Objective To study the effect of microtraumatic treatment of postoperative recurrent bone cysts in juvenile patients. Methods FromDecember 1984 to December 2003, 36 cases of postoperative recurrent bone cysts after focal curettage and bone graft included 19 males and 17 females, aging 9-21 years-with an average of 15 years. The size of bone cyst ranged from 2.5 cm×6.0 cm to 3.5 cm×13.0 cm with an average of 3.0 cm×8.0 cm. The locations were proximal humerus in 18 cases, humeral shaft in 10 and femoral trochanteric region in 8. The focal curette and bonegraft were given once in 23 cases, twice in 10 cases and 3 times in 3 cases. The interval between recurrence and microtraumatic treatment was 5-13 months (6.5 months on average). The posteroanterior and lateral X-ray films were takento determine the location, range and feature of the focus. Under local anesthesia, 2 canulated needles were used; one was used to aspirate the contents of the cyst, the other was used to inject hydrocortisone acetate. The dose was determined according to the range of the focus. The treatment was repeated every 3.54 months until the focus healed. Results All patients were followed up from 3 to 18 years with an average of 5 years. The microtraumatic treatment was repeated 3-11 times with an average of 6 times. Twenty-six cases healed completely, 6 cases healed significantly, and 4 cases healed partially. No local or general complications occurred during the treatment. Conclusion This microtraumatic method for the treatment of postoperative recurrent bone cyst in juvenile patients has following advantages : less pain, easy manipulation, no hospitalization, low cost and definite effect.
目的 探讨泡沫硬化剂治疗复发性下肢静脉曲张的临床疗效。方法 选择我院2011年1月至2012年3月期间23例（26条患肢）复发性下肢静脉曲张的患者，其中男9例，平均年龄58.6岁；女14例，平均年龄53.3岁。静脉曲张复发病史1个月～6年，平均3.2年。对其行超声引导下患肢曲张静脉内注射1%聚桂醇泡沫硬化剂后弹力袜压迫，治疗后3d、3个月超声检测曲张静脉闭合情况及有无深静脉血栓形成，3个月后不定期病房随访。结果 23例患者均在超声引导下成功行泡沫硬化剂治疗，20例（22条患肢）注射1次，3例（4条患肢）注射2次，每例患者每次平均应用5ml泡沫硬化剂。末次注射结束后3d观察曲张静脉均成功闭合。平均随访6个月，治疗后1周2例出现轻度血栓性浅静脉炎，2周内自行缓解，均无严重并发症发生。治疗后3个月3例（4条患肢）局部复发，复发率15.4%，再次局部泡沫硬化剂治疗后至今未复发。10例（12条患肢）注射部位皮肤出现轻度色素沉着，3个月后减轻，6个月至1年消退。所有患者临床症状得到不同程度的缓解。结论 泡沫硬化剂治疗复发性下肢静脉曲张近期疗效确切且并发症少。
ObjectiveTo investigate the correlation between glenohumeral joint congruence and stability in recurrent shoulder dislocations. Methods Eighty-nine patients (89 sides) with recurrent shoulder dislocation admitted between June 2022 and June 2023 and met the selection criteria were included as study subjects. There were 36 males and 53 females with an average age of 44 years (range, 20-79 years). There were 40 cases of left shoulder and 49 cases of right shoulder. The shoulder joints dislocated 2-6 times, with an average of 3 times. The three-dimensional models of the humeral head and scapular glenoid were reconstructed using Mimics 20.0 software based on CT scanning images. The glenoid track (GT), inclusion index, chimerism index, fit index, and Hill-Sachs interval (HSI) were measured, and the degree of on/off track was judged (K value, the difference between HSI and GT). Multiple linear regression was used to analyze the correlation between the degree of on/off track (K value) and inclusion index, chimerism index, and fit index. ResultsMultiple linear regression analysis showed that the K value had no correlation with the inclusion index (P>0.05), and was positively correlated with the chimerism index and the fit index (P<0.05). Regression equation was K=–24.898+35.982×inclusion index+8.280×fit index, R2=0.084. ConclusionHumeral head and scapular glenoid bony area and curvature are associated with shoulder joint stability in recurrent shoulder dislocations. Increased humeral head bony area, decreased scapular glenoid bony area, increased humeral head curvature, and decreased scapular glenoid curvature are risk factors for glenohumeral joint stability.
ObjectiveTo summarize the experience of diagnosis and treatment of a case of adult hepatic fibrohistiocytoma with recurrent rupture and hemorrhage.MethodsRetrospective analysis on this case of recurrent adult fibrohistiocytoma with rupture and hemorrhage admitted to Shengjing Hospital Affiliated to China Medical University in May 2018 was conducted, discussion on MDT was conducted before surgery, and the causes of recurrent rupture and hemorrhage, as well as the experience of diagnosis and treatment were summarized and analyzed.ResultsThis patient was generally in good condition. After MDT discussions among the imaging department, oncology department, interventional department, and hepatobiliary surgeons, it was considered that surgical treatment was the best treatment scheme. After full communication with the patient and his family, the patient had chosen open tumor resection and the operation was smooth. The operation time was 278 min, intraoperative bleeding was about 100 mL, and no blood transfusion was performed. No bleeding, abdominal infection, gastroparesis, and other complications occurred after the operation, and the patient was discharged successfully on the 13th day after the operation. The patient had been interviewed for 8 months and the tumor recurred again 1 month ago. Currently, oral apatinib had been targeted for treatment for more than 1 month, and the follow-up treatment continued.ConclusionsRecurrent adult fibrous histiocytoma with rupture and hemorrhage is rare in clinical practice, and the treatment is mainly based on surgical resection. Postoperative comprehensive treatment combined with radiotherapy, chemotherapy, molecular targeting, and immunotherapy is the main treatment. Its short-term efficacy is satisfactory, but long-term efficacy still needs to befurther observed.
ObjectiveTo observe the effectiveness of arthroscopic reconstruction of medial patellofemoral ligament (MPFL) with a single bundle of autogenous half peroneal longus tendon, and medial displacement of lateral hemitibial tuberosity for the treatment of recurrent dislocation of patella.Methods Retrospectively analyse the clinical data of 24 patients (24 knees) with recurrent patellar dislocation with tibial tuberosity-trochlear groove distance (TT-TG) values more than 15 mm who were admitted between September 2014 and September 2018. Of which 7 were male and 17 were female; aged 16-35 years old with an average of 25.8 years. The disease duration ranged from 15 to 46 months, with an average of 26.7 months. All patients had a history of knee trauma, and a positive result of apprehension test on the affected knee. All patients underwent the surgery of arthroscopic reconstruction of MPFL with a single bundle of autogenous half peroneal longus tendon, and medial displacement of lateral hemitibial tuberosity. Before and after operation, Kujala score was used to evaluate patellofemoral joint function, Lysholm score was used to evaluate knee joint function; CT and MRI were used to measure and compare the changes of congruence angle (CA), patellar tilt angle (PTA), and lateral patella displacement (LPD) in order to evaluate patella stability.ResultsAll incisions healed by first intention, and no infection or neurovascular injury occurred. Deep vein thrombosis of the lower extremities occurred in 2 cases at 4 and 7 days after operation respectively, and the thrombosis disappeared after symptomatic treatment. All the 24 patients were followed up 12-14 months (mean, 12.9 months). During follow-up, no patellar dislocation reoccurred in the affected knee. At last follow-up, the apprehension test was negative in every patients. The TT-TG, CA, PTA, and LPD were significantly improved when compared with those before operation (P<0.05). The Kujala score and Lysholm score at 1 month and last follow-up were significantly better than those before operation, and the above scores at last follow-up were significantly better than those at 1 month after operation (P<0.05). According to Lysholm score, the patients’ knee joint functions were excellent in 13 cases, good in 10 cases, and fair in 1 case, and the excellent and good rate was 95.8%.ConclusionArthroscopic reconstruction of MPFL with a single bundle of autogenous half peroneal longus tendon combined with medial displacement of lateral hemitibial tuberosity has the advantages of minimal invision and reliable effectiveness. It can be used as one of the effective surgical methods for the treatment of recurrent dislocation of patella.
ObjectiveTo summarize the current status and progress of surgical treatment for postoperative recurrent hepatocellular carcinoma (HCC).MethodThe literatures about studies of surgical treatment of postoperative recurrent HCC were reviewed.ResultsThe surgical operation was an effective method for the treatment of recurrent HCC. The operation methods included re-hepatectomy and salvage liver transplantation. There was no uniform standard for the indication of re-hepatectomy, but the basic principles were the same. At present, the indication of salvage liver transplantation was mainly based on Milan criteria. For patients with recurrent HCC who met the operation indications, surgical operation could improve the long-term survival rate of patients and benefit the patients.ConclusionIt migh prolong the survival time and improve the long-term survival rate of patients with recurrent HCC when the appropriate patients and reasonable surgical methods are chosen according to the surgical indications, the tumor situation of initial hepatectomy, postoperative recurrence time, and other factors.
ObjectiveTo review the causes of Latarjet surgery failure and various revision surgeries, in order to provide the reference for the revision of treatment options for Latarjet surgery failure.MethodsLiterature on the causes of Latarjet surgery failure and revision surgeries was extensively reviewed and analyzed. ResultsLatarjet surgery is widely used in clinical practice for recurrent anterior dislocation of shoulder with glenoid defects, especially for the defects of more than 25%. The main reasons for its failure are ununion, bone resorption, graft dislocation, trauma, and graft fracture, etc. The revision surgeries are diverse, the standard treatment has not yet been formed. The revision surgeries include open iliac bone grafting, microscopic Eden-Hybinette surgery, soft tissue reconstruction, open or arthroscopic bone grafting, etc. The differences among the revisions are mainly reflected in grafts, complications, and their costs.ConclusionLatarjet surgery is difficult to operate and requires high technical requirements for the surgeons. It is necessary to continuously improve the surgical technology to reduce the complications related to Latarjet surgery and its revision surgery.