Objective To evaluate the effect of sensory disturbance after the sagittal split ramus osteotomy (SSRO）on quality of life. Methods From September2004 to September 2005, 21 patients undergoing SSRO were studied by using questionnaires. There were 12 males and 9 females, aging 1927 years(mean 22.6 years).The patients were followed up at 4 weeks and 24 weeks after operation. The subjective questionnaire was completed by patient to evaluate the degree of living quality descending. Results At 4 weeks,19(90.48%) patients’ living quality descended because of postoperative sensory disturbance. Among them, 7(33.33%) patients had severe descending of living quality. The average effecting time of living accounted for total time 26.9%(about 6.5 h/d). At 24 weeks, 12(6316%) patients’ living quality descended because of postoperative sensory disturbance, 7(36.84%) patients could achieve preoperative living quality. The average effecting time of living accounted for total time 15.5%(about 3.7 h/d). Conclusion Most patients have descending of living quality after SSRO because of sensory disturbance. However, this condition can be improved during the followup and more than 1/3 patients canachieve their preoperative living quality.
Thirty cases of mandibular deformities undergoing sagittal splitting ramus osteotomy for their corrections were presented. The surgical precedure was carefully designed according to each individual deformity before operation, After treatment, the facial configuration and the function of occlusion were markedly improved. There was no non-union of the osteotomy and no recurrence of the deformity after correction. Complications happened in 4 cases and were all improved following treatment. The planning and techniques of the operation were discussed in detailed.
Crouzon s syndrome is one of the craniofacial dysostosis. It not only presents midface retrusion but also obstructs the air way. There were much more effective changes on speech and velopharyngeal function following LeFort Ⅲ maxillary advancement. In our study, 9 cases underwent maxillary advancement in the last seven years. All patients in this series underwent serial cephalometric study before and after maxillary advancement. The results showed that the distance from the posterior nasal spine to the posterior pharyngeal wall on the posterior pharyngeal wall on the lateral cephalograms reached 18.89mm which was 9.30mm more larger than that of the preoperative distance in average.The angle formed by the soft palate and the hard palate reached 159.4 degree which was 16 degree larger than the preopertive angle 144.6 degree. Clinically, improvement of phonation was very obvious.
The symptomatic subluxation of hip is not uncommon in adults, and several kinds of surgical options are available. Twenty-six patients (26 hips) suffering from residual symptomatic subluxation of the hip were treated with innominate osteotomy during 1985 to 1991. The patients were followed-up for 4 to 9 years. The ages of the patients ranged from 22 to 38 years with an average of 26 years and 6 months. The duration of symptoms ranged from 3 to 6 years with an average of 3 years and 5 months. The pertinent prior diseases were the congenital dislocation of hip in 12 cases, Perthes disease in 10 cases, and in the remaining 4 cases, the causes were not identified. The indications for operative intervention were that presence of a reasonable articular cartilaginous space, a reasonable range of motion preserved and particularly a reasnable joint congruity must exist. A new method of re-alignment of the acetabulum was used to placing the ipsilateral foot on the contralateral thigh. The result was evaluated by the symptoms, the function of the hip and the radiographic findings. According to these criteria, the excellent results were obtained in 11 cases and the good result in 15 cases. It was suggested that the innominate osteotomy were also suitable for the treatment of residual symptomatic subluxation of hip in carefully selected adults and the new method of re-alignment of acetabulum was simple and effective.
Objective To review the research progress of surgical methods of osteotomy around the knee in the treatment of valgus knee osteoarthritis. MethodsThe relevant literature on the surgical treatment of valgus knee osteoarthritis at home and abroad in recent years was reviewed, and the advantages, disadvantages, and effectiveness of different surgical methods of osteotomy around the knee were summarized. Results For young and active patients with symptomatic valgus knee osteoarthritis, osteotomy around the knee is a safe and reliable treatment option. At present, the main surgical methods include medial closing wedge distal femoral osteotomy, lateral opening wedge distal femoral osteotomy, medial closing wedge high tibial osteotomy, and lateral opening wedge high tibial osteotomy. The indications, advantages, and disadvantages of different osteotomies are different, and the selection of appropriate surgical method is the key to achieve good effectiveness. ConclusionThere are many osteotomies in the treatment of valgus knee osteoarthritis. In order to achieve good results, improve survival rate, and reduce postoperative complications, the most reasonable surgical strategy needs to be developed according to different situations.
Objective To assess the effect of medial distal femoral osteotomy combined with interlocking nailing on the treatment of knee osteoarthritis with valgus deformity. Methods From May 1996 toAugust 2000, 16 patients with knee osteoarthritis accompanied by valgus deformity were treated by medial wedged distal femoral osteotomy combined with interlocking nailing. Full-length radiographs were taken before operation and 8 weeks and 2 years after operation. The parameters, including the femorotibial angle, the tibial angle, the femoral angle, the femoral condyletibial plateau angle, and the lateral joint space, were measured by these radiographs. The function of knee was evaluated by the 100 point rating scale standard of knee. Results The mean postoperative score was significantly improved from 50.4±15.9 points to 78.5±12.9 points 2 years after the surgery. The lateraljoint space was increased from 2.1±1.8 mm to 4.7±1.7 mm and the femoral condyletibial angle decreased from 5.6±2.9° to 1.6±3.4°. There were complications in 2 cases: 1 case of delayed union and 1 case of superficial wound infection. Conclusion Medial distal femoral osteotomy combined with interlocking nailing proves to be an effective approach to treat knee osteoarthritis with valgus deformity.
ObjectiveTo investigate the early effectiveness of artificial intelligence (AI) assisted total hip arthroplasty (THA) system (AIHIP) in the treatment of patients with Crowe type Ⅳ developmental dysplasia of the hip (DDH).MethodsThe clinical data of 23 patients with Crowe type Ⅳ DDH who met the selection criteria between May 2019 and December 2020 were retrospectively analyzed. There were 3 males and 20 females, the age ranged from 44 to 74 years, with an average of 52.65 years. The absolute value of the lower limbs discrepancy before operation was (15.17±22.17) mm. The preoperative Harris score was 62.4±7.2. The AIHIP system was used for preoperative planning, and the operations were all performed via conventional posterolateral approach. Thirteen patients with difficulty in reduction during operation underwent subtrochanteric shortening osteotomy (SSOT). The operation time, hospital stay, and adverse events were recorded; Harris score was used to evaluate the function of the affected limb at 1 day before operation and 1 week and 6 months after operation; pelvic anteroposterior X-ray film was taken at 1 day after operation to evaluate the position of the prosthesis. The matching degree of prosthesis was evaluated according to the consistency of intraoperative prosthesis model and preoperative planning.ResultsThe matching degree of acetabular cup model after operation was 16 cases of perfect matching, 4 cases of general matching (1 case of +1, 3 cases of –1), and 3 cases of mismatch (all of them were +2), the coincidence rate was 86.96%. The matching degree of femoral stem model was perfect matching in 22 cases and general matching in 1 case of –1, and the coincidence rate was 100%. One patient had a periprosthesis fracture during operation, and was fixed with a wire cable during operation, and walked with the assistance of walking aid at 6 weeks after operation; the rest of the patients walked with the assistance of walking aid at 1 day after operation. The operation time was 185-315 minutes, with an average of 239.43 minutes; the hospital stay was 8-20 days, with an average of 9.96 days; and the time of disengagement from the walking aid was 2-56 days, with an average of 5.09 days. All patients were followed up 6 months. All incisions healed by first intension, and there was no complication such as infection, dislocation, refracture, and lower extremity deep venous thrombosis; X-ray films at 1 day and 6 months after operation showed that the acetabular and femoral prostheses were firmly fixed and within the safe zone; the absolute value of lower limbs discrepancy at 1 day after operation was (11.96±13.48) mm, which was not significantly decreased compared with that before operation (t=0.582, P=0.564). All osteotomies healed at 6 months after operation. The Harris scores at 1 week and 6 months after operation were 69.5±4.9 and 79.2±5.7 respectively, showing significant differences between pre- and post-operation (P<0.05). At 6 months after operation, the hip function was evaluated according to Harris score, and 13 cases were good, 9 cases were fair, and 1 case was poor.ConclusionAIHIP system-assisted THA (difficult to reposition patients combined with SSOT) for adult Crowe type Ⅳ DDH has high preoperative planning accuracy, easy intraoperative reduction, early postoperative landing, and satisfactory short-term effectiveness.