Role of valgus osteotomy and fixation by double-angle blade plate in neglected displaced intracapsular fracture of neck of femur in younger patients

Head preservation is the mainstay of management in younger patients with intracapsular fracture neck of femur. In this prospective study, we have tried to evaluate the role of valgus osteotomy and internal fixation by double-angle blade plate in patients below 60 years of age with displaced intracapsular fractures and whose time since injury is equal to or more than 3 weeks. Among the 20 fractures which are managed by this procedure, 18 fractures united. We recommend this procedure for the treatment of neglected displaced intracapsular fractures in young patients.     

Histomorphological evaluation of loaded plate-form and root-form implants in Macaca mulatta monkeys

As part of a long-term evaluation of endosteal dental implants in primates, this paper describes the histological response to plate-form and root-form implants. Thirty-six primates received 48 mandibular distal abutment implants. After healing, the implants were restored with fixed partial dentures, which remained in function for two years. A subset of the group was ligated at the gingival sulcus to biologically stress tissues supporting the implants. Crestal bone height around implants was quantified using digital subtraction radiographic techniques. The ligated implants lost more crestal bone than non-ligated implants, as shown by ANOVA (P < 0.05). After retrieval, implants were embedded and sectioned for histomorphometric analysis including measurement of per cent osseointegration. Both plate-form and root-form non-ligated implants demonstrated about 60% osseointegration. When ligated, plate-form implants dropped to an average integration of only 34%, while root-form implants maintained 62% integration, a significant difference. These data show that in this primate model, plate-form and root-form implants maintained integration while in function for two years. When stressed with ligation, root-form implants maintained relative amounts of osseointegration, while per cent osseointegration of plate-form implants decreased.     

Neck injuries from skate blades in ice hockey: a report of three cases

This article describes three neck slash injuries in amateur ice hockey players, with a fatal outcome in two. One player died of asphyxation secondary to hemorrhage into the respiratory passage, but the other died of hemorrhage from the main blood vessels in the neck, severed by the skate blade. All three were not wearing any neck protecting device. Neck slash injury from skate blades, as a preventable sports-related injury, and the need for neck protective equipment in preventing such injuries are discussed.     

Craniotomies without burr holes using an oscillating saw

Summary Objective. The object of this study is to describe a new method for performing craniotomies which obviates the need for burr holes, improves bony reconstruction, and reduces post-operative cosmetic deformities. Moreover, this technique provides excellent exposure of skull base structures and dural venous sinuses.Methods. Craniotomies in varied locations are created with the use of a micro-oscillating saw and chisel. No burr holes are used and reconstruction with plates and screws is unnecessary.Results. We initially applied our technique to approaches to the anterior skull base with combined craniofacial tumour resections. We have since performed over 2000 craniotomies of any size and shape in all supratentorial locations using the oscillating saw.Conclusions. We have found that our method creates better cosmetic results than standard techniques and is safer for craniotomies spanning dural venous sinuses. With experience, operating time was significantly reduced and costs were lowered because reconstruction with fixation devices was not needed.     

快速锯配合MEBO在早期深度烧伤创面中的应用

目的：寻找一种促进创面尽快脱痂的方法。方法：用快速锯对深度烧伤创面的连续性进行破坏，然后配合湿润烧伤膏（MEBO）治疗。结果：51例患在用快速锯对创面处置后，深Ⅱ度创面10天-15天坏死组织完全液化，创面干净，可见大量毛囊乳突，皮岛，皮钉出现。Ⅲ度创面2周内可见坏死痂脱落，创基形成新鲜肉芽组织。结论：快速锯配合MEBO能使深度烧伤创面坏死组织尽快清除，促进再生修复，有利行早期愈合。     

Epidemiological studies of vibration disease due to brush saw operation

Summary A longitudinal study was performed to evaluate the risk for vibration disease during the period 1961–1980 among a given population of forest workers using brush saws in Japan. The vibration levels in the measurements occasionally exceeded the 60-min line proposed by the ISO/DIS 5349 in 1/3 octave bands mainly centered on 125 Hz in vertical during the sawing operations. The peak prevalence rate was 12.0% found in the cohort group beginning in 1961–1962. Thereafter, it decreased significantly and no patients with VWF were found in the cohort group beginning in 1969–1970. In the study periods, the prevalence rate was around 2, 4, 6 and 7% after 3, 7, 11 and 13 years of exposure time respectively. The incidence rate had two peaks of 2.2% in 1965 and in 1973. Among workers using brush saws, the prevalence rate and incidence rate were smaller than those of workers using various other kinds of vibrating tools. The workers used brush saws for 4 to 5 months a year during the warmer season for grass trimming and limbing. This is the main reason why the prevalence rate was so low in spite of the high acceleration levels of the brush saw. On the other hand, the latency period (6.4 ± 3.5 years) was rather shorter than that of the chain saw. This result suggests that the individual susceptibility of workers to contract VWF may play a more important role in the case.     

弧形刀片夹持器的设计及在白内障手术中的应用

目的 探讨弧形刀片夹持器夹持剃须刀片做小切口白内障囊外摘出人工晶状体植入术的效果。方法 对312眼老年性白内障囊外摘出后房人工晶状体植入术随机分成两组。A组常规以新月形隧道刀做巩角膜隧道切口及以角膜刀穿刺前房并扩大切口；B组用特制的弧形刀片夹持器夹持剃须刀片，做隧道式切口、穿刺前房及扩大切口。其余手术步骤两组完全相同。术后观察1周及3月的视力和角膜散光情况。结果 术后1周及3月的视力和角膜散光度两组均相近，差异无统计学意义（P〉0．05），手术均无重要并发症。结论 弧形刀片夹持器夹持剃须刀片作小切口白内障摘出人工晶状体植入术安全可靠，更为经济，而且取材方便，值得在基层医院推广。     

Modified One-piece Supraorbital Approach for Orbital Tumors: Widely Preserved Orbital Roof in a Self-fitting Flap

Objectives The one-piece supraorbital approach is a rational approach for the removal of orbital tumors. However, cutting the roof through the orbit is often difficult. We modified the technique to facilitate the osteotomy and improve the cosmetic effect. Design Three burr holes are made: the first, the MacCarty keyhole (burr hole 1), exposes the anterior cranial fossa and orbit; the second is placed above the supraorbital nerve (burr hole 2); and the third on the superior temporal line. Through burr hole 2, a small hole is created on the roof, 10 mm in depth. Next the roof is rongeured through burr hole 1 toward the preexisting small hole. Seamless osteotomies using a diamond-coated threadwire saw and the preexisting four holes are performed. Lastly the flap is removed. On closure, sutures are passed through holes in the cuts made with the threadwire saw, and tied. Results We applied our technique to address orbital tumors in two adult patients. The osteotomies in the roof were easy, and most parts of the roof were repositioned. Conclusions Our modification results in orbital osteotomies with greater preservation of the roof. Because the self-fitting flap does not require the use of fixation devices, the reconstruction is cosmetically satisfactory.     

定量半横断刀改进大鼠脊髓半横断块状缺损模型

目的研究自制定量半横断刀对大鼠脊髓半横断块状缺损模型的改进效果。方法清洁级健康成年雄性SD大鼠48只,体重220～250 g。将实验动物随机分为实验组和对照组,每组24只。实验组采用自制定量半横断刀制作脊髓半横断块状缺损模型,对照组采用眼科手术刀制作模型。观察两组大鼠术后并发症;模型制备前及制备后21 d行电生理检测;模型制备后6 h及5、28 d,光镜下观察各组脊髓半横断块状缺损边缘的组织结构;模型制备后1、3、5、7、14、21、28、35、42、56、84 d,对两组实验动物行健、患侧后肢BBB运动功能评分。结果实验组和对照组实验动物死亡率分别为0和26.67%,比较差异有统计学意义(P=0.028)。电生理检测:两组术前健侧感觉诱发电位(sensory evokedpotentials,SEP)及运动诱发电位(motor evoked potentials,MEP)潜伏期和波幅比较差异均无统计学意义(P>0.05);术后21 d,对照组MEP及SEP潜伏期明显延长,波幅降低,与术前及实验组术后21 d比较差异均有统计学意义(P<0.05);实验组组内术前及术后21 d比较差异无统计学意义(P>0.05)。组织学观察:对照组健侧脊髓损伤后6 h可观察到小血肿,5 d时见脊髓组织间隙疏松及嗜神经现象,28 d时见脊髓块状缺损边缘组织明显小空洞形成,未见正常形态神经元;而实验组5 d时未见神经元不可逆损伤,28 d时块状缺损边缘可见正常形态神经元及部分空泡样改变。运动功能评分:除实验组与对照组患侧BBB评分差异无统计学意义(P>0.05)外,其余组间或健、患侧间BBB评分比较差异均有统计学意义(P<0.05)。结论定量半横断刀制备大鼠脊髓半横断损伤模型,制作过程重复性好且制成的模型稳定,是研究脊髓半横断损伤的理想模型。