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11.
Treatment of complete acromioclavicular joint disruption remains controversial and ranges from rehabilitation to extensive surgical reconstruction. However, high-grade injuries (type IV, V, and VI) are typically treated surgically. Most reconstruction techniques addressing these injuries selectively focus on coracoclavicular ligament augmentation because it has been shown to be the primary stabilizer of the acromioclavicular joint. The conventional coracoclavicular polydioxanone (PDS) loop, which is widely performed, has been detected to have some pivotal disadvantages, including anterior subluxation of the clavicle, extensive preparation of the coracoid, and bony avulsion of the clavicle as a result of rotational clavicle movement. Therefore we present an augmentation technique that reduces these complications by replicating the orientation of the native coracoclavicular ligament complex and providing a minimally invasive subcoracoid and clavicular fixation of a double PDS loop by use of 2 flip buttons, typically used for extracortical anterior cruciate ligament graft fixation. The key step of the procedure includes the anatomic, secure, and stable placement of the double PDS cerclage under the coracoid base transferring a flip button through a coracoid bone tunnel. Our clinical experience shows that the presented technique is easy to perform and has a comparable invasiveness to recently presented arthroscopic techniques. 相似文献
12.
目的:评价泰勒宁片和科洛曲片对隆乳手术后疼痛的疗效和不良反应。方法:采用随机开放平行对照试验。共完成60例,其中A组30例予泰勒宁片,单次1片;B组30例予科洛曲片,单次1片。结果:泰勒宁片对隆乳手术后引起的中度或重度疼痛总有效率可达96.7%,科洛曲片的总有效率可达83.3%。服药后泰勒宁片组的疼痛强度差均高于科洛曲组,经统计学处理,有显著性差异(P<0.05)。不良反应发生率较科洛曲片组高。结论:泰勒宁片为中强度镇痛药,对于隆乳手术后引起的中重度疼痛有良好的镇痛效果。 相似文献
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Claudia Trenkwalder MD Heike Benes MD Ludger Grote MD Svenja Happe MD Birgit Högl MD Johannes Mathis MD Gerda M. Saletu‐Zyhlarz MD Ralf Kohnen PhD CALDIR study group 《Movement disorders》2007,22(5):696-703
We report the first large-scale double-blind, randomly assigned study to compare two active dopaminergic therapies for Restless Legs Syndrome (RLS), the dopamine agonist cabergoline (CAB) and levodopa/benserazide (levodopa). Patients with idiopathic RLS were treated with fixed daily doses of 2 or 3 mg CAB or 200 or 300 mg levodopa for 30 weeks. Efficacy was assessed by changes in the IRLS (International RLS Severity Scale) and by time to discontinuation of treatment due to loss of efficacy or augmentation. 361 of 418 screened patients (age 58 +/- 12 years, 71% females) were randomly assigned and treated (CAB: n = 178; levodopa: n = 183) in 51 centers of four European countries. Baseline IRLS total score was 25.7 +/- 6.8. The baseline-adjusted mean change from baseline to week 6 in IRLS sum score was d = -16.1 in the CAB group and d = -9.5 in the levodopa group (d = -6.6, P < 0.0001). More patients in the levodopa group (24.0%) than in the CAB group (11.9%, P = 0.0029, log-rank test) discontinued because of loss of efficacy (14.2% vs. 7.9%, P = 0.0290) or augmentation (9.8% vs. 4.0%, P = 0.0412). Adverse events (AEs) occurred in 83.1% of the CAB group and in 77.6% of the levodopa group. In both groups, most frequent AEs were gastrointestinal symptoms (CAB: 55.6%, levodopa: 30.6%, P < 0.0001). This first large-scale active controlled study in RLS showed superior efficacy of cabergoline versus levodopa after a 30-week long-term therapy. Tolerability was found more favorable with levodopa than with cabergoline. 相似文献
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Sinus augmentation has been advocated to be a surgical technique with predictable results in peri‐implant surgery. Endoscopic surgery of the maxillary sinus so far has been used as diagnostic procedure. In this paper, the use of endoscopy is described as a low invasive adjunctive technique in sinus floor augmentation. After preparation of the mucoperiosteum, bone grafts can be placed under endoscopic control between sinus floor and mucoperiosteum. A laterobasal approach via a small osteotomy and a transalveolar approach are possible for mucosal elevation and graft placement. First clinical results are reported. Endoscopic sinus lift may contribute to a reduction of perioperative morbidity, reduction of oroantal fistulae and control of graft position. The less invasive technique may allow to extend the indication for sinus augmentation. 相似文献
16.
以往以乳头为圆心的同心圆剥离法常形成假体的移位,使假体的体表轮廓与前方的自然乳房分离,产生“双重乳房”现象。在研究了女性不同体位下不同的乳房形态及总结了以前的经验后,提出了偏心圆剥离的概念。偏心圆手术设计方法:以乳头为圆心,按其内侧、下侧为直径3/5的比例,以外侧、上侧为直径2/5的比例,形成一偏心圆的剥离范围。偏心圆的直径因考虑到假体的不同形态、大小及底面直径,以经中心假体纵截面的周长的1/2再放大2cm,作为剥离范围的直径。自1991年10月以来已应用了176例,无一术后移位现象,也没有固较多地剥离胸大肌内、下侧止点纤维而影响上肢活动。自然乳房并不是静态的圆锥形或半球形,它具有伸缩的组织学特点,又有随体位变动而变化的特点。用偏心圆法剥离,可使置入的假体与前方的自然乳房融为一体,消除“双重乳房”现象,而成为“真实”的乳房。同时也应积极寻找一种与身体组织相容性好的,弹性、比重与女性乳腺较为一致的,假体容量相对恒定的生物性材料。这样隆乳术才可以更广泛地开展。 相似文献
17.
Polylactic acid (PLA) root replica in ridge maintenance after loss of a vertically fractured incisor
Abstract A periodontally affected tooth was prepared for a special treatment: Calcium hydroxide was introduced into the apical half of the root canal whereas its cervical part was filled with glass ionomer cement. The tooth was shortened subgingivally. After 6 weeks of epithelization over the residual root a palatal full-thickness flap was mobilized. The root was carefully extracted and chairside copy-milled from the biodegradable polylactic acid (PLA) material. The PLA-replica was implanted immediately into the socket and the flap was sutured. Aim of the treatment was to prevent the ridge collapse of the extraction area. Ridge height could be preserved during the 21 months of observation. With time the radiographic density of the cancellous bone increased in the implanted area, indicating that a PLA-replica is replaced by host's bone tissue. 相似文献
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假体隆乳术后并发症的防治 总被引:9,自引:0,他引:9
目的探讨乳房假体隆乳术后并发症产生的相关因素及预防方法。方法对198例患者乳房假体隆乳术后1~17年出现的并发症进行分析,阐述防治措施,针对不同情况进行相应的处理。结果本组198例患者,其中92例患者随访半年至1年,除Ⅲ°包膜挛缩患者术后仍出现Ⅱ~Ⅲ°包膜挛缩外(包膜松解术后3例,包膜切除术后4例),余患者对治疗效果满意。结论乳房假体隆乳术后出现的并发症,多数是可以预防和治疗的,只要术中操作规范,对并发症及早准确的处理,是提高手术效果,减少并发症发生的有效方法。 相似文献