中国修复重建外科杂志最新文献

{"title":"[Surgical strategies for osteotomy correction of severe lower limb deformities in hypophosphatemic rickets].","authors":"Shaofeng Jiao, Sihe Qin, Zhenjun Wang, Yue Guo, Hongsheng Xu, Zhijie Liu, Shilong Wang","doi":"10.7507/1002-1892.202503128","DOIUrl":"10.7507/1002-1892.202503128","url":null,"abstract":"<p><strong>Objective: </strong>To explore the corrective strategies and effectiveness of osteotomy surgery for severe lower limb deformities in hypophosphatemic rickets.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 29 patients with severe lower limb deformities of hypophosphatemic rickets who underwent surgical treatment between February 2012 and August 2024. There were 9 males and 20 females. The age ranged from 13 to 53 years, with an average of 24.6 years. All patients were deformities of both lower limbs, presenting as 24 cases of O-shaped legs, 2 cases of wind-blown deformities, and 3 cases of X-shaped legs. Based on the full-length films of both lower limbs in the standing position before operation, the osteotomy planes of the femur, tibia, and fibula were designed. Among them, if both the same-sided thigh and leg were deformed, staged surgeries of both lower limbs were selected. If only the thigh or leg were deformed, simultaneous surgeries of both lower limbs were selected. The femur deformity was corrected immediately after osteotomy at the deformed plane; the osteotomy fragment was temporarily controlled with an external fixator, which was removed after perform internal fixation with a steel plate. After fibular osteotomy, the Ilizarov frame or Taylor frame was installed on the tibia and fibula. The threaded rods were removed and then tibial osteotomy was performed on the deformed plane. Patients using the Taylor frame did not undergo deformity correction during operation. The external fixators were adjusted starting 7 days after operation to correct the varus, valgus, and rotational deformities of the lower limb. Patients using the Ilizarov frame corrected the rotational deformity of the tibia during operation. The external fixator was adjusted starting 7 days after operation to correct the varus and valgus deformities of the lower limb. During the treatment period, the patient could walk with partial weight-bearing on the operated limb with crutches. The external fixator was removed after the bone healed. Before operation and at last follow-up, the medial proximal tibial angle (MPTA), lateral distal tibial angle (LDTA), posterior proximal tibial angle (PPTA), anterior distal tibial angle (ADTA), anatomic lateral distal femoral angle (aLDFA), posterior distal femoral angle (PDFA), and mechanical axis deviation (MAD), lower limb rotation, limb length discrepancy (LLD) were measured. The self-made scoring criteria were adopted to evaluate the degree of lower limb deformity of the patients.</p><p><strong>Results: </strong>All operations were successfully completed, and no complications such as nerve or vascular injury occurred. The adjustment time of the external fixator of the lower limb after operation was 28-46 days, with an average of 37.4 days. The wearing time of the external fixator ranged from 134 to 398 days, with an average of 181.5 days. Mild pin tract infections occurred in 2 limbs. The osteofascia","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 6","pages":"701-707"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369262","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":"[Comparison of muscle injury between piriformis muscle release and preservation in total hip arthroplasty via supercapsular percutaneously-assisted total hip approach].","authors":"Fengping Gan, Qibiao Zhang, Fulai Mo, Linjie Li, Fei Zheng, Xinxin Lin, Hao Qin","doi":"10.7507/1002-1892.202502039","DOIUrl":"10.7507/1002-1892.202502039","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effects of piriformis muscle release versus preservation in total hip arthroplasty (THA) via supercapsular percutaneously-assisted total hip (SuperPATH) approach on muscle injury.</p><p><strong>Methods: </strong>Forty-nine patients undergoing initial THA via SuperPATH approach between June 2022 and June 2023 were randomly divided into two groups, with 24 patients in trial group and 25 patients in control group. The trial group received piriformis muscle release intraoperatively, whereas the control group underwent muscle preservation. There was no significant difference in baseline data such as gender, age, body mass index, disease type, American Society of Anesthesiologists (ASA) grading, and preoperative muscle infiltration, muscle atrophy, muscle injury serological indicators, Harris score, <i>etc.</i> ( <i>P</i>>0.05). The incision length, operation time, intraoperative blood loss, total blood loss, hospital stay, preoperative and postoperative 1-day muscle injury serological indicators [including creatine kinase (CK) and lactic dehydrogenase (LDH)], and incidence of complications between two groups were recorded. Harris score was used to evaluate the recovery of hip joint function. MRI was used to evaluate the extent of hip muscle injuries (gluteus minimus, gluteus medius, piriformis, obturator internus, quadratus femoris), including tendon integrity, degree of muscle fat infiltration, and degree of muscle atrophy preoperative and 1 year postoperatively.</p><p><strong>Results: </strong>The operation time, intraoperative blood loss, and total blood loss in the trial group were significantly shorter than those in the control group ( <i>P</i><0.05). There was no significant difference in the incision length and length of hospital stay between the two groups ( <i>P</i>>0.05). Both groups showed a significant increase in serum CK and LDH levels on postoperative day 1 compared to preoperative levels ( <i>P</i><0.05), but there was no significant difference between the two groups ( <i>P</i>>0.05). All patients were followed up, the follow-up time for the trial group and the control group was (14.8±2.8) and (15.1±3.0) months, respectively, with no significant difference ( <i>t</i>=-0.400, <i>P</i>=0.691). Incisions healed by first intention in both groups, with 1 case in the trial group and 2 cases in the control group experiencing venous thrombosis in the calf muscle space. There was no complication such as deep vein thrombosis, pulmonary embolism, hip dislocation, prosthesis loosening, or periprosthetic infection in the lower limbs. There was no significant difference in the incidence of complications between the two groups ( <i>P</i>>0.05). At 1 year after operation, both groups of patients showed a significant increase in Harris scores compared to preoperative levels ( <i>P</i><0.05), but there was no significant difference between the two groups ( <i>P</i>>0.05). Compared with preoperative results, ","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 6","pages":"715-722"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369315","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":"[Poster Fusion Cage combined with xenogeneic bone graft augmentation for bone defect management in distal radius fractures].","authors":"Yi Gao, Xiaomeng Ren, Chuyang Zeng, Longbo Du, Meng Li, Rui Ma, Wei Zhang","doi":"10.7507/1002-1892.202504038","DOIUrl":"10.7507/1002-1892.202504038","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of Poster Fusion Cage combined with xenogeneic bone graft augmentation for bone defect management in distal radius fractures.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 20 patients with bone defects complicating distal radius fractures who met the selection criteria and were treated between June 2022 and June 2024. The cohort comprised 2 males and 18 females, aged 54-87 years (mean, 63.3 years). Etiologies included falls in 17 cases, traffic accidents in 2 cases, and crush injury in 1 case. According to AO classification, there were 5 cases of type A, 8 cases of type B, and 7 cases of type C. The interval from injury to operation ranged from 2 to 10 days (mean, 5.8 days). All patients underwent volar plate fixation augmented with Poster Fusion Cage and demineralized xenogeneic bone matrix grafting. The operation time, intraoperative blood loss, fracture healing time, and postoperative complications were recorded. Radiographic parameters, including radial height, volar tilt, and ulnar deviation, were measured on standardized X-ray films obtained immediately postoperatively and at last follow-up, and whether secondary reduction loss occurred was judged. At last follow-up, wrist range of motion (extension, flexion, radial deviation, ulnar deviation, pronation, and supination) and grip strength (expressed as a percentage of the contralateral side) were measured. Wrist function was assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) score and Patient-Rated Wrist Evaluation (PRWE) score.</p><p><strong>Results: </strong>The operation time was 70-200 minutes (mean, 116.4 minutes), and the intraoperative blood loss was 10-80 mL (mean, 36.5 mL). All surgical incisions healed by first intention, with no neurovascular complications documented. All patients were followed up 9-12 months (mean, 11.6 months). All fractures healed normally, with a healing time of 8-14 weeks (mean, 9.95 weeks). No significant difference was observed in radial height, volar tilt, or ulnar deviation between immediate postoperatively and last follow-up ( <i>P</i>>0.05). All fractures achieved satisfactory reduction, with no secondary loss of reduction or implant failure occurring during follow-up. At last follow-up, the range of motion of the affected wrist joint was 60°-65° (mean, 62.5°) in extension, 67°-75° (mean, 71.1°) in flexion, 18°-23° (mean, 20.4°) in radial deviation, 28°-33° (mean, 30.1°) in ulnar deviation, 69°-80° (mean, 74.7°) in pronation, and 69°-82° (mean, 75.6°) in supination. Grip strength recovered to 75%-85% (mean, 80%) of the contralateral side. Functional scores showed a DASH score of 5-15 (mean, 9.4) and PRWE score of 8.0-12.5 (mean, 10.2).</p><p><strong>Conclusion: </strong>The combination of Poster Fusion Cage and xenogeneic bone graft augmentation provides a safe and effective treatment for bone defects in distal radius fractures.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 6","pages":"655-661"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369259","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 on treatment of complete radial tear of meniscus using arthroscopic All-inside single needle vertical suture technique].","authors":"Xinduo Tian, Yi Miao, Xin Liu, Wei Wang, Na Liu, Xuesong Zhang","doi":"10.7507/1002-1892.202502044","DOIUrl":"10.7507/1002-1892.202502044","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effectiveness of arthroscopic All-inside single needle vertical suture technique in treatment of complete radial tear of the meniscus.</p><p><strong>Methods: </strong>Between January 2019 and January 2022, 18 patients (18 knees) with complete radial tear of the meniscus were treated by using arthroscopic All-inside single needle vertical suture technique. Among them, there were 12 males and 6 females with an average age of 37.1 years (range, 16-50 years). The causes of radial meniscus tears included the sports injuries in 11 cases, sprains/falls in 4 cases, and traffic accident injuries in 3 cases. The interval between injury and operation was 3-25 days (mean, 11.7 days). All patients had knee joint pain. Knee joint tenderness and McMurray sign were both positive. MRI showed the 15 cases of lateral meniscus tear and 3 cases of medial meniscus tear; 15 cases of anterior cruciate ligament injury, 1 case of posterior cruciate ligament injury, and 15 cases of tibial plateau bone contusion. Six patients underwent isolated meniscus repair and 12 patients with cruciate ligament rupture underwent meniscus repair and simultaneous cruciate ligament reconstruction. The operation time and incidence of postoperative complications were recorded. At last follow-up, the meniscus healing was evaluated according to Barrett's criteria and knee joint MRI, respectively. Lysholm score and International Knee Documentation Committee (IKDC) score were used to evaluate the functional recovery of the knee joint.</p><p><strong>Results: </strong>The operation time was 19-28 minutes (mean, 23.3 minutes) in 6 patients with isolated meniscus repair and 38-52 minutes (mean, 45.8 minutes) in 12 patients with meniscus repair and simultaneous cruciate ligament reconstruction. All incisions healed by first intention. After operation, 1 patient developed the deep vein thrombosis of lower limb, the other patients had no complication. All patients were followed up 12-18 months (mean, 15.2 months). At last follow-up, 16 cases of meniscus reached clinical healing according to Barrett's criteria, with a healing rate of 88.9%. MRI re-examination of the knee joint showed that 5 cases had complete healing of the meniscus, 11 cases had partial healing, and 2 cases did not heal. The total healing rate (complete healing and partial healing) was 88.9%. After operation, the Lysholm score and IKDC score of 18 patients increased compared to preoperative scores, and further improved with time. The differences between different time points were significant ( <i>P</i><0.05). Six patients with isolated meniscus repair had the same changes in the above scores, and the differences between the different time points were significant ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>The arthroscopic All-inside single needle vertical suture technique can achieve good short-term effectiveness in the treatment of complete radial tears of the meniscus.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 5","pages":"550-555"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080883","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":"[Treatment of irreducible intertrochanteric femoral fracture in elderly with proximal femoral nail antirotation combined with minimally invasive clamp reduction technique by Kocher pincers].","authors":"Hongwei Tang, Yong Yin, Yinhua Ma","doi":"10.7507/1002-1892.202503024","DOIUrl":"10.7507/1002-1892.202503024","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the effectiveness of proximal femoral nail antirotation (PFNA) combined with minimally invasive clamp reduction technique by Kocher pincers in the treatment of irreducible intertrochanteric femoral fracture in the elderly.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The clinical data of 35 elderly patients with irreducible intertrochanteric femoral fractures who were treated with PFNA combined with minimally invasive clamp reduction technique by Kocher pincers between January 2016 and December 2022 were retrospectively analysed. There were 16 males and 19 females, aged from 63 to 95 years (mean, 75.2 years). The causes of injury included traffic accident in 3 cases and falling in 32 cases. The time from injury to operation was 2-11 days (mean, 3.6 days). According to AO/Orthopaedic Trauma Association (AO/OTA) classification system for intertrochanteric fractures, there were 14 cases of type A1, 18 cases of type A2, and 3 cases of type A3. According to the displacement of fracture by intraoperative fluoroscopy, there were 5 cases with only coronal displacement, 17 cases with only sagittal displacement, and 13 cases with both coronal and sagittal displacement. The operation time, intraoperative blood loss, rate of hemoglobin decline at 1 day after operation, length of hospital stay, and fracture healing time were recorded. The reduction quality of fracture during operation was evaluated according to reduction quality criteria proposed by Chang &lt;i&gt;et al.&lt;/i&gt; The Harris scoring system was used to evaluate the hip joint function at last follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The operation time was 45-105 minutes (mean, 54.4 minutes); the intraoperative blood loss was 80-300 mL (mean, 116.3 mL). The reduction quality of fracture during operation was good in 22 cases (62.9%) and acceptable in 13 cases (37.1%). The rate of hemoglobin decline at 1 day after operation ranged from 6.2% to 18.6% (mean, 10.2%); the length of hospital stay was 5-18 days (mean, 7.2 days). One case died of respiratory failure due to pulmonary infection, 2 cases were lost to follow-up, and the remaining 32 cases were followed up 6-24 months (mean, 10.6 months). All 32 patients achieved bony union and the healing time was 3-9 months (mean, 3.6 months). There was no complication such as incision infection, internal fixation failure, or coxa varus during follow-up. At last follow-up, the Harris score of hip joint was 67-96 (mean, 88.9); among them, 19 cases were excellent, 10 cases were good, 2 cases were fair, and 1 case was poor, with an excellent and good rate of 90.6%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;For the elderly patients with irreducible intertrochanteric femoral fracture, the application of PFNA combined with minimally invasive clamp reduction technique by Kocher pincers can achieve high-quality fracture reduction, which has the advantages of simple reduction operation, less trauma, and can avoid the radiation exposure of operators durin","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 5","pages":"536-541"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080954","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":"[Hair transplantation in wound healing and scar repair in special areas].","authors":"Zhewei Huang, Xifei Qian, Yanwen Xu, Samuel Tumaini Kaindi, Collins Daniel Pakaya, Jufang Zhang","doi":"10.7507/1002-1892.202502051","DOIUrl":"10.7507/1002-1892.202502051","url":null,"abstract":"<p><strong>Objective: </strong>To review recent advances in the application of hair transplantation in wound healing and scar repair in special areas.</p><p><strong>Methods: </strong>An extensive review of the literature on the application of hair transplantation in wound healing and scar repair in special areas was conducted, focusing on cellular functions, molecular mechanisms, and clinical applications.</p><p><strong>Results: </strong>Hair transplantation has been shown to effectively promote wound healing and scar repair in special areas. The underlying mechanisms are complex, but current understanding emphasizes a strong association with hair follicle-associated stem cells (including epidermal stem cells, dermal papilla cells, dermal sheath cells, <i>etc</i>).</p><p><strong>Conclusion: </strong>The application of hair transplantation in wound healing and scar repair in special areas remains in its early stages. Further investigation into its mechanisms of action is essential, and randomized controlled trials are needed to establish its efficacy.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 5","pages":"647-654"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080690","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":"[Impact of surgical timing on effectiveness of closed reduction and percutaneous Kirschner wire fixation for pediatric supracondylar humerus fractures].","authors":"Tianlong Pan, Xianghua Hou, Jingdong Zhang","doi":"10.7507/1002-1892.202503106","DOIUrl":"10.7507/1002-1892.202503106","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effectiveness of early versus delayed closed reduction and percutaneous Kirschner wire fixation in the treatment of pediatric supracondylar humerus fractures.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 468 children with supracondylar humerus fractures, who were admitted between January 2020 and December 2023 and met the inclusion criteria. Among them, 187 children were treated during 12 hours after injury (early operation group) and 281 were treated after 12 hours (delayed operation group). There was no significant difference between the two groups ( <i>P</i>>0.05) in the gender, age, injury mechanism, fracture side and type, while there was significant difference in interval from injury to operation ( <i>P</i><0.05). The operative outcomes, including the operation time, intraoperative blood loss, the length of hospital stay, fracture healing time, elbow function assessed by Flynn criteria at 3 months after operation, and complications, were compared.</p><p><strong>Results: </strong>Compared to the delayed operation group, the early operation group demonstrated significantly shorter operation time and less intraoperative blood loss ( <i>P</i><0.05). There was no significant difference in the length of hospital stay between the two groups ( <i>P</i>>0.05). All children were followed up 3-12 months. The follow-up time was (6.7±2.9) months in the early operation group and (6.9±2.8) months in the delayed operation group, showing no significant difference between the two groups ( <i>P</i>>0.05). There was no significant difference in the fracture healing time between the two groups ( <i>P</i>>0.05). At 3 months after operation, the early operation group exhibited superior Flynn elbow functional outcomes to the delayed operation group ( <i>P</i><0.05). In the early operation group, there was 1 case of fracture non-union and 3 cases of cubital varus deformity after operation. In the delayed operation group, there was 1 case of nerve injury, 7 cases of fracture non-union, and 12 cases of cubital varus deformity after operation. There was significant difference in the incidence of complications between the two groups ( <i>P</i><0.05). One case of the early operation group and 10 cases of the delayed operation group underwent secondary operation, showing no significant difference in the incidence of secondary operation between the two groups ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>For pediatric supracondylar humerus fractures, early closed reduction and percutaneous Kirschner wire fixation can reduce operation time, minimize intraoperative blood loss and postoperative complications, and improve the functional recovery compared to delayed operation.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 5","pages":"569-573"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080694","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":"[Application of intermediate screw assisted reduction and fixation technique in treatment of Schatzker type <b>Ⅴ</b> and <b>Ⅵ</b> tibial plateau fractures].","authors":"Zhaodong Wang, Keyou Duan, Yajun Liu, Chen Xu, Zhonglian Zhu, Pinghui Zhou, Jianzhong Guan","doi":"10.7507/1002-1892.202412051","DOIUrl":"10.7507/1002-1892.202412051","url":null,"abstract":"<p><strong>Objective: </strong>To explore effectiveness of intermediate screw assisted reduction and fixation technique in the treatment of Schatzker type Ⅴ and Ⅵ tibial plateau fractures.</p><p><strong>Methods: </strong>A clinical data of 22 patients with Schatzker type Ⅴ and Ⅵ tibial plateau fractures, who were admitted between June 2022 and December 2023 and met the selection criteria, was retrospectively analyzed. During operation, the intermediate screw assisted reduction and fixation technique was used. There were 14 males and 8 females with an average age of 46.3 years (range, 17-65 years). The fractures were caused by traffic accident in 13 cases, by falls in 5 cases, and by falling from height in 4 cases. According to Schatzker classification criteria, 9 cases were type Ⅴ and 13 cases were type Ⅵ. The interval between injury and operation was 5-12 days (mean, 7.9 days). The operation time, intraoperative fluoroscopy times, and length of hospital stay were recorded. The range of motion of knee joint and Hospital for Special Surgery (HSS) score were recorded at last follow-up. X-ray films were taken to review the fracture healing. Rasmussen score, tibial plateau varus angle (TPVA), and posterior tibial slope (PTS) were estimated before operation, at immediate after operation, and at last follow-up in order to evaluate the fracture reduction effect and postoperative outcome.</p><p><strong>Results: </strong>The operation time was 85-140 minutes (mean, 103.9 minutes). Intraoperative fluoroscopy was performed 7-15 times (mean, 10.1 times). All incisions healed by first intention after operation, and no complication such as nerve or blood vessel injury occurred. The length of hospital stay ranged from 8 to 17 days (mean, 12.4 days). All patients were followed up 10-22 months (mean, 14.8 months). At last follow-up, the range of motion of knee joint was 110°-140° (mean, 125°). HSS score was rated as excellent in 16 cases, good in 5 cases, and fair in 1 case, with an excellent and good rate of 95.5%. X-ray films reexamination showed that all fractures healed with the healing time of 12-17 weeks (mean, 14.8 weeks). No internal fixation failure occurred. Rasmussen score, TPVA, and PTS at immediate after operation and at last follow-up were significantly superior to those before operation ( <i>P</i><0.05). And there was no significant difference between immediately after operation and last follow-up ( <i>P</i>>0.05).</p><p><strong>Conclusion: </strong>The treatment of Schatzker type Ⅴ and Ⅵ tibial plateau fractures with intermediate screw assisted reduction and fixation technique is reliable, which can reduce the difficulty of reduction and fixation, improve the efficiency of reduction and fixation, reduce the operation time, achieve satisfactory reduction and fixation effect and postoperative prognosis, and achieve good recovery of knee joint function.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 5","pages":"529-535"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080879","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":"[Biomechanical advantages of personalized Y-shaped plates in treatment of distal humeral intra-articular fractures].","authors":"Hao Yu, Jiachen Peng, Jibin Yang, Lidan Yang, Zhi Xu, Chen Yang","doi":"10.7507/1002-1892.202503066","DOIUrl":"10.7507/1002-1892.202503066","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the biomechanical properties of personalized Y-shaped plates with horizontal plates, vertical plates, and traditional Y-shaped plates in the treatment of distal humeral intra-articular fractures through finite element analysis, and to evaluate their potential for clinical application.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study selected a 38-year-old male volunteer and obtained a three-dimensional model of the humerus by scanning his upper limbs using a 64-slice spiral CT. Four types of fracture-internal fixation models were constructed using Mimics 19.0, Geomagic Wrap 2017, Creo 6.0, and other software: horizontal plates, vertical plates, traditional Y-shaped plate, and personalized Y-shaped plate. The models were then meshed using Hypermesh 14.0 software, and material properties and boundary conditions were defined in Abaqus 6.14 software. AnyBody 7.3 software was used to simulate elbow flexion and extension movements, calculate muscle strength, joint forces, and load torques, and compare the peak stress and maximum displacement of the four fixation methods at different motion angles (10°, 30°, 50°, 70°, 90°, 110°, 130°, 150°) during elbow flexion and extension.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Under dynamic loading during elbow flexion and extension, the personalized Y-shaped plate exhibits significant biomechanical advantages. During elbow flexion, the peak internal fixation stress of the personalized Y-shaped plate was (28.8±0.9) MPa, which was significantly lower than that of the horizontal plates, vertical plates, and traditional Y-shaped plate ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). During elbow extension, the peak internal fixation stress of the personalized Y-shaped plate was (18.1±1.6) MPa, which was lower than those of the other three models, with significant differences when compared with horizontal plates and vertical plates ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). Regarding the peak humeral stress, the personalized Y-shaped plate model showed mean values of (10.9±0.8) and (13.1±1.4) MPa during elbow flexion and extension, respectively, which were significantly lower than those of the other three models ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). Displacement analysis showed that the maximum displacement of the humerus with the personalized Y-shaped plate during elbow flexion was (2.03±0.08) mm, slightly higher than that of the horizontal plates, but significantly lower than that of the vertical plates, showing significant differences ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). During elbow extension, the maximum displacement of the humerus with the personalized Y-shaped plate was (1.93±0.13) mm, which was lower than that of the other three models, with significant differences when compared with vertical plates and traditional Y-shaped plates ( &lt;i&gt;P&lt;/i&gt;&lt;0.05). Stress contour analysis showed that the stress of the personalized Y-shaped plate was primarily concentrated at the bifurcation of the Y-shaped structure. Displacement contour analysis showed that the personalized Y-shaped plate effe","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 5","pages":"574-583"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080880","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":"[Treatment of cervical ossification of the posterior longitudinal ligament using ultrasonic bone scalpel-assisted anterior controllable antedisplacement and fusion].","authors":"Hongwei Fu, Nenghua Yuan, Siying Chen, Ansu Wang, Lin Chen","doi":"10.7507/1002-1892.202503004","DOIUrl":"10.7507/1002-1892.202503004","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the technical key points and effectiveness of ultrasonic bone scalpel-assisted anterior controllable antedisplacement and fusion (ACAF) for treating cervical ossification of the posterior longitudinal ligament (OPLL).</p><p><strong>Methods: </strong>Between June 2022 and December 2024, 11 OPLL patients underwent ultrasonic bone scalpel-assisted ACAF. The cohort included 8 males and 3 females, aged 49-74 years (mean, 56.7 years). The OPLL classification included 5 cases of mixed-type, 4 cases of segmental-type, and 2 cases of continuous-type cases. Ossification involved 2-5 spinal segments (mean, 3.2). Disease duration ranged from 2 to 18 months (mean, 6.2 months). The operation time, intraoperative blood loss, and complications were recorded. Pain improvement was assessed using the visual analogue scale (VAS) score, and neurological function was evaluated using Japanese Orthopaedic Association (JOA) score. Postoperative cervical CT and MRI were performed to measure spinal canal encroachment rate, spinal canal area, and spinal cord sagittal diameter.</p><p><strong>Results: </strong>All operations were successfully completed. The operation time ranged from 174 to 360 minutes (mean, 255.9 minutes). The intraoperative blood loss ranged from 170 to 530 mL (mean, 345.9 mL). The C ₅ nerve root palsy occurred in 1 patient. No cerebrospinal fluid leakage, aggravated spinal cord injury, or recurrent/superior laryngeal nerve injuries occurred. All patients were followed 3-12 months (mean, 7.2 months). At last follow-up, VAS scores significantly decreased and JOA scores significantly increased compared to preoperative values ( <i>P</i><0.05). According to the JOA improvement rate, the effectiveness was rated as excellent in 2 cases, good in 8, and fair in 1, with an excellent and good rate of 90.9%. Radiological re-examination revealed no implant loosening, screw breakage, or aggravated spinal stenosis. Postoperative spinal canal encroachment rate significantly decreased, while spinal canal area and spinal cord sagittal diameter significantly increased compared to preoperative measurements ( <i>P</i><0.05).</p><p><strong>Conclusion: </strong>For the treatment of cervical OPLL via ACAF, the intraoperative application of ultrasonic bone scalpel-assisted osteotomy enables precise vertebral groove creation and mobilization of the vertebra-ossification complex, thereby enhancing surgical safety and achieving satisfactory short-term effectiveness.</p>","PeriodicalId":23979,"journal":{"name":"中国修复重建外科杂志","volume":"39 5","pages":"605-611"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080951","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}