中国修复重建外科杂志最新文献

{"title":"[Perioperative changes of serum interleukin 6 levels in elderly male patients with intertrochanteric fracture].","authors":"Xiangxu Chen, Huanyi Zhu, Wei Wu, Chuwei Tian, Liu Shi, Wenbin Fan, Cheng Zhang, Yingjuan Li, Hui Chen, Wei Gao, Yunfeng Rui","doi":"10.7507/1002-1892.202405057","DOIUrl":"10.7507/1002-1892.202405057","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the perioperative changes in serum interleukin 6 (IL-6) levels in elderly male patients with intertrochanteric fractures, and provide evidence for inflammatory control in this patient population.</p><p><strong>Methods: </strong>The clinical data of 40 male patients aged more than 60 years with intertrochanteric fractures who met the selection criteria between January 2021 and December 2022 were retrospectively analyzed, including 25 non-osteoporosis patients (T value>-2.5, group A) and 15 osteoporosis patients (T value≤-2.5, group B). In addition, 40 healthy men aged more than 60 years old were included as controls (group C) according to the age matching rule. There was no significant difference in age, smoking history, drinking history, body mass index, complications (hypertension and diabetes), alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, and total protein among the 3 groups ( <i>P</i>>0.05). Serum samples were collected from group C subjects and from groups A and B patients preoperatively and on postoperative days 1, 3, 5, and 7. IL-6 levels were measured using ELISA assay. Pearson correlation analysis was used to assess the relationship between IL-6 levels and T values at various time points in groups A and B. Postoperative complications during hospitalization and 1-year mortality rates were recorded for groups A and B.</p><p><strong>Results: </strong>Preoperative IL-6 levels were significantly higher in groups A and B than in group C ( <i>P</i><0.05), with group B being significantly higher than group A ( <i>P</i><0.05). In groups A and B, IL-6 levels increased significantly on postoperative day 1 compared to preoperative levels and then gradually decreased, approaching preoperative levels by postoperative day 7. IL-6 levels in group B were significantly higher than those in group A at all postoperative time points ( <i>P</i><0.05). Correlation analysis showed that IL-6 levels were negatively correlated with T values at all perioperative time points in all patients from groups A and B ( <i>P</i><0.05). Complications occurred in 4 patients (16.0%) in group A, including 2 cases of pulmonary infection, 1 case of urinary tract infection, and 1 case of heart failure, and in 3 patients (20.0%) in group B, including 2 cases of pulmonary infection and 1 case of gastrointestinal bleeding. There was no significant difference in the incidence of complications between the two groups ( <i>χ</i> <sup>2</sup>=0.104, <i>P</i>=0.747). There were 2 cases (8.0%) and 4 cases (26.7%) died within 1 year after operation in groups A and B, respectively, and there was no significant difference in 1-year mortality rates between the two groups ( <i>χ</i> <sup>2</sup>=2.562, <i>P</i>=0.109).</p><p><strong>Conclusion: </strong>Serum IL-6 levels significantly increase in the early postoperative period in elderly male patients with intertrochanteric fractures, especially in those with ","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1249-1253"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Preliminary application of ulnar cortex transverse transport technique in treatment of upper extremity thromboangiitis obliterans].","authors":"Xiaojin Mo, Chunnian He, Jian Zhou, Wei Chen, Kaiyu Nie, Zairong Wei, Shusen Chang","doi":"10.7507/1002-1892.202404096","DOIUrl":"10.7507/1002-1892.202404096","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the feasibility and effectiveness of ulnar cortex transverse transport technique in treating upper extremity thromboangiitis obliterans (TAO).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 7 male patients with upper extremity TAO who were admitted and met the inclusion criteria between January 2019 and July 2022. The patients ranged in age from 32 to 50 years, with a mean age of 40.1 years. The disease duration ranged from 6 to 24 months, averaging 13.6 months. The smoking history ranged from 8 to 31 years, with a mean of 18.4 years. All patients presented with finger ulcers or gangrene, including 1 case affecting the thumb and index finger, 1 case affecting the index and middle fingers, 1 case affecting the middle and ring fingers, 1 case affecting only the ring finger, and 3 cases affecting the ring and little fingers. The preoperative visual analogue scale (VAS) score was 9.1±0.7. All patients underwent treatment with the ulnar cortext transverse transport technique. The wound healing time and the disappearance time of rest pain were recorded. The VAS score was used to assess the degree of hand pain before and after operation. Serum interleukin 6 (IL-6) levels were measured before operation and at 1 month after operation. Computed tomography angiography (CTA) of the affected limb was performed before operation and at 3 months after operation to evaluate changes in blood vessels. The clinical outcomes were evaluated at 1 year after operation based on the Patwa and Krishnan grading system.</p><p><strong>Results: </strong>All 7 patients were followed up 12-17 months, with an average of 13.7 months. All patients experienced successful healing of ulcers, with wound healing time ranging from 14 to 21 days, averaging 17.3 days. During the follow-up, no complication occurred, and there was no recurrence of ulcers. The disappearance time of rest pain ranged from 8 to 15 days, averaging 12.1 days. The pre- and post-operative (1-month) serum IL-6 levels were (25.1±5.9) pg/mL and (11.9±2.9) pg/mL, respectively, with a significant difference ( <i>t</i>=5.363, <i>P</i>=0.002). CTA examination at 3 months after operation revealed partial revascularization of upper extremity arteries and establishment of collateral circulation, showing significant improvement compared to preoperative status. The VAS scores at 1, 7, 28 days, and 6 months postoperatively were 6.4±0.8, 3.7±0.8, 0.6±0.8, and 0.1±0.4, respectively, all of which significantly improved compared to preoperative scores ( <i>P</i><0.05). Furthermore, the VAS scores gradually decreased over time, with significant differences observed between postoperative time points ( <i>P</i><0.05). At 1 year after operation, the effectiveness of all 7 patients were evaluated as excellent based on the Patwa and Krishnan grading system.</p><p><strong>Conclusion: </strong>The ulnar cortex transverse transport technique can imp","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1242-1248"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of clinical features, treatment methods, and prognostic influence factors in patients with malignant peripheral nerve sheath tumor].","authors":"Bochong Shi, Haoyu Zheng, Huajian Wu, Xianglin Hu, Wangjun Yan","doi":"10.7507/1002-1892.202406040","DOIUrl":"10.7507/1002-1892.202406040","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical features, treatment methods, and prognostic influence factors of patients with malignant peripheral nerve sheath tumor (MPNST).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 96 MPNST patients treated between January 1, 2015 and December 31, 2021. There were 46 males and 50 females, aged between 15 and 87 years (mean, 48.2 years). The tumors were located in the trunk in 50 cases, extremities in 39 cases, and head and neck in 7 cases. The maximum tumor diameter was <5 cm in 49 cases, ≥5 cm in 32 cases, with 15 cases missing data. Tumor depth was deep in 77 cases and superficial in 19 cases. The Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) histological grading was G1 in 9 cases, G2 in 12 cases, and G3 in 34 cases, with 41 cases missing data. There were 37 recurrent MPNST cases, 32 cases with neurofibromatosis type 1 (NF1), and 26 cases in stage Ⅳ. Postoperative adjuvant radiotherapy was administered to 25 patients, perioperative chemotherapy to 45 patients, and anlotinib-targeted therapy to 30 patients. R <sub>0</sub> resection was achieved in 73 cases. Patients were divided into groups based on the presence or absence of NF1, and baseline data between the two groups were compared. Kaplan-Meier curves were generated to assess disease-free survival (DFS) and overall survival (OS) based on various factors (age, gender, presence of NF1, recurrent MPNST, stage Ⅳ MPNST, FNCLCC grade, R <sub>0</sub> resection, tumor location, tumor size, tumor depth, perioperative chemotherapy, postoperative adjuvant radiotherapy, and anlotinib-targeted therapy), and differences between survival curves were analyzed using the Log-Rank test. Multivariate COX proportional hazards regression was used to identify independent prognostic factors for MPNST.</p><p><strong>Results: </strong>Patients with NF1 had a significantly higher proportion of superficial tumors and lower FNCLCC grade compared to those without NF1 ( <i>P</i><0.05); no significant difference was found for other variables ( <i>P</i><0.05). Kaplan-Meier analysis showed that recurrent MPNST, stage Ⅳ MPNST, FNCLCC grade, R <sub>0</sub> resection, perioperative chemotherapy, and anlotinib-targeted therapy were factors influencing 1-year DFS ( <i>P</i><0.05), while stage Ⅳ MPNST, FNCLCC grade, and perioperative chemotherapy were factors affecting 3-year OS ( <i>P</i><0.05). Multivariate COX proportional hazards regression analysis revealed that recurrent MPNST and high-grade FNCLCC (G3) were independent prognostic factors for 1-year DFS ( <i>P</i><0.05), while stage Ⅳ MPNST, superficial tumor depth, age over 60 years, postoperative adjuvant radiotherapy, and anlotinib-targeted therapy were independent prognostic factors for 3-year OS ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>MPNST patients with NF1 tend to have more superficial tumors and lower FNCLCC grades. FNCLCC grade, R <sub>0</sub> resection","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1193-1201"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Emergency management and perioperative strategies for intra-tumoral hemorrhage in neurofibromatosis type 1-related giant plexiform neurofibroma].","authors":"Baochen Zhu, Yang Xiao, Ruiheng Liao, Hanxing Zhao, Xuewen Xu, Yan'ge Zhang","doi":"10.7507/1002-1892.202406074","DOIUrl":"10.7507/1002-1892.202406074","url":null,"abstract":"<p><strong>Objective: </strong>To review the emergency management and perioperative strategies for ruptured neurofibromatosis type 1 (NF1)-related giant plexiform neurofibroma (PNF), providing a systematic treatment protocol to improve the therapeutic outcomes and quality of life for patients with giant PNF.</p><p><strong>Methods: </strong>The literature on the management of giant PNF rupture and hemorrhage was reviewed, and the diagnosis, treatment, and perioperative management were summarized based on clinical experiences.</p><p><strong>Results: </strong>By implementing an integrated diagnostic and treatment strategy that includes early diagnosis, imaging evaluation, emergency ultra-selective arterial embolization combined with surgical excision, acute hemorrhage can be effectively controlled while also reducing the risk of major intraoperative bleeding and minimizing postoperative complications. As a result, this approach significantly improves treatment success rates and patient quality of life.</p><p><strong>Conclusion: </strong>For ruptured NF1-related giant PNF, employing emergency ultra-selective arterial embolization combined with surgical excision, under the collaboration of a multidisciplinary team, can effectively improve treatment success rates, rapidly control bleeding, reduce tumor size, and lower mortality. Future research should focus on assessing the long-term quality of life of patients treated for ruptured and hemorrhaging giant PNF and on further optimizing treatment protocols.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1180-1185"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical study of Cross-Union surgery for treatment of pseudarthrosis of tibia with neurofibromatosis type 1 in children].","authors":"Yueqiang Mo, Chunxing Wu, Bo Ning, Dahui Wang","doi":"10.7507/1002-1892.202406056","DOIUrl":"10.7507/1002-1892.202406056","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of Cross-Union surgery for the treatment of pseudarthrosis of the tibia (PT) with neurofibromatosis type 1 (NF1).</p><p><strong>Methods: </strong>The clinical data of 8 children of PT with NF1 who met the selection criteria between January 2018 and December 2023 was retrospectively analyzed. There were 5 boys and 3 girls, and the operative age ranged from 1.8 to 13.3 years with a median age of 3.5 years. According to Paley classification, there were 2 cases of type 2a, 2 cases of type 3, 2 cases of type 4a, and 2 cases of type 4c. There were 5 cases of first operation and 3 cases of re-fracture after previous operation. Six cases had leg length discrepancy before operation, and 2 of them had shortening over 2.0 cm. Except for 1 case of ankle fusion, the other 7 cases had ankle valgus. Preoperative coronal/sagittal angulation was recorded. Postoperative pseudarthrosis healing and refracture were observed. Leg length discrepancy and tibiotalar angle were measured and recorded before operation and at last follow-up. Inan imaging evaluation criteria was used to evaluate the imaging effect.</p><p><strong>Results: </strong>All patients were followed up 12-37 months (mean, 23.5 months). One pseudarthrosis failed to heal at 12 months after operation and healed at 3 months after reoperation, while the other pseudarthrosis healed with a healing rate of 87.5% and a healing time of 4-8 months (mean, 5.3 months). No refracture occurred during the follow-up. At last follow-up, there were 2 new cases with leg length discrepancy, which were 0.7 cm and 1.3 cm, respectively. In 2 cases with the leg length discrepancy more than 2.0 cm before operation, the improvement was from 4.1 cm and 12.6 cm to 2.1 cm and 9.0 cm, respectively. There was no significant difference in leg length discrepancy between pre- and post-operation in 8 cases ( <i>P</i>>0.05). At last follow-up, 6 patients still had ankle valgus, and there was no significant difference in the tibiotalar angle between pre- and post-operation ( <i>P</i>>0.05); the tibial coronal/sagittal angulation significantly improved when compared with that before operation ( <i>P</i><0.05). According to Inan imaging evaluation criteria, 1 case was good, 6 cases were fair, and 1 case was poor.</p><p><strong>Conclusion: </strong>Cross-Union surgery is an effective method for the treatment of PT with NF1 in children, can achieve good bone healing results with a low risk of re-fracture. The surgery may not have significant effects on leg length discrepancy and ankle valgus, and further treatment may be required.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1214-1219"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Experimental study on the causes of spontaneous osteogenesis of Masquelet technique induced membrane].","authors":"Qudong Yin, Dong Mao, Yongjun Rui","doi":"10.7507/1002-1892.202403021","DOIUrl":"10.7507/1002-1892.202403021","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the causes of spontaneous osteogenesis of Masquelet technique induced membrane.</p><p><strong>Methods: </strong>Forty-two male Sprague-Dawley rats aged 7-9 weeks were selected to establish a critical-sized bone defect of the right middle femur model. Then the rats were randomly divided into 4 groups, with 12 rats in groups A-C and 6 rats in group D. The bone defects in groups A-C were filled with vancomycin-loaded polymethyl methacrylate bone cement spacers. Then the Kirschner wires were used for intramedullary fixation in groups A and B, and the bone cement was used to connect the bone cement spacers and the bone ends in group B. The steel plate was used to fixation in group C. The bone defect in group D was only fixed with steel plate as a blank control group. The general condition was observed after operation. At 5 weeks after operation, 6 rats in groups A-C were selected for STRO-1 immunohistochemical staining to observe the content of mesenchyme stem cells (MSCs) in the induced membrane (STRO-1 ⁺ cells). At 12 weeks after operation, the remaining rats in groups A-D were taken for X-ray observation, gross observation, and histological observation (HE, safranin O-green staining) to observe the spontaneous osteogenesis of the membrane.</p><p><strong>Results: </strong>All rats in the 4 groups survived until the completion of the experiment. At 5 weeks after operation, the immunohistochemical staining showed that group B was negative, while the contents of MSCs in the induced membrane in groups A and C were 14.20%±1.92% and 5.00%±0.71%, respectively, with a significant difference ( <i>P</i><0.05). At 12 weeks after operation, group A showed that the new bone formed at the osteotomy site and growth towards the center of the bone defect, with an average length of 3.1 mm on one side; and the presence of bone, cartilage lesions, fibers, and a small amount of neovascularization were observed in the induced membrane. Group C only had a small amount of new bone at the osteotomy site, and a small amount of neovascularization in the induced membrane. Groups B and D did not have any new bone, but bone resorption or atrophy at the osteotomy site.</p><p><strong>Conclusion: </strong>Although the Masquelet technique induced membrane has osteogenesis, the key factor for the spontaneous osteogenesis is the bone marrow overflow from the bone marrow cavity providing MSCs. The spontaneous osteogenesis of the induced membrane belongs to endochondral ossification.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1254-1260"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical experiences in precision treatment of giant plexiform neurofibromas of head, face, and neck].","authors":"Bingcheng Liu, Zhiqi Hu","doi":"10.7507/1002-1892.202406085","DOIUrl":"10.7507/1002-1892.202406085","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the treatment strategies and clinical experiences of 5 cases of giant plexiform neurofibromas (PNF) involving the head, face, and neck.</p><p><strong>Methods: </strong>Between April 2021 and May 2023, 5 patients with giant PNFs involving the head, face, and neck were treated, including 1 male and 4 females, aged 6-54 years (mean, 22.4 years). All tumors showed progressive enlargement, involving multiple regions such as the maxillofacial area, ear, and neck, significantly impacting facial appearance. Among them, 3 cases involved tumor infiltration into deep tissues, affecting development, while 4 cases were accompanied by hearing loss. Imaging studies revealed that all 5 tumors predominantly exhibited an invasive growth pattern, in which 2 and 1 also presenting superficial and displacing pattern, respectively. The surgical procedure followed a step-by-step precision treatment strategy based on aesthetic units, rather than simply aiming for maximal tumor resection in a single operation. Routine preoperative embolization of the tumor-feeding vessels was performed to reduce bleeding risk, followed by tumor resection combined with reconstructive surgery.</p><p><strong>Results: </strong>All 5 patients underwent 1-3 preoperative embolization procedures, with no intraoperative hemorrhagic complications reported. Four patients required intraoperative blood transfusion. A total of 10 surgical procedures were performed across the 5 patients. One patient experienced early postoperative flap margin necrosis due to ligation for hemostasis; however, the incisions in the remaining patients healed without complications. All patients were followed up for a period ranging from 6 to 36 months, with a mean follow-up duration of 21.6 months. No significant tumor recurrence was observed during the follow-up period.</p><p><strong>Conclusion: </strong>For patients with giant PNF involving the head, face, and neck, precision treatment strategy can effectively control surgical risks and improve the standard of aesthetic reconstruction. This approach enhances overall treatment outcomes by minimizing complications and optimizing functional and cosmetic results.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1208-1213"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on femoral attachment positioning during medial patellofemoral ligament reconstruction].","authors":"Peng'an Yan, Fan Lu, Yifan Cai, Zhenxing Yan, Yuqiao Wei, Chongxiao Sun, Bin Geng, Yayi Xia","doi":"10.7507/1002-1892.202405051","DOIUrl":"10.7507/1002-1892.202405051","url":null,"abstract":"<p><strong>Objective: </strong>To review research progress on femoral attachment positioning during medial patellofemoral ligament (MPFL) reconstruction, so as to provide a reference for accurate positioning in clinic.</p><p><strong>Methods: </strong>The literature at home and abroad on femoral attachment positioning during MPFL reconstruction was extensively reviewed and summarized.</p><p><strong>Results: </strong>MPFL is the main ligament that restricts patellar outward migration, so MPFL reconstruction is the main treatment for patellar dislocation, but the accuracy of intraoperative femoral attachment positioning will significantly affect the effectiveness. At present, there are three main methods for femoral attachment positioning in MPFL reconstruction, including imaging positioning, bony landmark positioning, and new technology. Among them, the main imaging positioning method is the \"Schöttle point\" method, but it has high requirements for fluoroscopic positioning, and can only be accurately positioned under standard lateral fluoroscopy of the femur. The bony landmark positioning method mainly locates the femoral attachment by touching or dissecting the bony landmarks such as adductor tubercles and medial epicondyle of femur, but its disadvantages are that the positioning is not accurate enough, the intraoperative visual field exposure requirements are high, and a large incision is required. In order to avoid the problem that the simple bony landmark positioning method, in recent years, the combination of bony landmarks combined with arthroscopy, three-dimensional (3D) printing technology, and robot-assisted positioning methods have begun to be used in clinical practice. New technology localization methods have shown good results by preparing guides before operation, planning positioning paths in advance, or directly using robots to assist positioning during operation.</p><p><strong>Conclusion: </strong>The accurate positioning of the femoral attachment in MPFL reconstruction is crucial, and the method of accurate and rapid intraoperative determination needs to be further improved and optimized. In the future, it is expected that the combination of computer image recognition correction technology and intraoperative position assistance will solve this problem.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1276-1282"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of tibial rotation on knee and ankle function in patients with extra-articular distal tibial fractures after minimally invasive plate osteosynthesis treatment].","authors":"Jianping Zhang, Hui Liu, Weizhen Xu, Yuanfei Xiong, Jinhui Zhang, Jin Wu","doi":"10.7507/1002-1892.202404041","DOIUrl":"10.7507/1002-1892.202404041","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the effect of tibial rotation on knee and ankle function in the patients with extra-articular distal tibial fractures after minimally invasive plate osteosynthesis (MIPO) treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on 45 patients with extra-articular distal tibial fractures who underwent MIPO between January 2021 and December 2022. There were 20 males and 25 females, aged from 19 to 68 years (mean, 43.6 years). The causes of fractures included falling from heights in 11 cases, traffic accidents in 15 cases, bruising by a heavy object in 7 cases, and falling in 12 cases. The time from injury to hospitalization was 1-6 hours (mean, 3.7 hours). There were 28 cases of simple tibial fractures and 17 cases of tibial fractures combined with ipsilateral fibular fractures; 9 cases of open fractures and 36 cases of closed fractures. According to AO/Orthopaedic Trauma Association (AO/OTA) classification, the distal tibial fractures were classified as type 43A1 in 12 cases, type 43A2 in 17 cases, and type 43A3 in 16 cases. During follow-up, the Lower Limb Function Score (LEFS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and Knee Injury and Osteoarthritis Score (KOOS) were used to evaluate the lower limb, ankle, and knee joint functions, respectively. The range of motion (ROM) of the knee and ankle joints was measured. The Short Form Health Survey (SF-36) was used to assess the quality of life of the patients. The fracture healing was observed by anteroposterior and lateral X-ray films of the ankle joint. The bilateral tibial rotation angles were measured on CT and the differences between the affected and healthy sides were caculated. The difference ≥10° was judged as tibial malrotation. According to whether there was tibial malrotation, the patients were allocated into a normal group and a malrotation group for efficacy comparison.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The incisions of all patients healed by first intention without any early complications. All patients were followed up 12-26 months (mean, 18.6 months). Imaging re-examination showed that all fractures healed, with a healing time of 9-14 weeks (mean, 11.2 weeks). At last follow-up, the LEFS score was 60-68 (mean, 62.3); the AOFAS score was 89-97 (mean, 92.6); the KOOS score was 158-164 (mean, 161.3). The ROM of ankle was 40.0°-45.0° (mean, 42.8°) in flexion and 10.5°-22.0° (mean, 17.7°) in extension; the ROM of knee was 130.0°-135.0° (mean, 132.6°) in flexion and -8.8°- -5.0° (mean, -7.1°) in extension. The SF-36 score was 89-93 (mean, 90.7). The absolute value of difference of tibial rotation angle was 2.6°-17.3° (mean, 8.9°) in 45 patients, and the malrotation was observed in 15 patients (33.3%), including 10 cases of internal rotation and 5 cases of external rotation. There was no significant difference ( &lt;i&gt;P&lt;/i&gt;&gt;0.05) in the proportion of patients with fibular fractures before operation between t","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1236-1241"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Progress in neurosurgical treatment of neurofibromatosis type 1].","authors":"Ce Li, Binghan Liu, Yanjun Wang, Taifei Yu, Zhiming Zheng, Guodong Wang","doi":"10.7507/1002-1892.202407058","DOIUrl":"10.7507/1002-1892.202407058","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the latest developments in neurosurgical treatments for neurofibromatosis type 1 (NF1) and explore therapeutic strategies to provide comprehensive treatment guidelines for clinicians.</p><p><strong>Methods: </strong>The recent domestic and international literature and clinical cases in the field of NF1 were reviewed. The main types of neurological complications associated with NF1 and their treatments were thorough summarized and the future research directions in neurosurgery was analyzed.</p><p><strong>Results: </strong>NF1 frequently results in complex and diverse lesions in the central and peripheral nervous systems, particularly low-grade gliomas in the brain and spinal canal and paraspinal neurofibromas. Treatment decisions should be made by a multidisciplinary team. Symptomatic plexiform neurofibromas and tumors with malignant imaging evidence require neurosurgical intervention. The goals of surgery include reducing tumor size, alleviating pain, and improving appearance. Postoperative functional rehabilitation exercises, long-term multidisciplinary follow-up, and psychosocial interventions are crucial for improving the quality of life for patients. Advanced imaging guidance systems and artificial intelligence technologies can help increase tumor resection rates and reduce recurrence.</p><p><strong>Conclusion: </strong>Neurosurgical intervention is the primary treatment for symptomatic plexiform neurofibromas and malignant peripheral nerve sheath tumors when medical treatment is ineffective and the lesions progress rapidly. Preoperative multidisciplinary assessment, intraoperative electrophysiological monitoring, and advanced surgical assistance devices significantly enhance surgical efficacy and safety. Future research should continue to explore new surgical techniques and improve postoperative management strategies to achieve more precise and personalized treatment for NF1 patients.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"38 10","pages":"1171-1179"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}