BJECTIVE: To study the effect of transposition of great adductor muscular tendon pedicled vessels in repairing the medial collateral ligament defect of knee joint. METHODS: From September 1991 to September 1999, on the basis study of applied anatomy, 30 patients with the medial collateral ligament defect were repaired with great adductor muscular tendon transposition pedicled vessels. Among them, there were 28 males and 2 females, aged 26 years in average. RESULTS: Followed up for 17 to 60 months, 93.3% patients reached excellent or good grades. No case fell into the poor grade. CONCLUSION: Because the great adductor muscular tendon is adjacent to the knee joint and similar to the knee ligament, it is appropriate to repair knee ligament. Transposition of the great adductor muscular tendon pedicled vessels is effective in the reconstruction of the medial collateral ligament defect of knee joint.
Based on the anatomical studies, the authors had designed an operation for treating old dorsal subluxation of the inferior radio-ulnar joint.The periosteum was longitudinally incised at the dorsal side of the lower ulna. forming musculo-periosteal flap, and a periosteal flap, and a periosteal valves of pronator quadratus. They were subluxation, passing the flap from palmar to the dorsal side through thc subperiosteal tunnel at the lateral margin of the radius corresponding to the ulna. Then it was circled round the lower end on the ulna and sutured to the muscular flap and the tough interosseous membranes at the palmar side, being used to stabilize the recuperated dorsal subluxation of the inferior radio-ulnar joint. The result of its clinical use was satifying.
【摘要】 目的 了解青年早期宫颈癌患者在卵巢移位术后的卵巢功能。 方法 2001年1月-2009年12月收治53例年龄26~40岁宫颈癌Ⅰb~Ⅱa期患者，其中27例在宫颈癌根治术中行卵巢移位术为观察组，26例行宫颈癌根治术切除双侧卵巢的为对照组。术后应用血清卵泡刺激素（FSH）、黄体生成激素（LH）、雌二醇（E2），B超及Kuppermann评分进行卵巢功能测定，随访1~4年。 结果 观察组术后4年内卵巢功能基本正常，对照组术后1个月卵巢功能丧失。观察组术后4年内血FSH、LH、E2及Kuppermann评分与对照组比较有显著性意义（Plt;0.05）；两组复发率比较无显著性意义（P gt;0.05）。 结论 青年早期宫颈癌患者在宫颈癌根治术中行卵巢移位术对其卵巢功能无明显影响。【Abstract】 Objective To investigate the function of ovary after ovarian transposition among young patients with early-stage cervical cancer. Methods A total of 53 young females (26-40 years old) with early stage cervical cancer (FIGO ⅠB or ⅡA) from January 2001 to December 2009. Ovarian transposition was performed at the same time of radical hysterectomy and pelvic lymphadenectomy on 27 patients who were the experimental group. Radical hysterectomy and pelvic lymphadenectomy was done without ovarian transposition on other 26 patients who were the control group. The function of ovarian was evaluated by serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), the ultrasound examination and Kuppermann score system in all patients during 1- 4 years’ follow-up. Results The patients in the control group became climacteric in one month after the operation. However, among the patients in the experimental group, their normal ovarian function was preserved within 1- 4 years’ follow-up. There was statistically significant difference between the experimental group and the control group regarding to serum E2, FSH, LH level and Kuppermann score of the patients (Plt;0.05). However, there was no statistically significant difference between the two groups regarding to the recurrence rate (Pgt;0.05). Conclusion Ovarian transposition has statistical significant effect on protection of ovarian function in young patients with early stage cervical cancer, who undergoes radical hysterectomy and pelvic lymphadenectomy.
【摘要】目的探讨颌下腺移位术对预防急性放射性口腔黏膜反应及口干燥症的临床效果。方法2007年7月2009年6月间选择40例患者进行前瞻性临床对照研究。治疗组20例,在放疗前将颌下腺移位至颊下区。对照组20例不行颌下腺移位术。观察放疗中两组急性口腔黏膜反应,测定放疗前后唾液分泌量的变化,放疗后3个月进行口干燥程度问卷调查。结果治疗组急性口腔黏膜反应明显轻于对照组(Plt;0.05)。治疗组放疗后3个月移位术侧颌下腺摄取、排泌功能均明显较对照好,两组比较有统计学意义(Plt;0.05)。结论颌下腺移位术预防鼻咽癌放疗后口干燥症的临床近期疗效较好,可改善鼻咽癌患者放疗后的生活质量。
OBJECTIVE To investigate the therapeutical effect of treatment of ischemic necrosis of femoral head by the transfer of vascular pedicled iliac periosteum. METHODS From June 1983 to August 1997, 106 cases with ischemic necrosis of femoral head (II stage in 64 cases, III stage in 39 cases, IV stage in 3 cases) were treated by the transfer of vascular pedicled iliac periosteum with ascending branch of lateral femoral circumflex vessel or deep circumflex iliac vessel pedicle. RESULTS Followed up 2 years and 4 months to 16 years, there were excellent in 54 cases, better in 38 cases, moderate in 9 cases, poor in 5 cases, and 86.8% in excellent rate according to the criterion of the therapeutical effect on the repair and reconstruction of adult ischemic necrosis of femoral head. CONCLUSION Treating ischemic necrosis of femoral head by the transfer of vascular pedicled iliac periosteum has the advantage of constant pedicle, easily drawing materials and reliable therapeutical effect.
Objective To compare the effects and indications of total hip replacement(THR) and transplantation of vascularized bone graft in treating late ischemic necrosis of the femoral head.Methods From March 1986 to March 1993, 81 patients with late ischemic necrosis underwent treatment. Of 81 patients, 59 patients who suffered in unilateral hip were divided into 2 groups: 26 underwent total hip replacement and 33 underwent transplantation of vascularized bone graft. There was no significant difference in the Harris-scores of the two groups before operations (Pgt;0.05). The Harris hip scores were compared between different ages(＜30 years, 31.50 years, and ＞51 years) in two groups. Results The follow-up ranged from 10 years and 3 months to 16 years and 5 months (15 years and two months on average). The changes of Harrisscores of the two groups after operations had significant difference in initial stage（Plt;0.05）,but had no significant difference in the long term（Pgt;0.05）. The change of Harris-scores of patients who underwent total hip replacement had no significant difference between different ages （Pgt;0.05），but that of patients who underwent transplantation of vascularized bone graft had significant difference between different ages（Plt;0.05）. Both groupshad satisfactory effects in treating late ischemic necrosis of the femoral head. Conclusion Both methods are effective in treating late ischemic necrosis of the femoral head. Total hip replacement can be more effective insenior patients. Transplantation of vascularized bone can be more effective in young patients.
OBJECTIVE: To provide a series of surgical approaches for treatment of talus neck fracture, ischemic necrosis of talus body, and other bone lesions in ankle and foot. METHODS: The major blood supply to cuboid bone, medial cuneiform bone and navicular bone was observed in 30 adult cadavers, by infiltration of red emulsion via major arteries of the lower limbs. Based on these anatomical investigations, 3 types of vascularized tarsal bone grafting were designed for repair of bone lesions in the area of ankle and foot, and applied in 49 clinical cases, ranging from 10 to 58 years in age, and 43 cases of which were followed up for 4 years and 3 months in average. RESULTS: Primary healing was achieved in 40 cases, and secondary healing achieved after further surgical intervention in other 3 cases. The function of all ankle joints recovered satisfactorily. CONCLUSION: The designed three types of vascularized tarsal bone flaps are easy and reliable for dissection because of their superficial pedicles, and they are available for different clinical cases with various bone lesions in ankle and foot.
Objective To review the research progress of bone graft resorption after Latarjet procedure for the treatment of recurrent anterior shoulder dislocation, and provide a guide for further research on bone graft resorption. Methods The relevant literature in recent years was extensively reviewed. The pathogenesis, classification, risk factors, clinical function impact, and management of bone graft resorption after Latarjet procedure for the treatment of recurrent anterior shoulder dislocation were summarized. Results Bone graft resorption is the common complication after Latarjet procedure for the treatment of recurrent anterior shoulder dislocation. Stress shielding and poor blood supply may contribute to the occurrence of bone graft resorption. The absence of significant preoperative glenoid bone loss, open procedure, earlier graft healing may to be the risk factors for bone graft resorption. Various assessment methods and classification systems are used to evaluate the region and severity of bone graft resorption. Partial resorption may be considered as a natural glenoid remodeling process after the surgery, but severe and complete resorption is proved to be one of the reasons for failed procedures and there is no effective measure to prevent it, except for accepting revision surgery. Conclusion The pathogenesis, risk factors, clinical function impact of bone graft resorption after Latarjet procedure for the treatment of recurrent anterior shoulder dislocation has not been fully elucidated and there is a lack of effective management strategies, so further clinical and basic researches are needed.
ObjectiveTo provide anatomical basis for vascularized pisiform transfer in the treatment of advanced avascular necrosis of the lunate (Kienböck’s disease) by studying its morphology and blood supply pattern based on digital technique.MethodsTwelve adult fresh wrist joint specimens were selected and treated with gelatin-lead oxide solution from ulnar or radial artery. Then the three-dimensional (3D) images of the pisiform and lunate were reconstructed by micro-CT scanning and Mimics software. The morphologies of pisiform and lunate were observed and the longitudinal diameter, transverse diameter, and thickness of pisiform and lunate were measured. The main blood supply sources of pisiform were observed. The number, diameter, and distribution of nutrient foramina at proximal, distal, radial, and ulnar sides of pisiform were recorded. The anatomic parameters of the pedicles (branch of trunk of ulnar artery, carpal epithelial branch, descending branch of carpal epithelial branch, recurrent branch of deep palmar branch) were measured, including the outer diameter of pedicle initiation, distance of pedicle from pisiform, and distance of pedicle from lunate. ResultsThere were significant differences in the longitudinal and transverse diameters between pisiform and lunate (t=6.653, P=0.000; t=6.265, P=0.000), but there was no significant difference in thickness (t= 1.269, P=0.109). The distal, proximal, radial, and ulnar sides of pisiform had nutrient vessels. The nutrient foramina at proximal side were significantly more than that at distal side (P<0.05), but there was no significant difference in the diameter of nutrient foramina between different sides (P>0.05). The outer diameter of pedicle initiation of the recurrent branch of deep palmar branch was significantly smaller than the carpal epithelial branch and descending branch of carpal epithelial branch (P<0.05). There was no significant difference in the distance of pedicle from pisiform/lunate between branch of trunk of ulnar artery and recurrent branch of deep palmar branch (P>0.05), and between carpal epithelial branch and descending branch of carpal epithelial branch (P>0.05). But the differences between the other vascular pedicles were significant (P<0.05). ConclusionThere are abundant nutrient vessels at the proximal and ulnar sides of pisiform, so excessive stripping of the proximal and ulnar soft tissues should be avoided during the vascularized pisiform transfer. It is feasible to treat advanced Kienböck’s disease by pisiform transfer with the carpal epithelial branch of ulnar artery and the descending branch.