龈下楔状缺损予以微创牙冠延长术结合纳米树脂修复治疗的美学效果

目的 探讨龈下楔状缺损予以微创牙冠延长术结合纳米树脂修复治疗的美学效果。方法 选取我 院2021年12月-2022年12月收诊的50例龈下楔状缺损患者，按治疗方式的不同分为对照组与观察组，每组 25例，对照组配合常规牙冠延长术治疗，观察组采取微创牙冠延长术结合纳米树脂修复治疗，比较两组临 床指标、美学效果及满意度。结果 观察组治疗后附着丧失、探诊深度低于治疗前，且观察组低于对照组 （P＜0.05）；两组出血指数、牙齿松动度比较，差异无统计学意义（P＞0.05）；观察组治疗后美观度、舒 适度、牙齿颜色贴合度各项评分高于对照组（P＜0.05）；观察组满意度为100.00%，高于对照组的84.00% （P＜0.05）。结论 为龈下楔状缺损患者实施微创牙冠延长术结合纳米树脂修复治疗，能在提升患者美学 效果的同时，改善患者的临床相关指标，获得较高的满意度。     

Lateral column lengthening (LCL) using a rectangular shape graft for managing symptomatic flexible flatfoot showed acceptable early functional and radiological outcomes

Purpose: We aimed to report the results of performing lateral column lengthening (LCL) using a rectangular-shaped graft to correct the flat foot deformity. Methods: A total of 28 feet of 19 patients (10 males, 9 females) having an average age of 10 ± 3.2 years who were unresponsive to conservative management underwent flat foot deformity correction through LCL procedure supplemented with rectangular-shaped graft harvested from the fibula. Functional assessment was performed according to the American Orthopedic Foot and Ankle Society (AOFAS) scale. The radiographic assessment consisted of four parameters, Meary’s angle in both anteroposterior (AP) and lateral (Lat.) views, calcaneal inclination angle (CIA), and calcaneocuboid angle (CCA). Results: After an average of 30.2 ± 8.1 months, the AOFAS improved significantly from 46.7 ± 10.2 preoperatively to 86.7 ± 9.5 at the last follow up (P < 0.05). All the osteotomies showed healing at an average of 10.3 ± 2.7 weeks. All the radiological parameters showed significant improvement at the last follow up compared to the preoperative measurements, CIA from 6.3 ± 2.8–19.3 ± 3.5, Lat. Meary's angle from 19.3 ± 4.9–5.8 ± 2.5, AP Meary’s Angle from 19.3 ± 5.8–6.1 ± 3.1, and CCA from 23.9 ± 8.2–6.8 ± 4.5, (P < 0.05). No pain at the site of the fibular osteotomy was reported in any of the patients. Conclusion: Lateral column lengthening using a rectangular graft effectively restores bony alignment with good radiological and clinical results, high patient satisfaction, and acceptable complications.     

Biological reconstruction for massive bone defect following resection of tumor in Japan

BackgroundSeveral procedures of biological reconstruction for massive bone defect are available following tumor resection. Since the 1980s, allografting has been advanced mainly in the United States. However, allogeneic bone grafting has not been sufficiently developed in Japan for socioreligious reasons, and many other biological reconstructive methods have been developed.Status of biological reconstructionBone lengthening, recycled and vascularized bone grafting have yielded favorable outcomes. Once bone union is achieved, reoperation is scarcely performed, with lower rate of infection than that observed with a prosthesis. However, there are disadvantages, such as complicated surgical procedures and relatively common postoperative complications. However, if sufficient donors are available, allogeneic bone grafting can be a good alternative.Prospects of the Japanese Orthopaedic AssociationRegenerative medicine with iPS cells, etc., which is under investigation, is expected to be employed for defect reconstruction. However, several biological reconstructive procedures should be further developed. These procedures are not inferior to prosthetic and allograft reconstructions in the short term, but rather are superior in the long term. Favorable outcomes are being obtained by combining recycled bone reconstruction and vascularized bone grafting, suggesting possible improvement in the future. Data should be accumulated to develop biological reconstruction in Japan. Although Japan has the challenge in terms of the ability to convey its message, the disadvantages of the procedures should be minimized.ConclusionThe construction of an allogeneic bone grafting system should be promoted, while biological reconstruction methods developed in Japan should be further developed and convey our message clearly and logically.     

包皮系带延长阴茎整形术在儿童隐匿阴茎治疗中的应用价值

目的 研究包皮系带延长阴茎整形术在儿童隐匿阴茎患者治疗中的应用价值。方法 选择2020年 11月-2022年11月重庆市丰都县人民医院收治的60例隐匿阴茎患儿，按照随机数字表法分为对照组与观察 组，各30例。对照组实施脱套固定手术治疗，观察组实施包皮系带延长阴茎整形术治疗，比较两组临床 效果、手术指标、裸露阴茎平均长度、疼痛评分、并发症发生情况。结果 观察组治疗总有效率与对照组 比较，差异无统计学意义（P ＞0.05）；观察组手术时间、术中出血量以及住院时间均少于对照组，差异 有统计学意义（P ＜0.05）；观察组治疗后裸露阴茎平均长度、疼痛评分均优于对照组，差异有统计 学意义（P ＜0 . 0 5）；观察组并发症发生率为3 . 3 3 %，低于对照组的2 3 . 3 3 %，差异有统计学意义 （P ＜0 . 0 5）。结论 对儿童隐匿阴茎患儿实施包皮系带延长阴茎整形术的治疗效果确切，可减少 手术时间、术中出血量以及住院时间，减轻患儿疼痛，延长裸露阴茎长度，临床应用价值较高。     

Incidence and Risk Factors of Iliopsoas Tendinopathy After Total Hip Arthroplasty: A Radiographic Analysis of 1,602 Hips

BackgroundIliopsoas tendinopathy (IPT) can cause persistent groin pain and lead to dissatisfaction after total hip arthroplasty (THA). This study aimed to report the characteristics, incidences, risk factors, and treatment outcomes of IPT after THA.MethodsWe reviewed primary THAs performed at a single institution between January 2012 and May 2018. Clinical and radiographic analyses were performed on 1,602 THAs (1,370 patients). Patient characteristics, component sizes, inclination and anteversion angles, and antero-inferior cup prominence (≥8 millimeters (mm)), were compared between the groups with and without IPT. Changes in teardrop to lesser trochanter distance were measured to estimate changes in leg length and horizontal offset caused by THA. Logistic regression models were used to identify the risk factors for IPT. IPT was identified in 53 hips (3.3%).ResultsPatients with IPT had greater leg lengthening (12.3 versus 9.3 mm; P = .001) and higher prevalence of antero-inferior cup prominence (5.7 versus 0.4%; P = .002). There was no significant difference in inclination, anteversion, and horizontal offset change between the two groups. In multivariate analyses, greater leg lengthening, prominent acetabular cup, women, and higher body mass index were associated with IPT. All patients reported improvement in groin pain after arthroscopic tenotomy, while 35.7% with nonoperative management reported improvement (P < .001).ConclusionsSymptomatic IPT occurred in 53 (3.3%) of the 1,602 primary THAs. Our findings suggest that leg lengthening as well as prominent acetabular cup in THAs can be associated with the development of IPT. Arthroscopic tenotomy was effective in relieving groin pain caused by IPT.     

微创截骨单臂架骨延长术治疗先天性跖骨短小症

目的 探讨微创截骨单臂架骨延长术治疗先天性跖骨短小症的临床效果.方法 回顾性分析2016年9月至2020年7月在北京积水潭医院矫形骨科应用外固定架治疗的9例跖骨短小症病人的临床资料,其中男1例,女8例,年龄为(24.5±4.2)岁(18～31岁),共14足,均为第四趾短小,其中4例为单侧,5例为双侧受累.使用背侧入路安...