finger using Dorsal Digital–metacarpal Flap Versus Free Medial Plantar Artery Flap: A Comparative Study

2020 ◽  
Author(s):  
Quanzhe Liu ◽  
Wenlai Guo ◽  
Wenrui Qu ◽  
Xiaolan Ou ◽  
Rui Li ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Nerve Injury ◽  
Donor Site ◽  
Graft Loss ◽  
Operation Time ◽  
Plantar Artery ◽  
Significant Difference ◽  
Medial Plantar Artery ◽  
Volar Surface

Abstract Background: The treatment of defects on the volar surface of the finger has been scarcely reported, and its utility for digital resurfacing remains unclear. This study compared the outcomes of free medial plantar artery flap (MPAF) and dorsal digital–metacarpal flap (DDMF) in finger reconstruction.Methods: This retrospective cohort study included 24 patients with soft-tissue defects on the volar surface of the finger from March 2014 to March 2017. The patients were divided into two groups: the MPAF group and the DDMF group. The operation time, complications, such as flap necrosis, graft loss, infection, paresthesia, and donor-site morbidity, as well as two-point discrimination (2-PD) were carefully recorded. The Michigan Hand Outcomes Questionnaire was used for conduct follow-up assessment.Results: After more than 12 months of follow-up, the MPAF group had a longer operative time compared with DDMF group, but there was no significant difference between postoperative complications and 2-PD test result in patients without nerve injury. And in terms of overall function, Modified VSS score and 2-PD test (the patients with nerve injury), There were relatively obvious statistical differences, MPAF was superior to DDMF (p < 0.005).Conclusion: MPAF and DDMF are reliable for reconstruction of the volar surface of the finger; however, MPAF offers better functional outcomes and is associated with a lower incidence of postoperative complications.

scholarly journals Treatment of volar defects of the finger using dorsal digital–metacarpal flap versus free medial plantar artery flap: a comparative study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Quanzhe Liu ◽  
Wenlai Guo ◽  
Wenrui Qu ◽  
Xiaolan Ou ◽  
Rui Li ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Nerve Injury ◽  
Donor Site ◽  
Graft Loss ◽  
Operation Time ◽  
Plantar Artery ◽  
Significant Difference ◽  
Medial Plantar Artery ◽  
Volar Surface

Abstract Background The treatment of defects on the volar surface of the finger has been scarcely reported, and its utility for digital resurfacing remains unclear. This study compared the outcomes of free medial plantar artery flap (MPAF) and dorsal digital–metacarpal flap (DDMF) in finger reconstruction. Methods This retrospective cohort study included 24 patients with soft-tissue defects on the volar surface of the finger from March 2014 to March 2017. The patients were divided into two groups: the MPAF group and the DDMF group. The operation time, complications, such as flap necrosis, graft loss, infection, paresthesia, and donor-site morbidity, as well as two-point discrimination (2-PD) were carefully recorded. The Michigan Hand Outcomes Questionnaire was used for conduct follow-up assessment. Results After more than 12 months of follow-up, the MPAF group had a longer operative time compared with DDMF group, but there was no significant difference between postoperative complications and 2-PD test result in patients without nerve injury. And in terms of overall function, Modified VSS score and 2-PD test (the patients with nerve injury), There were relatively obvious statistical differences, MPAF was superior to DDMF (p < 0.005). Conclusion MPAF and DDMF are reliable for reconstruction of the volar surface of the finger; however, MPAF offers better functional outcomes and is associated with a lower incidence of postoperative complications.

scholarly journals Treatment of Volar Defects of the Finger using Dorsal Digital–metacarpal Flap Versus Free Medial Plantar Artery Flap: A Comparative Study

2020 ◽  
Author(s):  
Quanzhe Liu ◽  
Wenlai Guo ◽  
Wenrui Qu ◽  
Xiaolan Ou ◽  
Rui Li ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Donor Site ◽  
Graft Loss ◽  
Operation Time ◽  
Donor Site Morbidity ◽  
Plantar Artery ◽  
Significant Difference ◽  
Medial Plantar Artery ◽  
Volar Surface

Abstract Background: The treatment of defects on the volar surface of the finger has been scarcely reported, and its utility for digital resurfacing remains unclear. This study compared the outcomes of free medial plantar artery flap (MPAF) and dorsal digital–metacarpal flap (DDMF) in finger reconstruction.Methods: This retrospective cohort study included 24 patients with soft-tissue defects on the volar surface of the finger from March 2014 to March 2017. The patients were divided into two groups: the MPAF group and the DDMF group. The operation time, complications, such as flap necrosis, graft loss, infection, paresthesia, and donor-site morbidity, as well as two-point discrimination (2-PD) were carefully recorded. The Michigan Hand Outcomes Questionnaire was used for conduct follow-up assessment.Results: After more than 12 months of follow-up, the MPAF group had a longer operative time compared with DDMF group, but there was no significant difference in postoperative complications and the results (2-PD and Modified VSS score) were significant. In terms of overall function, MPAF was superior to DDMF (p < 0.005).Conclusion: MPAF and DDMF are reliable for reconstruction of the volar surface of the finger; however, MPAF offers better functional outcomes and is associated with a lower incidence of postoperative complications.

scholarly journals Treatment of Defects on the Volar Surface of the Finger using the Dorsal Digital–metacarpal Flap Versus the Free Medial Plantar Artery Flap: A Comparative Study

2020 ◽  
Author(s):  
Quanzhe Liu ◽  
Wenlai Guo ◽  
Wenrui Qu ◽  
Xiaolan Ou ◽  
Rui Li ◽  
...  
Keyword(s):  
Donor Site ◽  
Graft Loss ◽  
Donor Site Morbidity ◽  
Plantar Artery ◽  
Reconstruction Methods ◽  
Finger Reconstruction ◽  
Tissue Defects ◽  
Medial Plantar Artery ◽  
Volar Surface

Abstract Background Few cases are reported on the treatment of defects on the volar surface of the finger, and its utility for digital resurfacing remains unclear. This study compared the outcomes of the free medial plantar artery flap (MPAF) and dorsal digital–metacarpal flap (DDMF) in finger reconstruction. Methods This cohort study was conducted on 24 patients who had soft-tissue defects on the volar side of the finger from March 2014 to March 2017. The patients were divided into the following 2 groups: the MPAF group and the DDMF group. The operative time as well as complications, including flap necrosis, graft loss, infection, paresthesia, donor-site morbidity, and two-point discrimination (2-PD) were carefully recorded. The Michigan Hand Outcomes Questionnaire (MHQ) was applied to conduct follow-up assessment. Results After more than 12 months of follow-up, the results were significant. In terms of overall function, MPAF was superior to DDMF (p < 0.005). Conclusion The MPAF and the DDMF are available and reliable for reconstruction of the volar surface of the finger; however, the MPAF offers better functional outcomes with a lower frequency of postoperative complications.

scholarly journals Traditional versus mirror three-dimensional printing technology for isolated acetabular fractures: a retrospective study with a median follow-up of 25 months

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110285
Author(s):  
Kai Xiao ◽  
Bo Xu ◽  
Lin Ding ◽  
Weiguang Yu ◽  
Lei Bao ◽  
...  
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Operation Time ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Printing Technology ◽  
Three Dimensional Printing ◽  
3D Printing Technology ◽  
Significant Difference

Objective To assess the outcomes of traditional three-dimensional (3D) printing technology (TPT) versus mirror 3D printing technology (MTT) in treating isolated acetabular fractures (IAFs). Methods Consecutive patients with an IAF treated by either TPT or MTT at our tertiary medical centre from 2012 to 2018 were retrospectively reviewed. Follow-up was performed 1, 3, 6, and 12 months postoperatively and annually thereafter. The primary outcome was the Harris hip score (HHS), and the secondary outcomes were major intraoperative variables and key orthopaedic complications. Results One hundred fourteen eligible patients (114 hips) with an IAF (TPT, n = 56; MTT, n = 58) were evaluated. The median follow-up was 25 months (range, 21–28 months). At the last follow-up, the mean HHS was 82.46 ±14.70 for TPT and 86.30 ± 13.26 for MTT with a statistically significant difference. Significant differences were also detected in the major intraoperative variables (operation time, intraoperative blood loss, number of fluoroscopic screenings, and anatomical reduction number) and the major orthopaedic complications (loosening, implant failure, and heterotopic ossification). Conclusion Compared with TPT, MTT tends to produce accurate IAF reduction and may result in better intraoperative variables and a lower rate of major orthopaedic complications.

Total Knee Arthroplasty Is Safe in Jehovah's Witness Patients—A 12-Year Perspective

2019 ◽  
Vol 33 (01) ◽  
pp. 034-041 ◽  
Author(s):  
Theodore S. Wolfson ◽  
David Novikov ◽  
Kevin K. Chen ◽  
Kelvin Y. Kim ◽  
Afshin A. Anoushiravani ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Complications ◽  
Knee Arthroplasty ◽  
Subgroup Analysis ◽  
Blood Management ◽  
Folate Supplementation ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Total Knee

AbstractDespite the evolution of blood management protocols, total knee arthroplasty (TKA) occasionally requires allogeneic blood transfusion. This poses a particular challenge for Jehovah's Witnesses (JW) who believe that the Bible strictly prohibits the use of blood products. The aim of this study was to compare JW and a matched-control cohort of non-JW candidates undergoing TKA to assess the safety using modern blood management protocols. Fifty-five JW patients (63 knees) who underwent TKA at our institution between 2005 and 2017 were matched to 63 non-JW patients (63 knees). Patient demographics, intraoperative details, and postoperative complications including in-hospital complications, revisions, and 90-day readmissions were collected and compared between the groups. Additionally, subgroup analysis was performed comparing JW patients who were administered tranexamic acid (TXA) between the two groups. Baseline demographics did not vary significantly between the study cohorts. The mean follow-up was 3.1 years in both the JW and non-JW cohorts. Postoperative complications, including in-hospital complications (7.9 vs. 4.8%; p = 0.47), revision TKA (1.6 vs. 1.6%; p = 1.00), and 90-day readmission (1.6 vs. 4.8%; p = 0.31) were not significantly different between the JW and non-JW groups. Subgroup analysis demonstrated JW patients who received TXA had a significantly lower decline in postoperative hemoglobin (Hgb) (8.6 vs. 14.0%; p < 0.01). At a follow-up of up to 12 years, JW patients who underwent TKA have outcomes equivalent to non-JW patients without the need for transfusion. Our findings support that surgeons are more likely to optimize JW patients preoperatively with iron and folate supplementation. Despite these variations in preoperative optimization efforts, no significant difference with regard to Hgb or hematocrit levels was demonstrated. Level of evidence is III, retrospective observational study.

scholarly journals Is It Necessary to Reduce Thoracolumbar Compression Fractures  with Intermediate Screws in the Fractured Vertebra?

2021 ◽  
Author(s):  
ZeJun Xing ◽  
Shuai Hao ◽  
XiaoFei Wu
Keyword(s):  
Blood Loss ◽  
Body Height ◽  
Pedicle Screws ◽  
Operation Time ◽  
Short Segment ◽  
Compression Fractures ◽  
Significant Difference ◽  
Before And After ◽  
Screw Group

Abstract PurposeTo compare the efficacy and safety of percutaneous short-segment pedicle screws fixation (PPSF) with or without intermediate screws (IS) for the treatment of thoracolumbar compression fractures.MethodsFrom January 2016 to March 2019, a retrospective study of 38 patients with thoracolumbar compression fractures conducted. The patients were divided into a 4-screw group (without IS) and a 6-screw group (with IS) according to whether pedicle screws were placed in the fractured vertebrae. Combined positional reduction effects with the technique of pre-contoured lordotic rods were used to reduce the fracture by lengthening the anterior column of the fractured vertebrae. The posterior structure of the fractured vertebrae was undertaken as the fulcrum point for both groups. The operation time, intra-operative blood loss, visual analogue scale (VAS), anterior vertebral body height (AVBH), segment kyphosis（SK）before and after operation and complications were recorded.ResultsAlthough the operation time and blood loss in the 6-screw group were higher than in the 4-screw group, difference was not significant (P＞0.05). There was no significant difference in VAS, AVBH and SK between the two groups (P＞0.05). Nevertheless, these results were significant differences between the preoperative and the immediate postoperative, between preoperative and follow-up groups (P < 0.001). No neurologic injury was observed in either groups. ConclusionsIn the treatment of thoracolumbar compression fractures, percutaneous short-segment pedicle screws fixation without intermediate screws in the 4-screw construct may obtain the same clinical effect as that in the 6-screw construct.

scholarly journals Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing ： A retrospective cohort study

2019 ◽  
Author(s):  
Yiliang Cui ◽  
Xingyi Hua ◽  
Florian Schmidutz ◽  
Jian Zhou ◽  
Zongsheng Yin ◽  
...  
Keyword(s):  
Blood Loss ◽  
Intramedullary Nailing ◽  
Functional Outcomes ◽  
Operation Time ◽  
Tibial Shaft ◽  
Shaft Fractures ◽  
Significant Difference ◽  
Special Surgery ◽  
Tibial Shaft Fractures

Abstract Background: Tibial shaft fractures are routinely managed with intramedullary nailing (IMN). An increasingly accepted technique is the suprapatellar (SP) approach. The purpose of this study was to compare the clinical and functional outcomes of knee joint after tibia IMN through an suprapatellar (SP) or traditional infrapatellar (IP) approach. Methods: Retrospective analysis was performed in patients with tibial shaft fractures that were treated with IMN through a SP or IP approach between 01/01/2014 and 31/12/2016. The clinical and functional outcomes of the knee were assessed with the Hospital for Special Surgery (HSS) Knee Score. Secondary outcomes included the operation time and intraoperative blood loss. Results: A total of 50 patients/fractures (26 IP and 24 SP) with a minimum follow-up of 15 months were evaluated. All fractures were OTA 42. No significant differences were found between the two groups in age, gender, side of fractures, operation time, intra-operative blood loss, and follow-up time. No significant difference was seen in HSS score ( P = 0.62) between them. Sub analysis of all the HSS components scores revealed no significant differences between pain ( P = 0.57), the stand and walk ( P = 0.54), the need for walking stick ( P = 0.60) and extension lag ( P = 0.60). The other HSS components showed full scores (IP 10 vs. SP 10) in both approaches, including muscle force, flexion deformity and stability components. The range of motion (ROM) component score was superior in the IP group ( P = 0.04) suggesting a higher ROM. Conclusions: Both SP and IP approach results in equivalent overall HSS knee scores. However, for the HSS component, the IP approach was superior to SP approach regarding the ROM.

scholarly journals Three-dimensional laparoscopic partial nephrectomy for renal hilar tumors: an empirical analysis of 290 patients

2020 ◽  
Author(s):  
Feiya Yang ◽  
Lianjie Mou ◽  
Nianzeng Xing
Keyword(s):  
Partial Nephrectomy ◽  
Preoperative Evaluation ◽  
Three Dimensional ◽  
Intraoperative Ultrasound ◽  
Operation Time ◽  
Laparoscopic Partial Nephrectomy ◽  
Renal Tumors ◽  
Significant Difference ◽  
Group A

Abstract Objective To explore the feasibility of laparoscopic partial nephrectomy(LPN) in the treatment of renal hilar tumors. Methods Clinical data of 290 patients undergoing laparoscopic partial nephrectomy from January 2013 to August 2019 were retrospectively analyzed, including 27 patients with renal hilar tumors and 263 patients with non-hilar renal tumors. Perioperative data and follow-up results were compared between the two groups. Results Tumor size in Group A is smaller(2.97±0.88 vs 3.55±1.46,p<0.05), R.E.N.A.L. nephrometry score of Group A is higher(8.4±1.3 vs 6.5±1.7,p<0.01).The operation time, WIT and intraoperative blood loss in the Group A were slightly higher, but with no statistical difference (p>0.05). There was no significant difference between the two groups in intraoperative ultrasound rate, collection system repair rate, drainage time,postoperative hospital stay, and eGFR changes (p>0.05).The median follow-up period was 40 months. One patient with postoperative pathologic report of angiomyolipoma was found tumor recurrence and was currently undergoing regular reexamination. Conclusion Three-dimensional laparoscopic partial nephrectomy for renal hilar tumors is safe and feasible after detailed preoperative evaluation of the tumor and selection of appropriate surgical strategies.

scholarly journals Humerus trochlear angle (HTa)—a possible alternative for Baumann angle in the reduction of supracondylar humerus fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gang Chen ◽  
Lu Cui ◽  
Jiaqi Shi ◽  
Peng Zhang ◽  
Jun Li ◽  
...  
Keyword(s):  
Articular Surface ◽  
Operation Time ◽  
Contralateral Side ◽  
Gender And Age ◽  
Supracondylar Humerus Fractures ◽  
Significant Difference ◽  
Reliable Parameter ◽  
Cosmetic Outcomes ◽  
Humerus Fractures

Abstract Background The supracondylar humerus fractures are the most common fracture in children’s elbows. Generally, close reduction and percutaneous pinning can provide satisfactory outcomes after adequate reduction. Baumann angle is commonly used to evaluate reduction quality, however, it may fail to assess reduction well when the elbow is in flexion and/or when the patient is young. We conducted this study to evaluate the potential value of the humerus trochlear angle (HTa) for the reduction evaluation and compare it with the Baumann angle. Methods We retrospectively reviewed supracondylar humerus fractures in our trauma center from 2016 to 2019. Patients were grouped as followed: in the HTa group, an arthrogram was used to evaluate the HTa angle and reduction (HTa, defined by the intersection of the axis of the humerus shaft and the tangent of the articular surface of the trochlear); In the Baumann group, the Baumann angle was used to assess the reduction. Baumann angle ratio (BA of injured side/BA of contralateral side) was calculated to evaluate the reduction quality between groups. Flynn’s grading criteria were utilized to evaluate both function and cosmetic outcomes in two groups during the follow-up. Operation time, fluoroscopy shots, complications and Flynn’s grading scores were compared between groups. Results A total of 57 patients with an average age of 4.62 years and follow-up duration of 21.49 ± 5.40 months were included in the analysis. The gender and age distributions were similar in the two groups. Fluoroscopy shots in the HTa group were significantly less than in Baumann group (16.17 ± 0.73 vs. 21.85 ± 0.78, p < 0.0001), and operation time were also less in HTa group (45.78 ± 1.96 min vs. 62.21 ± 1.58 min, p < 0.0001). Baumann ratio showed no significant difference between the two groups (1.002 ± 0.023 in the Baumann group and 1.01 ± 0.023 in HTa group, p < 0.0001). Length of hospitalization, complications, and Flynn’s grading scores were similar between groups. The HTa angle was positively correlated with Baumann angle in the HTa group (R-value is 0.71 and P = 0.0002). Conclusions There was no significant difference in reduction quality and Flynn’s scores between HTa and Baumann groups. Furthermore, HTa was associated with shorter operation time and less radiation exposure in this investigation. Therefore, HTa may be a convenient and reliable parameter that could guide the reduction of supracondylar humerus fractures, especially for young children.

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