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1.
Background
Despite significant pain relief following total hip arthroplasty (THA) in patients with ankylosing spondylitis, a small subset of patients presenting with extra-articular extension contracture of hips remains unsatisfied.Methods
We retrospectively evaluated the patients with ankylosing spondylitis who underwent simultaneous bilateral THA and had extensor tightness of both hips preoperatively. They were managed with modified Z-plasty of iliotibial band. Patients with windswept deformity, commonly seen in bilateral hip arthritis caused by ankylosing spondylitis, were excluded.Results
Between July 2011 and June 2015, out of 148 patients with bilateral hip involvement, 10 patients (20 hips) had extension contracture of both hips that was addressed during surgery. All patients were followed up for a minimum of 2 years. They could sit comfortably on a chair of height 18 inches with hips and knees flexed to at least 90°. The mean postoperative sum range of motion was 144.6° with an average hip flexion of 95° (range, 90°-105°). None of them had recurrence of extension contracture. There was significant improvement in range of motion and hence ambulation and function. No radiolucent lines exceeding 2 mm were seen in any of the zones around either of the components as evaluated in latest X-rays.Conclusion
Extension contracture of hip although rare is a noticeable problem and needs to be addressed during THA. Modified Z-plasty technique of iliotibial band is a reliable method in managing these patients. 相似文献2.
3.
BackgroundHealth research reporting guidelines for case reports (CARE - CAse REport) published in 2013 and 2017 have become a generally accepted standard for publishing case reports. The CARE guidelines represent an architectural framework for writing an evidence-based case report that can be customized as need for a specialty (or disease) if needed. We aim to develop a CARE guideline extension for acupuncture following the EQUATOR Network (Enhancing the QUAlity and Transparency Of health Research) and the 2010″Guidance for Developers of Health Research Reporting". We have established a group of international experts including; clinicians, researchers and methodologists. We performed a needs assessment based on a review of acupuncture case reports published in the indexed medical literature. The needs assessment will be followed by (1) a series of expert interviews to establish a draft, (2) a modified Delphi process, and (3) a consensus meeting. Following the consensus meeting we will pilot test the CARE draft before publishing the CARE extension for acupuncture.MethodsWe will develop the CARE extensions for acupuncture following recommendations of the EQUATOR Network and the 2010 "Guidance for Developers of Health Research Reporting". We will establish an international multidisciplinary group including clinical practitioners, acupuncturists, researchers of reporting guidelines on acupuncture, clinical epidemiologists and statisticians.We performed a needs assessment, reviewing published case reports using acupuncture as a therapeutic intervention from indexed medical journals (PubMed-PMC and Medline, Scopus, Embase, the Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Wan Fang database, Chinese BioMedicine database (CBM), China National Knowledge Infrastructure (CNKI), and VIP). In consultations with advisors we will develop a draft of potential items to be included in the CARE extension for acupuncture. Then we will conduct a modified Delphi process of at least three rounds, hold a face-to-face consensus meeting, pilot test and submit the CARE extension for acupuncture for publication.ConclusionThe development of a widely accepted CARE extension for acupuncture for case reports published in indexed medical journals. These guidelines will follow the EQUATOR Network recommendations and the 2010 "Guidance for Developers of Health Research Reporting". 相似文献
4.
介绍几种残指延长拇指再造的方法 总被引:1,自引:0,他引:1
本文报告带血管神经蒂组织瓣移位及手残指缓慢延长术治疗64例拇指缺损,拇指平均延长2.6cm,平均随访时间3年6个月,再造拇指外形及功能均较满意。本法简单、安全、有效。拇指掌指关节以远缺如,残端指骨长1cm以上者行指骨延长术,不足1cm者可行第1掌骨延长术、二期行虎口加深术。掌指关节平面缺如采用第1掌骨延长术或带血管蒂皮瓣移位再造拇指。也可用带桡骨片的前臂桡侧皮瓣一期再造拇指。第1掌骨近侧平面缺如, 相似文献
5.
6.
Effect of compressive follower preload on the flexion-extension response of the human lumbar spine. 总被引:5,自引:0,他引:5
Avinash G Patwardhan Robert M Havey Gerard Carandang James Simonds Leonard I Voronov Alexander J Ghanayem Kevin P Meade Thomas M Gavin Odysseas Paxinos 《Journal of orthopaedic research》2003,21(3):540-546
Traditional experimental methods are unable to study the kinematics of whole lumbar spine specimens under physiologic compressive preloads because the spine without active musculature buckles under just 120 N of vertical load. However, the lumbar spine can support a compressive load of physiologic magnitude (up to 1200 N) without collapsing if the load is applied along a follower load path. This study tested the hypothesis that the load-displacement response of the lumbar spine in flexion-extension is affected by the magnitude of the follower preload and the follower preload path. Twenty-one fresh human cadaveric lumbar spines were tested in flexion-extension under increasing compressive follower preload applied along two distinctly different optimized preload paths. The first (neutral) preload path was considered optimum if the specimen underwent the least angular change in its lordosis when the full range of preload (0-1200 N) was applied in its neutral posture. The second (flexed) preload path was optimized for an intermediate specimen posture between neutral and full flexion. A twofold increase in flexion stiffness occurred around the neutral posture as the preload was increased from 0 to 1200 N. The preload magnitude (400 N and larger) significantly affected the range of motion (ROM), with a 25% decrease at 1200 N preload applied along the neutral path. When the preload was applied along a path optimized for an intermediate forward-flexed posture, only a 15% decrease in ROM occurred at 1200 N. The results demonstrate that whole lumbar spine specimens can be subjected to compressive follower preloads of in vivo magnitudes while allowing physiologic mobility under flexion-extension moments. The optimized follower preload provides a method to simulate the resultant vector of the muscles that allow the spine to support physiologic compressive loads induced during flexion-extension activities. 相似文献
7.
髂骨截骨延长术下肢延长量计算方法的探讨 总被引:1,自引:0,他引:1
温鑫 《山东医学高等专科学校学报》1992,14(2):103-108
髂骨截骨延长术下肢的延长量及其测算方法报道不一。根据手术的生物力学原理和肢体延长的机理,认为肢体的延长量是由患肢绝对延长和相对延长两部分组成的,它与髂骨截骨间距密切相关,经数学推算,其方法为测量X线片髂骨截骨撑开的梯形中心间距(cm),减去X线片的放大值(cm)再除以0.7;手术时髂骨需要撑开的宽度(cm)为肢体短缩数(cm)乘以0.7。经临床103例手术验证,这种计算方法是准确的。 相似文献
8.
Granulocytic sarcoma (GS) is a localized tumour of immature granulocytes that is usually associated with myelogenous leukaemia. We report an unusual case of mastoid GS with meningeal extension but no bone marrow involvement on presentation. Histological examination of the surgical specimen and the characteristic cerebrospinal fluid (CSF) cytology showing cytoplasmic granulations and Auer bodies led to the diagnosis of GS. Positive cytochemical staining of the immature CSF cells for naphtol-ASD chloroacetate esterase and myeloperoxidase confirmed their myeloid origin. Immunophenotyping did not reveal common acute lymphoblastic leukaemia antigen, cytokeratin, T or B-cell antigens. The patient underwent surgical resection of the localized tumour, followed by radiation therapy, intrathecal and systemic chemotherapy, as if he had acute myelogenous leukaemia (AML). He did not develop AML in the 21 months after the tumour resection. This case emphasizes the value of CSF cytological examination of tumour cells and the use of an immumocytochemical marker for differentiating GS from malignant lymphoma. 相似文献
9.
10.
目的:检测lnc-CCDC33-1:1在甲状腺乳头状癌(PTC)中的表达,并分析其临床意义。方法:选取2021年11月至2022年3月杭州市萧山区第一人民医院收治的120例PTC患者,收集120例PTC组织及30例癌旁正常甲状腺组织。采用qRT-PCR检测lnc-CCDC33-1:1在PTC组织及癌旁组织中的表达。分析本地队列和TCGA队列中lnc-CCDC33-1:1表达水平与PTC患者临床病理因素的相关性。采用受试者工作特征(ROC)曲线评价lnc-CCDC33-1:1对PTC的诊断价值。结果:与癌旁正常甲状腺组织比,lnc-CCDC33-1:1在PTC组织中表达明显升高(P <0.001)。ROC曲线显示曲线下面积为0.803(95%CI =0.736~0.869,P <0.001)。本地队列显示lnc-CCDC33-1:1 表达与PTC肿瘤大小(P =0.048)、腺外侵犯(P =0.019)、T分期(P =0.011)和淋巴结转移(P =0.009)相关,TCGA组数据显示lnc-CCDC33-1:1表达水平与PTC腺外侵犯(P =0.036)和淋巴结转移(P <0.001)相关。结论:lnc-CCDC33-1:1在PTC中表达异常升高,与PTC高危特征相关,可能是潜在的诊断标志物和治疗靶点。 相似文献