A comparison of double single suture-button fixation,suture-button fixation,and screw fixation for ankle syndesmosis injury: A retrospective cohort study

Different methods have been used throughout the years for syndesmotic injury but there is no consensus on the ideal treatment. Some methods are expensive and some have more complications. The aim of this study is to compare single suture endobutton with double suture endobutton and screw fixation for syndesmotic injury.Sixty nine patients with syndesmotic injury with fibular fractures whom were treated with a single interosseous suture endobutton system (ZipTight^TM, Zimmer Biomet), a double interosseous suture endobutton system (ZipTight^TM, Zimmer Biomet) and 1 syndesmotic screw (TST, Istanbul, Turkey) were included in this study. Functional and radiological results from patient records between 2015 and 2018 were retrospectively evaluated.Twenty patients were treated with the double interosseous suture endobutton, 23 were treated with the single interosseous suture endobutton, and 26 were treated with traditional AO screw fixation. Three patients from the screw fixation group (11.5%) required revision surgery (P < .05). All the radiologic and clinical outcomes were statistical similar in all 3 groups.Our findings showed that the interosseous suture endobutton system is at least as safe as the screw fixation technique for treatment of syndesmosis joint injuries and can be used as an alternative to the screw method. The interosseous suture endobutton system eliminates the need for a second surgery to remove the hardware, which minimizes the probability of re-diastasis. Since our results showed no statistical difference between single and double interosseous suture endobutton systems, the less costly single endobutton system may be the better alternative.     

腹腔镜胆总管切开探查取石46例报告

目的探讨腹腔镜胆总管切开探查取石、胆总管一期缝合的可行性及其微创价值。方法回顾分析我院46例腹腔镜胆总管切开探查取石的临床资料。腹腔镜下完成手术44例,其中胆总管切开探查取石胆总管一期缝合24例,胆总管切开探查取石胆总管T管引流20例;中转开腹胆总管切开取石T管引流2例。结果手术中无副损伤。手术后无胆漏及其它并发症发生。所有病例是治愈出院。32例术后随访3～12个月,未发现残余结石及胆道狭窄。结论腹腔镜胆总管切开探查取石、胆总管一期缝合是可行的,而且具有极大的微创优势。     

经穹隆结膜入路埋线法重睑成形术应用探讨

目的:通过分析重睑形成原理,综合比较多种重睑成形的方法,讨论埋线法重睑成形术的优点和可行性。方法:对387例患者行经穹隆结膜入路间断缝合埋线法重睑术。其中88例为其他方法埋线后重睑线消失的患者。结果:手术方法可靠,术后所形成的重睑外形良好,重睑维持时间长。最长随访时间38个月。结论:此方法因符合重睑形成原理,可以充分的将较多的上睑提肌腱膜与上睑皮肤结扎固定、故术后所形成的重睑牢固。且在直视下经穹隆结膜入路,降低了对眼球组织损伤的危险性。是埋线法重睑成形术一种可靠的手术方法。     

微小切口双重荷包缝合法矫正重度乳头内陷

目的 介绍一种疗效确切,创伤小,矫正重度乳头内陷的新术式.方法 设计切口位于乳晕第四象限,方向斜向外下方,呈放射状切口,长约1.5 cm,松解乳头基底部,切断牵拉的纤维条索,上提乳头,在距乳头0.8cm和1.5cm处,双重荷包缝合固定.结果 12例乳头内陷患者术后随访1个月至4年,均获得满意疗效.乳头横径、纵径、高度及外观明显改善.结论 该术式矫正乳头内陷具有切口小、创伤轻微、操作简单易行、效果确切、不易复发和并发症少等优点.     

角膜缝线的细菌学试验研究

对常用的4种角膜缝线进行细菌的吸附试验和虹吸试验。结装发现3-0黑丝线吸附细菌最多,10-0尼龙线吸附细菌最少。3-0和5-0黑丝线对细菌虹吸试验阳性,9-0和10-0尼龙线虹吸试验阴性。试验证明,10-0尼龙线是角膜手术较理想的缝线。     

Arthroscopic Double-Row Suture Anchor Fixation of Minimally Displaced Greater Tuberosity Fractures

In cases of displaced greater tuberosity fractures, treatments by arthroscopic-assisted reduction and percutaneous screw fixation have been reported. However, in cases in which there is a comminuted fracture or a minimally displaced fracture combined with concomitant lesions such as rotator cuff tear or labral pathology, it is difficult to reduce the fracture and to treat other pathologies by use of a percutaneous screw. Recently, many surgeons have used the double-row repair method in rotator cuff repair, which provides a tendon-bone interface better suited for biologic healing and restoring normal anatomy. In accordance with this method, we used the arthroscopic technique of double-row suture anchor fixation for a minimally displaced greater tuberosity fracture without additional incision. Initially, debridement was performed on the fracture surface by use of a shaver, and the medial-row anchor was inserted through the anterior portal or the intact cuff. Two lateral-row anchors were inserted just anterior and posterior to the lower margin of the fractured fragment under C-arm guidance. The medial-row sutures and lateral-row sutures were then placed. Arthroscopic double-row suture anchor fixation of a displaced greater tuberosity fracture restores the original footprint of the rotator cuff and normal tendon-bone interface of the displaced greater tuberosity fracture.     

埋没导引缝合法矫治鹰钩鼻鼻尖畸形

目的介绍一种较新的矫治鹰钩鼻鼻尖畸形的手术方法。方法自1995年2月至2005年5月,采用埋没导引缝合技术对18例鹰钩鼻鼻尖畸形患者进行手术矫治,术后结合鼻管支撑的鼻孔悬吊法外固定7~10d。结果术后经14个月至3年的随访,18例患者的鼻尖外形良好,形态满意。其中1例患者因鼻腔内悬吊线穿透引起轻度炎症,术后3周剪除缝线,5d自愈。结论采用埋没导引缝合的手术方法对鹰钩鼻鼻尖畸形患者进行矫治,并结合缝合、悬吊和固定,获得了良好的术后效果。此方法是一种较理想的手术方法,值得推广应用。     

胰岛素生长因子1在颅缝闭合中调节作用的实验研究

目的：研究胰岛素生长因子1对大鼠颅缝细胞的骨诱导作用和体外调节小鼠矢状缝闭合的作用。方法：获取新出生的SD大鼠的矢状缝细胞进行培养和出生8d的CD1小鼠矢状缝进行体外无血清器官培养基培养，加入胰岛素生长因子1（insulin lilce growth factor 1 IGF1），浓度分别为10ng/ml和40ng/ml，并设立不加IGF1者为对照组，应用RT－PCR检测颅缝细胞的成骨细胞表型碱性磷酸酶、骨钙素和骨桥蛋白mRNA表达，ELISA法检测培养液I型胶原的分泌，光镜观察小鼠矢状缝闭合的情况。结果：加入IGF1的矢状缝细胞的成骨细胞表型碱性磷酸酶、骨钙素和骨桥蛋白mRNA表达以及培养液I型胶原分泌量较对照组明显增高。有IGF1干预的矢状缝移植体培养8d时，颅缝内侧面骨板开始接近，培养20d时，颅缝小部分闭合，培养30d时颅缝大部分闭合，无IGF1干预的对照组培养30d，颅缝未发生闭合。结论：胰岛素生长因子1通过增强颅缝细胞的骨诱导促进颅缝的闭合。     

耳脑医用粘合剂修补脑脊液漏

耳脑医用粘合剂是α－氰基丙烯酸正辛酯和α－氰基丙烯酸正丁酯及少量添加剂配伍而成的复合性医用粘合剂。应用此粘合剂粘合修补脑脊液漏２７例，其中外伤性脑脊液鼻漏５例，经鼻蝶入路垂体瘤切除术脑脊液漏６例，开颅手术后手术切口脑脊液漏１１例，脊膜膨出修补术后脑脊液漏５例。成功２５例，成功率９３％。应用此粘合剂修补脑脊液漏具有简便、迅速、有效的特点。