Radiographic Measurements of Patients With Juvenile Hallux Valgus Compared With Age-Matched Controls: A Cohort Investigation

The purpose of this study was to investigate radiographic measurements in a cohort of patients with juvenile hallux valgus (with a hallux valgus angle > 15 degrees ) using standardized weightbearing x-rays compared with an age-matched control group. First metatarsal protrusion distance, metatarsus primus adductus angle, metatarsus adductus, first metatarsal cuneiform angle, calcaneal inclination angle, and talocalcaneal angles were assessed with discriminant functional analysis. A total of 37 sets of data were analyzed from patients with a mean age of 13.45 +/- 1.75 years. The study identified 2 significant components of juvenile hallux valgus: a positive first metatarsal protrusion distance (P <.001) and metatarsal primus adductus angle (P = .002). Discriminant functional analysis was then used to determine the best predictors of juvenile hallux valgus. This analysis allowed only 1 variable, metatarsal protrusion distance, as a predictor of whether juvenile hallux valgus was present (P < .001), with 94.3% accuracy. This study showed that a positive metatarsal protrusion distance is a significant component of juvenile hallux valgus.     

眶骨延长术治疗眼球突出的实验研究

目的探讨眶骨延长术扩大眶容积治疗眼球突出的可行性。方法1年龄山羊6只,环行截开右侧眶壁,于眶上壁放置延长器,侧向延长1.5cm,经大体、X线、干骨标本及组织学观察成骨情况。结果6只山羊眶骨得到不同程度的侧向延长,延长侧随着眶骨容量的增加,眼球突度较自身对照侧为小。结论眶骨延长术可造成山羊眶骨侧向移位,有可能成为治疗眼球过度突出的方法之一。     

脊椎滑脱症合并腰椎间盘突出的治疗

1987年6月至1995年1月我院共治疗脊椎滑脱55例,其中17例合并腰椎间盘突出,占31％,临床表现为顽固的腰骶痛和下肢根性放射痛。手术复位、融合不稳定脊椎的同时,均摘除突出的椎间盘髓核组织。经半年以上随访,疗效满意,作者分析了本病的病因病理,认为诊断该病必须综合性检查分析,脊髓造影或CT检查有一定影像学诊断价值,治疗宜早行探查手术。     

Early postoperative colonic ventriculoperitoneal shunt migration with trans-anal protrusion: A unique case report

Introduction and importanceColonic ventriculoperitoneal shunt (VPS) migration with trans-anal protrusion remains uncommon. Patients may be asymptomatic, and diagnosis may only be made on visualization of the prolapsed catheter from the anus. This unique case of early post-operative trans-anal shunt protrusion highlight the possibility of this rare complication specially when shunt revision accompanies bowel surgery.Case presentationThe authors present a case of early postoperative colonic shunt migration in a thirteen-year-old female with who underwent Malone Antegrade Continence Enema (MACE) with concomitant revision of the distal part of the peritoneal catheter. She presented two weeks post operatively with shunt catheter protruding from the anus. This was noticed by her carer and she was asymptomatic on her presentation.Clinical discussionDelayed post-operative shunt related bowel perforation and trans-anal shunt protrusion is an uncommon complication after ventriculoperitoneal shunting. Most cases present months after surgery and majority are asymptomatic on presentation. The exact pathophysiology is not established, and mechanisms have been proposed. Early post -operative trans-anal shunt protrusion is rare and suggests inadvertent occult bowel injury especially when shunt placement or revision accompanies extensive bowel surgery.ConclusionThe authors recommended shunt imaging within the first two to three weeks after shunt revision in patient who undergo concomitant bowel surgery with risk of inadvertent bowel injury to identify early colonic migration and avoid its potentially fatal sequelae.     

中年人上颌前突错 的修复正畸疗效评价

目的　评价修复正畸法对中年人上颌前突错治疗的疗效。方法　应用修复正畸法在短时间内对 18例中年人 (女性 16例 ,男性 2例 ,平均年龄 45 .6岁 )上颌前突进行治疗 ,并以X线头颅侧位定位片分析方法 ,对其疗效进行评价。结果　经过修复正畸法治疗 ,上中切牙长轴明显舌侧倾斜 ,上下中切牙构成角度趋于正常 ,覆、覆盖关系基本接近正常 ;上下唇软组织最前点明显后退 ,侧貌形态显著改善。结论　修复正畸法为不适合正畸治疗的中年人错畸形提供了行之有效的治疗手段。     

自动经皮椎间盘切吸术治疗颈椎间盘突出症48例

目的　对自动经皮颈椎间盘切吸术治疗颈椎间突出症的适应证及疗效进行探讨。方法　在局麻下行颈前路经皮穿刺切吸术 ,4 8例以 4 0岁为限 ,小于 4 0岁为A组共 2 0例 ,大于 4 0岁为B组共 2 8例 ,术后随访 6～ 2 4个月。两组结果用 χ2 检验。结果　A组优良率为 95% ,B组优良率为 60 % ,其疗效比较有显著性差异 ,(P <0 .0 5)。结论　经皮颈椎间盘切吸术治疗颈椎病是一安全、有效的措施 ,严格掌握适应证是提高成功率的关键     

192例腰椎间盘突出症患者的诊断及手术治疗分析

目的：总结分析１９２例腰椎间盘突出症及侧隐窝狭窄伴黄韧带肥厚患者的诊断和手术治疗。方法：经临床检查明确定位、定性诊断,影像学检查证实,采用小切口半椎板或全椎板切除减压、突出椎间盘髓核切除手术治疗。结果：手术证实腰椎间盘突出症１８９例,侧隐窝狭窄伴黄韧带肥厚３例,术后随访６月－５年,优良率７９％。结论：临床检查是腰椎间盘突出症诊断的基础,影像学检查对进一步明确定位诊断和鉴别诊断是必要的。手术指征的严格把握是手术成功的关键。     

胶原酶注射治疗腰椎间盘突出症32例随访报告

为了解胶原酶治疗腰椎间盘突出症的远期疗效,对３２例病人进行了随访。其中１５例将胶原酶４００～６００Ｕ注入病变椎间盘内（盘内注射法）;１７例将胶原酶６００～１２００Ｕ注入病变椎间盘的椎间孔附近的硬膜外间隙（盘外注射法）。３年随访结果为：优１７例、良２例、可６例、劣７例（其中４例又做开放椎间盘髓核摘除术）。优良率５９．４％,有效率７８．１％,再手术率为１２．５％,未发现明显并发症。     

微型种植体支抗在正畸治疗双颌前突中切牙及磨牙位置变化的研究

目的：研究微型种植体支抗治疗双颌前突病例的，临床应用效果。方法：选择在沈阳市口腔医院正畸科就诊，符合纳入标准的双颌前突患者14例，随机分成2组，分别采用微型种植体与传统方法加强支抗，通过术前术后X线头影测量结果变化评价2种支抗方法的临床有效性。结果：2组患者在6～8个月后上下颌前牙内收均达到预定位置，实验组上下颌第一恒磨牙牙冠分别近中移动0、29mm和0．56mm，上下颌切牙切缘分别腭侧移动6．93mm和6．03mm；对照纽上下颌第一恒磨牙牙冠分别近中移动1．36mm和1．96mm，上下切牙切缘分别腭侧移动5．79mm和4．21mm。结论：微型种植体支抗完全可以代替传统支抗方法，满足正畸临床治疗双颌前突的需要，实现前牙最大程度的内收。     

椎弓根螺钉内固定联合后路椎间融合治疗复发性腰椎间盘突出症疗效观察

目的回顾性分析38例椎弓根螺钉内固定联合后路椎间融合治疗复发性腰椎间盘突出症病人的临床资料,评价椎弓根螺钉内固定联合后路椎间融合中的临床价值。方法38例病人,26～72岁,平均51.3岁。行腰椎后路病变节段脊柱附件切除椎管减压椎弓根螺钉内固定及椎间植骨融合术。平均随访4.7年。随访观察指标有JOA评分、植骨融合、临床症状缓解情况、并发症发生情况及病人满意度调查。结果所有患者临床症状都有不同程度的缓解。临床恢复率术后半年、术后1年及最终随访时分别为78.9%、92.1%和68.4%。最后1次随访的融合率达97.4%。2例未观察到可靠的融合,并在术后2年出现内固定的断裂而再次手术。围手术期并发症发生率为26.3%,远期并发症发生率为6.2%。病人满意率达94.7%。结论应用椎弓根螺钉内固定联合后路椎间融合治疗复发性腰椎间盘突出症病人可以取得良好疗效。