Annali italiani di chirurgia最新文献

{"title":"Chylous Leakage after Endometrial Carcinoma Surgery: A Case Report.","authors":"Shanshan Li, Wenwen Li, An Zhang, Chongyi Yang, Jie Liu","doi":"10.62713/aic.3583","DOIUrl":"10.62713/aic.3583","url":null,"abstract":"<p><strong>Aim: </strong>This report represents a case of chylous leakage after endometrial carcinoma surgery, providing therapeutic insights into similar cases in future.</p><p><strong>Case presentation: </strong>This report describes a case of chylous leakage after endometrial carcinoma surgery. A 67-year-old woman with a 25-year of menopause was admitted to the hospital due to vaginal bleeding that had persisted for 5 days. She was diagnosed with high-grade serous carcinoma with partial sarcomatoid changes. Subsequently, she received surgical treatment for a malignant endometrial carcinoma, and chylous leakage occurred afterwards. A series of treatments were administered, eventually achieving satisfactory control over the patient's condition.</p><p><strong>Results: </strong>The patient was managed with a multidisciplinary approach, including conservative measures such as bowel rest, total parenteral nutrition, and octreotide to reduce chyle production. Despite initial conservative treatment, chylous leakage persisted, leading to the decision for surgical intervention. Post-surgery, the patient showed significant improvement, with cessation of chylous drainage, and she was eventually discharged with a plan for follow-up care.</p><p><strong>Conclusions: </strong>Chylous leakage after endometrial carcinoma surgery is a serious complication that requires timely diagnosis and comprehensive treatment. This case provides valuable therapeutic insights into treatment plans and ways to improve prognosis of patients grappling with the same condition.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 2","pages":"127-137"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Butorphanol Improves Anaesthesia Outcomes in Patients Undergoing Percutaneous Transforaminal Discectomy: A Single-Centre Study.","authors":"Jinli Che, Jizheng Zhang, Jiaming Zheng, Xiaohua Sun, Wanlu Ren","doi":"10.62713/aic.3968","DOIUrl":"https://doi.org/10.62713/aic.3968","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to analyze the effect of the preoperative use of butorphanol on patients who underwent percutaneous transforaminal endoscopic discectomy (PTED), providing additional insights into the selection of an anaesthesia regimen for PTED.</p><p><strong>Methods: </strong>The medical records of 106 patients who underwent PTED in our hospital from February 2021 to May 2023 were selected for retrospective analysis. The patients were divided into a reference group (n = 56; no preoperative medication) and a research group (n = 50; preoperative intravenous butorphanol) based on whether they were using butorphanol. Moreover, the anaesthesia sedation effects and pain levels at different moments in the two groups were compared.</p><p><strong>Results: </strong>The Ramsay Sedation Scale (RSS) scores of patients in the research group at Time (T) 1-4 were significantly higher than those of the reference group (p < 0.001). At 6 h postoperatively, the numerical rating scale (NRS) scores were significantly higher than preoperative scores in both groups (p < 0.001). The NRS scores of patients in the research group were significantly lower than those of the reference group at 6 h postoperatively (p < 0.001). Central venous pressure (CVP) and heart rate (HR) levels in the study group were significantly lower than those in the reference group at the T1-T4 stage, while percutaneous oxygen saturation (SpO₂) was significantly higher than that in the reference group (p < 0.05). However, no significant differences in respiratory rate and the incidence of intraoperative adverse reactions were observed between the two groups (p > 0.05). A significant difference in Iowa Surgery Anesthesia Satisfaction Scale (ISAS) scores exists between the two groups (p < 0.05).</p><p><strong>Conclusions: </strong>The preoperative use of butorphanol in patients undergoing PTED may effectively enhance intraoperative sedation and reduce postoperative pain.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 4","pages":"496-504"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Step Endodontic and Surgical Treatment of Large Periapical Lesions in the Maxilla: A Case Report.","authors":"Bartłomiej Karaś, Artur Pitułaj, Mariusz Szyba, Jacek Matys, Maciej Dobrzyński","doi":"10.62713/aic.3770","DOIUrl":"10.62713/aic.3770","url":null,"abstract":"<p><p>The aim of this article was to present a two-step procedure for treating two large periapical lesions located near the maxillary sinus. The first lesion measuring 7.1 mm by 6.1 mm by 5.9 mm was located around the apices of both upper right premolars and was perforating the alveolar bone. The second lesion, measuring 13.7 mm by 16.3 mm by 12.5 mm, was located around all the roots of the first upper right molar. The first step of the procedure involved single-session endodontic treatment. The second step involved endodontic microsurgery. To plan the microsurgery, a Cone Beam Computed Tomography image and an intraoral scan were taken, and a surgical guide was printed to enhance the outcome of the surgery. During the surgical procedure, a 3D-printed guide for the window preparation in the alveolar bone was created with a piezosurgery unit. Next, a microsurgical procedure under magnification with a microscope, retro-preparation, and retrofilling with bioceramic material and platelet rich fibrin were placed in the chamber after the apicectomy. A control cone-beam computed tomography (CBCT) taken 8 months after the treatment revealed full healing in the treated areas. Proper planning, novel technologies, biological approach and precise treatment allowed clinicians to successfully heal both periapical lesions.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"286-295"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Esketamine as an Adjuvant for Adductor Canal Block on Postoperative Pain in Patients Undergoing Arthroscopic Knee Surgery: A Randomized Controlled Trial.","authors":"Shilei Zhao, Zongqiong Lu, Shaoqiong Zhang, Jianhua Wang, Xinyi Ma, Yugang Diao, Huijuan Cao, Yingjie Sun","doi":"10.62713/aic.3775","DOIUrl":"10.62713/aic.3775","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the efficacy of esketamine as an adjuvant for adductor canal block (ACB) in alleviating postoperative pain in patients undergoing arthroscopic knee surgery.</p><p><strong>Methods: </strong>This single-center prospective randomized controlled trial enrolled 100 patients who underwent arthroscopic knee surgery at The General Hospital of Northern Theater Command of the Chinese People's Liberation Army from October 2022 to March 2023. Patients were randomly and evenly divided into four groups. Patients in the R group received ACB of 0.375% ropivacaine 20 mL before awakening, while patients in the L, M, and H groups received 0.375% ropivacaine 20 mL mixed with 20 mg, 30 mg, and 40 mg of esketamine respectively.</p><p><strong>Results: </strong>The sensory block duration of the M and H groups was significantly longer than that of the R group (p = 0.042 and p = 0.003, respectively). Immediately and 8 hours after surgery, the resting and motor pain scores of the M and H groups were significantly reduced (p < 0.05), while the L group also showed a significant decrease at 8 hours after surgery (p = 0.003 and p = 0.032, respectively). Immediately after surgery, subjects of the H group were more deeply sedated than those of both the R and L groups (p = 0.039 and p = 0.041, respectively). However, the recovery quality of group H one day after surgery was worse compared with the other three groups (p < 0.001, p = 0.001 and p = 0.030, respectively).</p><p><strong>Conclusions: </strong>Compared to the use of ropivacaine alone, esketamine adjuvant can prolong the duration of ACB and reduce early postoperative pain. However, high-dose esketamine affects the quality of postoperative recovery and increases the risk of adverse effects.</p><p><strong>Clinical trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR2200065236).</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 5","pages":"617-625"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Traumatic Splenic Rupture as a Life-threatening Clinical Manifestation Treatable with Splenectomy: A Study of Twelve Cases and Literature Review.","authors":"Jiachen Zhang, Genfei Zhu, Ling Liu, Sunbing Xu, Changku Jia","doi":"10.62713/aic.3767","DOIUrl":"10.62713/aic.3767","url":null,"abstract":"<p><strong>Aim: </strong>While most splenic ruptures manifest as immediate hemorrhage, a minority of patients experience delayed rupture, which occurs days to weeks after the initial trauma. Although there have been reports of delayed splenic rupture following trauma, the exact pathophysiology of this condition and the appropriate treatment remain contentious. This article aims to further discuss and summarize the diagnosis and treatment protocols for delayed traumatic rupture of the spleen through the collection and analysis of existing clinical data, combined with previous literature.</p><p><strong>Case presentation: </strong>From 2012 to 2023, we identified 12 adults admitted to a trauma center with delayed traumatic rupture of the spleen (DRS). After excluding unrelated cases, we focused on patients with a definitive DRS diagnosis. The majority were male, aged 46-90 years, with some having pre-existing conditions like cirrhosis or cancer. Most injuries were from falls or car accidents, occurring 2-7 days before admission. Five patients had additional traumatic injuries. All experienced left-side abdominal pain and were diagnosed using imaging. They received medical intervention to stabilize their condition, with initial hemoglobin levels slightly low.</p><p><strong>Results: </strong>Clinical data of 12 splenic rupture cases presenting with symptoms between 2 and 7 days after splenic trauma but without any pre-existing splenic pathology were collected from November 2012 to August 2023. Among these cases, 8 patients underwent splenectomy immediately following the diagnosis of delayed splenic rupture. For the remaining 4 patients, conservative treatment was initially attempted, but due to inadequate control of their condition, the treatment plan was subsequently altered to surgical intervention, yielding favorable clinical outcomes.</p><p><strong>Conclusions: </strong>Delayed splenic rupture is a disease caused by multiple factors. The atypical clinical manifestations of delayed rupture pose challenges to timely and accurate diagnosis, making computed tomography (CT) the preferred diagnostic method for delayed splenic rupture. Emergency surgical treatment is the optimal surgical approach for managing delayed splenic rupture.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"296-308"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A CBCT-Based Comparative Study of Alveolar Bone Parameters and Implant Outcomes Among Patients Suffering the Mandibular First and Second Molar Defects.","authors":"Zhibin Mai, Zilong Deng, Wanghong Zhao","doi":"10.62713/aic.3951","DOIUrl":"https://doi.org/10.62713/aic.3951","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the anatomical differences in the alveolar bone at edentulous sites of the mandibular first and second molars using cone-beam computed tomography (CBCT) and to assess their impact on implant outcomes, thereby providing clinical insights to improve implant success in the mandibular second molar region.</p><p><strong>Methods: </strong>A total of 504 patients with missing mandibular first or second molars were recruited in the Department of Stomatology at Foshan Fosun Chancheng Hospital between June 2020 and June 2023. These patients were divided into two groups: mandibular first molar loss (n = 226; as 'first-molar group') and mandibular second molar loss (n = 278; as 'second-molar group'). All patients underwent CBCT imaging, and measurements for parameters such as alveolar bone inclination, alveolar ridge width, and the distance from the alveolar crest to the mandibular canal were taken. Postoperative evaluations were conducted to assess deviations in the implant neck, apex, and insertion angle and to analyze the effect of anatomical parameters on implant outcomes in the mandibular second molar region.</p><p><strong>Results: </strong>There were no significant differences between the two groups in terms of sex, age, duration of tooth loss, presence of third molars, or smoking history (p > 0.05). The first-molar group exhibited significantly higher values for alveolar bone inclination, alveolar ridge width, and canal-crest distance compared to the second-molar group (p < 0.05). Immediately post-implantation, the neck deviation, apical deviation, and insertion angle deviation were all significantly lower in the first-molar group than in the second-molar group (p < 0.05). Six months postoperatively, the implant failure rate for the second-molar group (9.45%, p < 0.001) was significantly higher than that for the first-molar group (0.00%), along with greater marginal bone resorption (p < 0.001). Additionally, patients with failed implants in the mandibular second molar region showed significantly lower preoperative alveolar bone inclination than those with successful implants (p < 0.05).</p><p><strong>Conclusions: </strong>The second-molar group presents less favorable anatomical conditions, such as reduced canal-crest distance and increased alveolar bone inclination, which may contribute to greater implant deviation when placed freehand. These findings suggest a need for enhanced preoperative planning and surgical precision in this region. However, as these observations are based on CBCT measurements and not direct intraoperative evidence, further studies are needed to validate these findings. Lower alveolar bone inclination may be a key factor in implant failure, highlighting the critical importance of preoperative planning and surgical precision in mandibular second molar implant procedures.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 5","pages":"644-653"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Factors Affecting Plaque Formation after Peri-Implantitis and Incorporating Crucial Factors to Develop a Predictive Model: A Retrospective Cohort Study.","authors":"Yingjie Xu, Yue Feng, Zhengting Tang, Dezhao Yang, Fanwen Meng","doi":"10.62713/aic.3881","DOIUrl":"10.62713/aic.3881","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to explore the factors impacting implant plaque re-formation after implant polishing surgery for peri-implantitis and to establish a predictive model using crucial factors, thereby providing an evidence-based reference for managing this condition.</p><p><strong>Methods: </strong>This retrospective study analyzed clinical data from 203 patients who underwent implant polishing and shaping procedures in Suzhou Stomatological Hospital between November 2018 and October 2023. Study subjects were divided into a training set (n = 142) and a validation set (n = 61) in a 7:3 ratio. Univariate and multivariate logistic regression analyses were used to assess the risk factors associated with biofilm formation after implant polishing and shaping surgery. Incorporating significantly linked factors, a risk prediction model was developed. Furthermore, the predictive model was evaluated in the training and validation sets using the Hosmer-Lemeshow (H-L) goodness-of-fit test, Receiver Operating Characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) to determine its discriminatory capability, goodness-of-fit, and predictive utility.</p><p><strong>Results: </strong>Multivariate logistic regression analysis revealed that calculus [Odds Ratio (OR) = 3.071, 95% Confidence Interval (CI): 1.104-8.541, p = 0.032], difficult-to-clean implant location (OR = 5.807, 95% CI: 1.895-17.798, p = 0.002), external connection implant abutment (OR = 4.378, 95% CI: 1.440-13.308, p = 0.009), and implant diameter (OR = 4.511, 95% CI: 2.141-9.504, p < 0.001) were significant factors affecting biofilm formation after implant polishing and shaping surgery. A regression equation (predictive model) was constructed, incorporating the four crucial risk factors and regression coefficients. ROC curve analysis demonstrated that the area under curve (AUC) of the predictive model was 0.9143 (95% CI: 0.8221-0.9782) in the training set and 0.8095 (95% CI: 0.7342-0.9051) in the validation set. Furthermore, the Hosmer-Lemeshow test indicated a good fit of the established model, with no statistically significant difference between predicted and observed values in both the training set (p = 0.399) and the validation set (p = 0.317). Additionally, DCA demonstrated that the predictive model provides a significant net benefit.</p><p><strong>Conclusions: </strong>The predictive model developed using the key risk factors contributing to plaque formation after implant polishing exhibits strong predictive capability, which provides an evidence-based reference in preventing and managing postoperative plaque formation.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"391-399"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Treatment of a Huge Epiphrenic Esophageal Diverticulum: A Case Report and Literature Review.","authors":"Agostino Fernicola, Giuseppe Palomba, Marianna Capuano, Giovanni Domenico De Palma, Giovanni Aprea","doi":"10.62713/aic.3802","DOIUrl":"10.62713/aic.3802","url":null,"abstract":"<p><strong>Aim: </strong>Epiphrenic diverticulum (ED) is a rare benign esophageal disorder commonly associated with esophageal motility conditions, such as achalasia. Esophagogastroduodenoscopy (EGDS), barium esophagography, and esophageal high-resolution manometry (HRM) are essential for accurate diagnosis. Surgical intervention is the standard treatment for symptomatic patients.</p><p><strong>Case presentation: </strong>We present the case of a 61-year-old man with a large epiphrenic diverticulum presenting with dysphagia and chest pain. Medical therapy was ineffective; therefore, the patient underwent laparoscopic diverticulectomy, hiatoplasty, Heller myotomy, and Dor fundoplication.</p><p><strong>Results: </strong>Complete resolution of symptoms was achieved, significantly improving the patient's quality of life, with no perioperative complications.</p><p><strong>Conclusions: </strong>The diagnosis and management of epiphrenic diverticula require a multidisciplinary approach. Abdominal laparoscopic surgery is a safe and effective option, with a low risk of complications and good symptom resolution.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"322-328"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Pterygium Excision Combined with Autologous Limbal Stem Cell Transplantation on Microvascular Density, Tear Film Stability, and Corneal Wound Healing.","authors":"Mengxuan He, Na Li, Jingjing Li, Xiaobo Huang","doi":"10.62713/aic.3800","DOIUrl":"10.62713/aic.3800","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the impact of pterygium excision combined with autologous limbal stem cell transplantation on microvascular density, tear film stability, and corneal wound healing in the management of pterygium.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 317 patients with pterygium who underwent treatment between January 2021 and January 2024. Patients were divided into a control group (pterygium excision alone, n = 161) and a study group (pterygium excision combined with autologous limbal stem cell transplantation, n = 156) based on the surgical approach. The study compared the surgical efficacy, perioperative outcomes, and corneal healing between the two groups. Preoperative and postoperative changes in conjunctival microvascular density, tear film stability indicators, and ocular comfort scores were also assessed.</p><p><strong>Results: </strong>The effective treatment rate was significantly higher in the study group compared to the control group (p < 0.05). Postoperative uncorrected visual acuity, vertical corneal curvature, and horizontal corneal curvature were significantly better in the study group, whereas corneal astigmatism was lower than in the control group (p < 0.05). The postoperative levels of pigment epithelial derived factor (PEDF) were higher in the study group, while levels of vascular endothelial growth factor (VEGF) and microvascular density (MVD) were lower than in the control group (p < 0.05). Corneal healing scores on postoperative days 1, 3, and 7 were lower in the study group than in the control group, and the time resolution of corneal wound congestion and corneal epithelial coverage was significantly shorter compared to the control group (p < 0.05). Tear film stability, as indicated by the Schirmer I test (SIt) and tear breakup time (BUT), was improved in the study group than that in the control group (p < 0.05). Postoperative ocular comfort scores were lower in the study group compared to the control group (p < 0.05). No significant difference in postoperative complication rates was observed between the groups (p > 0.05).</p><p><strong>Conclusions: </strong>Pterygium excision combined with autologous limbal stem cell transplantation effectively inhibits angiogenesis, improves visual function, enhances tear film stability, and accelerates corneal wound healing, making it a superior treatment option for pterygium.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 1","pages":"47-54"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Significance of MRI-Based Measurements of Tibial Plateau Widening Width and Joint Fluid Volume During Anterior Cruciate Ligament Injuries Among Patients With Tibial Plateau Fractures.","authors":"Qinglin Shi, Gang Yang, Juan Du","doi":"10.62713/aic.3899","DOIUrl":"10.62713/aic.3899","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to explore the diagnostic value of magnetic resonance imaging (MRI)-based tibial plateau widening width (TPW) and joint effusion volume during anterior cruciate ligament (ACL) injuries among patients with tibial plateau fractures.</p><p><strong>Methods: </strong>This retrospective study collected clinical data from 100 patients with tibial plateau fractures admitted between February 2022 and February 2024. The findings from arthroscopy or surgical intervention served used as the \"gold standard\". Based on the ACL injury, patients were divided into the injury group (62 cases) and the control group (38 cases). General data were compared between the two groups. Furthermore, TPW and joint effusion were assessed using MRI outcomes, and the diagnostic value of these indices in ACL injury was evaluated. Additionally, the diagnostic efficacy of these indices was assessed using the Receiver Operating Characteristic (ROC) curve, Area Under Curve (AUC), sensitivity, and specificity. Moreover, patients were followed-up for three months after surgery, and the relationship between postoperative knee function recovery, TPW, and joint effusion was evaluated.</p><p><strong>Results: </strong>The injury group demonstrated a significantly higher TPW than the control group (p < 0.001). Similarly, the joint effusion volume was significantly greater in the injury group compared to the control group (p < 0.01). The AUC of TPW was 0.826 (95% confidence interval (CI): 0.745-0.906), with a sensitivity of 66.10% and a specificity of 89.50%. However, the AUC of joint effusion was 0.691 (95% CI: 0.579-0.803), with a sensitivity of 85.50% and a specificity of 52.60%. Furthermore, the AUC of the joint index was 0.864 (95% CI: 0.793-0.936), with a sensitivity of 80.60% and a specificity of 86.80%. Additionally, correlation analysis revealed a negative correlation between TPW (r = -0.355, p < 0.001), joint effusion (r = -0.375, p < 0.001), and postoperative knee function recovery.</p><p><strong>Conclusions: </strong>MRI-measured TPW and joint effusion volume hold significantly diagnostic value in assessing ACL injuries associated with tibial plateau fractures and correlate with the patient's postoperative knee functional recovery. These metrics may provide clinicians with important diagnostic and prognostic insights and help formulate individualized treatment plans.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"400-408"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}