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101.
Binu Prathap Thomas Sreekanth Raveendran Thenmozhi Mani 《Indian Journal of Orthopaedics》2021,55(2):478
BackgroundTardy ulnar nerve palsy is the development of late onset ulnar nerve dysfunction and is usually treated by open anterior transposition of ulnar nerve. Open technique is done using a longitudinal incision about 6–8 inch. in length with chances of development of medial antebrachial cutaneous nerve neuromas.PurposeIn this study, we describe the technique of Endoscopic Anterior Transposition of Ulnar Nerve (EATUN procedure) to treat tardy ulnar nerve palsy and analyze the results.MethodsSeven patients diagnosed to have tardy ulnar nerve palsy was treated by EATUN. The humerus-elbow-wrist angle (HEW), pre- and post-operative intrinsic muscle power and sensory assessment, Dellon scores, and the Q-DASH was analyzed.ResultsThe minimum follow-up was 12 months (Mean 27.4 months, Range 12–36 months). Improvement in Dellon and Q-DASH scores following EATUN procedure was statistically significant. There was objective improvement of intrinsic muscle power and sensation on follow-up, though not statistically significant. No instance of neuroma of the medial cutaneous nerve of forearm was noted.ConclusionsThe endoscopic anterior transposition of the ulnar nerve is a good option in surgical management of tardy ulnar nerve palsy.Level of evidenceTherapeutic Level IV.Supplementary InformationThe online version contains supplementary material available at 10.1007/s43465-021-00366-w. 相似文献
102.
Congenital constriction band syndrome has varied clinical presentations ranging from small, incomplete skin deep constriction band to in utero amputation. Pseudarthrosis of underlying bone most commonly tibia has been reported by many authors. We report the first case of congenital pseudarthrosis of the femur with congenital constriction band syndrome. Nine-day-old female presented with the constriction band in the left thigh with open pseudarthrosis of the femur. The left femur had gross recurvatum deformity and the posterior apex of the pseudarthrosis was exposed via skin ulceration. She had an ipsilateral paralytic clubfoot. She was treated with single-stage excision of constriction band and Z-plasty. Spontaneous union of the femur was achieved at 3 months. Procurvatum deformity of the femur improved gradually over 3 years. This happens to be the first and only reported case of congenital pseudarthrosis of the femur with sciatic nerve palsy due to congenital constriction band. 相似文献
103.
104.
105.
Distal rectus femoris surgery in children with cerebral palsy: results of a Delphi consensus project
Robert M. Kay Kristan Pierz James McCarthy H. Kerr Graham Henry Chambers Jon R. Davids Unni Narayanan Tom F. Novacheck Jason Rhodes Erich Rutz Jeffrey Shilt Benjamin J. Shore Matthew Veerkamp M. Wade Shrader Tim Theologis Anja Van Campenhout Thomas Dreher 《Journal of children's orthopaedics》2021,15(3):270
PurposeThe purpose of this study was for an international panel of experts to establish consensus indications for distal rectus femoris surgery in children with cerebral palsy (CP) using a modified Delphi method.MethodsThe panel used a five-level Likert scale to record agreement or disagreement with 33 statements regarding distal rectus femoris surgery. The panel responded to statements regarding general characteristics, clinical indications, computerized gait data, intraoperative techniques and outcome measures. Consensus was defined as at least 80% of responses being in the highest or lowest two of the five Likert ratings, and general agreement as 60% to 79% falling into the highest or lowest two ratings. There was no agreement if neither threshold was reached.ResultsConsensus or general agreement was reached for 17 of 33 statements (52%). There was general consensus that distal rectus femoris surgery is better for stiff knee gait than is proximal rectus femoris release. There was no consensus about whether the results of distal rectus femoris release were comparable to those following distal rectus femoris transfer. Gross Motor Function Classification System (GMFCS) level was an important factor for the panel, with the best outcomes expected in children functioning at GMFCS levels I and II. The panel also reached consensus that they do distal rectus femoris surgery less frequently than earlier in their careers, in large part reflecting the narrowing of indications for this surgery over the last decade.ConclusionThis study can help paediatric orthopaedic surgeons optimize decision-making for, and outcomes of, distal rectus femoris surgery in children with CP.Level of evidenceV 相似文献
106.
107.
舌下神经-面神经直接侧端吻合的应用解剖学研究 总被引:4,自引:0,他引:4
目的:为舌下神经-面神经直接侧端吻合提供解剖学依据。方法:①在21例防腐固定的成人头颈部标本上,测量面神经干及其颞骨内乳突段、鼓室段长度;面神经干分叉处至舌下神经颈部的最短距离。②3例新鲜标本取舌下神经及面神经干行组织学检测,测定其神经束数目和横切面积。③2例标本摹拟术式设计。结果:舌下神经干在寰椎水平为单束形式,横切面积为(8.5±0.3)mm2;面神经干在出茎乳孔处为单束形式,横切面积为(5.1±0.2)mm2;面神经干的长度为(15.7±2.0)mm,颞骨内面神经乳突段的长度为(14.6±1.5)mm、鼓室段的长度为(9.6±1.2)mm;面神经干分叉处至舌下神经颈部的最短距离为(17.2±2.3)mm。结论:舌下神经-面神经直接侧端吻合治疗面瘫具有可行性。 相似文献
108.
109.
Involvement of nitric oxide synthase in the physiology and pathophysiology of facial nerve function and dysfunction 总被引:1,自引:0,他引:1
O. Michel Alexander Hess Martin Krolzig Eberhard Stennert Klaus Addick Wilhelm Bloch 《European archives of oto-rhino-laryngology》2000,257(4):188-192
To date few reports have discussed the presence and function of nitric oxide (NO) in structures of the facial nerve. We performed
nicotinamide adenine dinucleotide phosphate (NADPH-d)-diaphorase-histochemistry and immunohistochemistry on the intratemporal
portion of the facial nerve, including the geniculate ganglion, of guinea pigs using specific antibodies to the three known
isoforms of NO synthase and soluble guanylyl-cyclase (sGC). Normal facial nerves were compared to those treated intratympanically
with bacterial lipopolysaccharides (LPS) and tumor necrosis factor-α (TNF-α). Both constitutive NOS isoforms and sGC could
be detected in the bipolar ganglion cells of normal animals, while the inducible isoform (iNOS or NOS II) was not found. Endothelial
NOS (NOS III) and sGC were present in blood vessels and were predominantly found in the perineurial sheath and less in the
endoneurium. sGC could be detected in all fibers in a cross section of the facial nerve. LPS and TNF treatment led to the
detection of iNOS in the perikaryia of the geniculate ganglion and the perineural sheath. These findings imply that NO may
be involved in neurotransmission at least in the visceroafferent system. NO regulates vascular tone of nutrient blood vessels
in the perineural sheath and endoneurium. The presence of sGC indicates that NO acts via its second messenger cGMP. NOS II
expression may be a contributing factor to facial nerve palsy via two different mechanisms: NOS II-generated NO may lead to
an overstimulation of the visceroefferent nerve fibers and motor fibers of the facial nerve. Dysregulation in facial nerve
blood vessels could lead to edema and elevated pressure on the nerve within its osseous canal.
Received: 13 April 1999 / Accepted: 12 August 1999 相似文献
110.
影响鼻咽癌病人受损颅神经恢复的因素分析 总被引:1,自引:0,他引:1
目的:探讨影响鼻咽癌病人受损颅神经恢复的相关因素。方法:1989年1月至1991年1月我科收治鼻咽癌伴颅神经受损病人128例,共245条颅神经受损。对影响受损颅神经功能恢复的可能因素进行单因素及多因素Cox模型分析。结果:放疗后1年内受损颅神经中有65.7%(161/245)完全恢复,19.2%(47/245)部分恢复,15.1%(37/245)无变化,总的有效率为84.9%(208/245)。单 相似文献