Tetraparesis as clinical correlate of subacute cervical flexion myelopathy

Context: We report the case of a 20-year-old woman who underwent tracheal resection with postoperative chin-to-chest suture for 10 days, presenting with severe tetraparesis at our institution. Similar cases have been reported previously, however, not yet in the pathophysiological context of chronic cervical flexion myelopathy (Hirayama syndrome).

Findings: Extensive myelopathy at cervical level is the consequence of the fixed cervical spine position due to chin-to-chest suture. Predominantly affected young individuals (age range from 20–25 years) without evidence of degenerated spine disease suggest a similar mechanism as described in Hirayama syndrome—displacement of the dura with consecutive compression of the spinal cord vasculature.

Conclusions: Subacute flexion myelopathy represents a serious complication of operative/postoperative fixed cervical spine positions, warranting particular attention by respective surgeons.     

Catastrophic failure of an uncemented acetabular component due to high wear and osteolysisAn analysis of 154 Omnifit prostheses with mean 6-year follow-up

Background?The purposes of this study were (1) to evaluate the wear pattern of the hydroxyapatite-coated “Dual Radius” Omnifit cup, (2) to investigate whether wear is correlated to any demographic or prosthesis-related factors, and (3) to describe micromotion of both the cup and the stem.Patients and methods?154 hips were implanted between 1990 and 1996 and followed for an average of 6 years. Wear was measured according to the “Charnley-duo” method and, in 79 hips, with radiostereometry (RSA). RSA was also used to evaluate micromotion. We analyzed the femoral heads using scanning electron microscopy, energy dispersive X-ray spectroscopy and an atomic force microscope.Result?66 cups were revised and had a mean annual wear of 0.32?mm compared to 0.12?mm in hips not revised. Osteolytic processes were observed in 35 hips but at revision osteolysis was present in 51 cases. 43/66 sockets were loose. Micromotion evaluated by RSA, weight, age, side, size of cup, screws, polyethylene thickness or shelf-life of the polyethylene did not correlate to wear, whereas male gender did.Interpretation?It is still unclear why about half of our cases had an abnormal wear rate. Annual wear exceeding 0.2?mm is prognostic of late failure and should be considered a warning sign.     

子宫网压缝合术在难治性产后出血中的初步应用

目的:探讨子宫网压缝合术在难治性产后出血治疗中的应用价值。方法:回顾分析子宫网压缝合术对5例难治性产后出血患者的临床治疗,评价手术疗效及手术安全性。结果:经子宫按摩、促宫缩药物注射、宫腔纱条填塞、子宫动脉结扎或B-Lynch缝合等措施处理仍无法止血的5例宫缩乏力性产后出血患者,行子宫网压缝合术后,子宫活动性出血5~10分钟内停止,观察30分钟阴道无明显流血关腹,均成功止血并保留子宫。术后5天垂体激素、甲状腺激素、肾上腺激素及女性激素各项数值均在正常范围;磁共振成像(MRI)检查:术后4天宫壁见散在点状信号,未见宫腔积液;术后46天宫壁肌层信号均匀,宫内膜线清晰。超声检查:术后42天子宫前后径3.5~4.5 cm,宫壁肌层回声均匀,复旧形态良好。宫腔镜检查:术后5个月,宫腔无粘连,内膜形态正常,输卵管开口清晰。随访:例5在哺乳期,其余病例停止哺乳后1~2个月月经恢复正常;例2术后20个月再次妊娠,术后29个月经剖宫产诞下1健康女婴。结论:对经子宫按摩、促宫缩药物注射、宫腔纱条填塞、子宫动脉结扎及B-Lynch缝合等措施处理仍无法止血的宫缩乏力性产后出血患者,子宫网压缝合术治疗安全有效,可以考虑作为治疗难治性产后出血的一种止血方式。     

前壁切除联合改良荷包缝合加压固定治疗复发及复杂性耳廓假性囊肿

耳廓假性囊肿是耳廓软骨间的无菌性浆液性渗出性炎症,常表现为耳廓表面出现一个半球形的无痛囊性隆起。目前对耳廓假性囊肿的临床治疗方法多样,缺乏统一,且多疗效欠佳,复发率较高,可遗留耳廓增厚、变形等后遗症[1]。本研究采用前壁切除联合改良荷包缝合加压固定术治疗复发及复杂性耳廓假性囊肿26例,取得满意疗效,现总结报道如下。     

关节镜下治疗前交叉韧带胫骨止点撕脱骨折

正2010年7月~2015年2月,我科采用关节镜下Orthocord线治疗32例前交叉韧带胫骨止点撕脱骨折患者,疗效良好,报道如下。1材料与方法1.1病例资料本组32例,男18例,女14例,年龄13~61岁。根据MeyersMc Keever分型:Ⅱ型16例,Ⅲ型12例,Ⅳ型4例。新鲜骨折29例,陈旧性骨折     

Tissue reactions to modern suturing material in colorectal surgery

Morphological changes in the wall of the large intestine were studied after its manual suturing by a double-row interrupted suture with modern suture threads. Light and scanning electron microscopy showed “fuse properties” and “sawing effect” of polyfilament twisted threads (e.g. vicryl). Monofilament threads were free from these drawbacks and therefore were preferable. Metal elastic threads on the basis of titanium-nickelide alloys caused no inflammatory changes in tissues. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 143, No. 6, pp. 714–717, June, 2007     

PLGA-based monolithic filaments prepared by hot-melt extrusion: In-vitro comparative study

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美容缝合法与传统缝合法在动静脉内瘘手术皮肤切口中的对比研究

目的 探讨美容缝合法与传统缝合法在动静脉内瘘手术皮肤切口缝合中的效果差异。方法 选取南充市中心医院血液净化中心2020年10月~12月行动静脉内瘘手术的40例患者作为研究对象,随机分为美容缝合法组和传统缝合法组,各20例;前者采用美容缝合法缝合内瘘手术皮肤切口,后者采用传统缝合法缝合内瘘手术皮肤切口。观察两组患者的皮肤切口缝合时间,术后即刻的内瘘通畅率,内瘘血流量,观察两组患者术后1周、2周皮肤切口的并发症（红肿、感染）发生及线结反应情况,观察两组患者术后3周的皮肤切口愈合及切口瘢痕形成情况,比较两组患者的满意度。结果 与传统缝合法相比,美容缝合法组的缝合时间更长,线结反应程度以及瘢痕评分更低,然而满意度更高（P＜005）;美容缝合法发生切口并发症的例数较少、甲级愈合比例较高,但是与传统缝合法相比,并无统计学差异（P＞005）;两组患者在术后即刻的内瘘通畅率以及内瘘血流量方面,无统计学差异（P＞005）。结论 美容缝合法具有并发症发生程度低,患者满意度高的优势,值得临床推广。     

关节镜下双后内侧入路单纯缝线联合经胫骨骨隧道二次固定治疗后交叉韧带胫骨止点撕脱骨折16例疗效分析

目的　研究关节镜下双后内侧入路单纯缝线联合经胫骨骨隧道二次固定治疗后交叉韧带胫骨止点撕脱骨折的临床效果。　方法　选取2018年5月至2020年8月收治的单纯后交叉韧带止点撕脱骨折16例,对其行关节镜下双后内入路单纯缝线复位固定联合经胫骨骨隧道二次固定技术,术后随访1年,对其临床治疗效果（Lysholm评分、IKDC评分及后抽屉试验）进行评价。　结果　手术顺利,术中无副损伤。术后1年后抽屉试验阴性,Lysholm膝关节功能评分（91.67±5.16）及IKDC评分（89.74±4.28）较术前明显增加,差异有统计学意义（P<0.05）。　结论　关节镜下双后内入路,应用单纯缝线联合经胫骨骨隧道二次固定技术治疗单纯后交叉韧带止点撕脱骨折临床效果肯定,值得普遍推广。     

Comparison between suture and staple fixations as internal fixation techniques for Akin osteotomy

BackgroundSuture and staple fixations are commonly used methods for Akin osteotomy; however, there has been a paucity of studies comparing these methods without bias.Patients and methodsWe retrospectively compared the outcomes of 58 Akin osteotomies performed by a single surgeon using suture fixation and 39 Akin osteotomies performed by the same surgeon using staple fixation during the same period.ResultsBone union at the osteotomy site was achieved in all cases with no cases of complications related to the materials used. Occurrence of breakage of the lateral cortex of the proximal phalanx showed no significant difference between the suture and staple groups. The lateral cortex breakage produced greater instability at the osteotomy site with the staple fixation compared to the suture fixation.ConclusionsComparison of suture and staple fixations of Akin osteotomy demonstrated the superiority of suture fixation against staple fixation in terms of stability and cost-efficiency.