The "bayonet" deformity from poliomyelitis is a peculiar type of deformity of knee. From January 1986 through December 1994, 23 cases of this type of knee deformity were corrected by surgery. The operative procedures performed were suprachondylar osteotomy of femur or subplateau osteotomy of tibia. The patients were followed up from 1 to 5 years, with an average of 3 years. The result rated excellent to good was 95.6%. The features of this disorder and the main points in the surgical procedure were discussed.
In 1984, according to the criteria of the classifieation for congenital hand deformity which wasput out by the International Hand Surgery Committee, we had made an investigation for congenitalhand deformity among 318066 newborns in Shanghai. It was found that the inctdence of a congenitalhand malformation was 0. 0808 percent among the total newborns. The congenital malformation ofthe thumb was 37. 74 percent of all deformities of the hand. According to the statistical analysis, we ...
Abstract Postburn deformities, including hypertrophic scars, scar contracture and defect or deformity of tissue or organ, are the commonest disorders in plastic surgery. It is also difficult to deal with. If the diformity involved multiple organs, oftentimes the teatmentis very difficult because the material for repair is limited and the donorsite usually could not provide adequate amount of skin for repair. Since 1978,2496 cases of various postburn deformities were admitted. In this article, theoptimal time to operate was discussed. The use of flap transfer and soft tissueexpander was described. Prolonged traction in the treatment of severe contracture of large joint was also described.
The hydroxyapatite particles were used to repair 23 cases of depressed deformities of face. The patients were follwed up for 3 to 8 months and the short termresults were satisfactory. The operative procedure was briefly introduced. The advantages and attentions relevant to the operation were discussed.
Objective To analyze the cl inical results of different surgical approaches in treating hallux valgus deformity in children and adolescents. Methods From April 2000 to April 2007, 18 cases of hallux valgus deformity (30 feet) were treated. According to different ages, they were divided into children group ( 10 years) and adolescent group (11-18 years). In children group, 4 female patients included 2 bilateral and 2 unilateral hallux valgus deformity (2 left feet, 4 right feet). Each patient underwent a combination of Austin osteotomy and McBride procedure. The American Orthopaedic Foot and AnkleSociety-Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) score was 55.0 ± 15.0, and the visual analogue scale (VAS) score was 6.0 ± 2.0. The hallux valgus angle (HVA) and 1st-2nd intermetatarso-phalangeal angle (IMA) were (35.0 ± 4.0)° and (14.4 ± 2.0)°. In adolescent group, 14 patients included 3 males (4 feet) and 11 females (20 feet), 10 bilateral and 4 unilateral hallux valgus deformity (10 left feet, 14 right feet). Each patient underwent the modified Mitchell osteotomy. The AOFAS-HMI score was 55.6 ± 14.0, and the VAS score was 7.0 ± 1.0. The HVA and IMA were (38.5 ± 5.0)° and (15.0 ± 3.0)°. Results All incisions healed primarily. The patients of two groups were followed up 12-32 months (21 months on average). In adolescent group, pain of metatarsophalangeal joint occurred in 1 case and the symptom disappeared after 3-month physical therapy; 1 case recurred after 21 months of operation and achieved satisfactory results after Lapidus operation. In children group, the AOFASHMI score was 92.1 ± 5.0, the VAS score was 1.0 ± 0.6, HVA was (14.7 ± 3.0)°, and IMA was (5.5 ± 2.0)°; showing significant differences (P lt; 0.05) when compared with those before operation. In adolescent group, the AOFAS-HMI score was 90.0 ± 6.0, the VAS score was 1.0 ± 0.6, HVA was (13.7 ± 3.0)°, and IMA was (6.8 ± 2.0)°; showing significant differences (P lt; 0.05) when compared with those before operation. Conclusion It has the advantages of rapid bone heal ing, short course of treatment, and less compl ication to treat hallux valgus deformity in children with a combination of Austin osteotomy and McBride procedure and in adolescent with the modified Mitchell osteotomy.
Double adjacent-finger skin flap could be used to treat severe cicatricial contracture of fingers with resultant complete release of contracture and good coverage of raw surface. From the follow-up, it was noted that the appearance of the fingers following treatment looked nice, no recurrence of contracture in the late stage, and partial sensation of the fingers could be recovered as well. It had no ill-effect on the donor fingers, The method was simple and reliable,from 1987, a total of 4 cases had been done,and the functional recovery wassatisfactory.
Objective To introduce an integral classification method of thoracic deformity. Methods From March 2015 to March 2017, 869 patients with thoracic deformity were observed. The patients were classified according to the traditional classification method at first, and then were classified according to the integral classification method. According to the standard plane of the normal chest wall, the chest deformities were classified into types Ⅰ and Ⅱ: those below the plane belonged to type Ⅰ, and those above the plane belonged to type Ⅱ. Then two types were divided into subtypes Ⅰ-a, Ⅰ-b, Ⅰ-c, Ⅰ-d, Ⅰ-e, Ⅰ-f, Ⅰ-g and Ⅱ-a, Ⅱ-b, Ⅱ-c, Ⅱ-d according to the specific characteristics of malformation. Results There were 840 patients included in the classification system, accounting for 96.7% of the total patients, and the remaining 29 (3.3%) were complicated malformations, which could not be accurately described by using a single classification type. Compared with the traditional classification methods, patients with pectus excavatum and pectus carinatum were divided into different subtypes. Poland syndrome did not exist any longer, and Dove chest alone became the type Ⅱ-c. Conclusion Integral classification method is a simple and practical classification method. Since the method directly depends on the characteristics of malformation which is related to the operation, it plays a guiding role in the operation. But its superiority needs to be further confirmed.
Objective To develop a multidisciplinary nursing program for Prader-Willi syndrome with spinal deformity and evaluate its effectiveness in clinical practice. Methods In July 2016, a multidisciplinary collaborative team was established before the treatment of children with Prader-Willi syndrome complicated with spinal deformity. For the nursing difficulties in the perioperative period, relevant literature was consulted, and a multidisciplinary collaborative nursing plan was formulated, which included nutrition management and blood glucose control, management of obstructive sleep apnea hypopnea syndrome, behavioral intervention related to mental change, and early identification and management of complications. The developed multidisciplinary collaborative nursing program was applied to three children with Prader-Willi syndrome complicated with spinal deformity in Peking Union Medical College Hospital from July 2016 to October 2018, and their postoperative recovery was evaluated. Results One child had inguinal skin ulceration when admitted to hospital, which was significantly improved after active treatment. The perioperative blood glucose level control of the three children was satisfactory, and there was no postoperative gastrointestinal dysfunction, deep wound infection, respiratory complications, internal fixation failure or other complications, and no asphyxia, fall, loss, or other adverse events. The follow-up compliance after discharge was 100%. Conclusions Multidisciplinary collaboration programs can escort patient’ safety and promote their recovery, improve the professional level of nursing staff, and reflect the nursing value. As a working mode, it can be further popularized and used for reference in the nursing of other difficult diseases.
Objective To detect the operative technique and aesthetic problem of reconstruction to deformity of bilateral cleft lip． Methods From March 2003 to December 2004, 26 patients with bilateral cleft lip were treated, aged 10 months to 11 years. Of 26 patients, there were 13 bilateral complete cleft lip and palate, 9 bilateral incomplete cleft lip and 4 mixed cleft lip with unilateral complete cleft palate. The chief design principle was keeping the length of prolabium. During operation, sufficient dissociation was made in the base of the ala base and orbicularis oris muscle to reconstruct these structures．The circle suture was made for the bilateral orbicularis oris muscle. The shape of vermilion was achieved by lateral red lip muscle flap and simultaneous simple rhinoplasty was performed. Results Primary healing of the incisions was achieved in all cases. After the 10 days-3 months follow-up, the results were satisfactory in thewidth and chubbiness of the nose bottom,the shapes of nostril and Cupid’s bow were good without whistle deformity. Theapperance of upper lip was good in either dynamic or static state． Conclusion Excellent shapes and function of the nose and lip， and opportunity for twostage repair could be obtained with this method，which being believed important methods for the primary repair of bilateral cleft lip．
ObjectiveTo explore the practical feasibility of the weaving technique for pectus carinatum.MethodsFrom January 2011 to December 2018, a total of 51 patients with pectus carinatum, including 47 males and 4 females at age of 9-29 (13.7±2.9) years, were applied with minimally invasive waving technique for the correction. The steel plate was inserted through the subcutaneous layer, intercostal space and over the sternal surface under direct thoracoscopic vision. The number of implanted steel plates was determined by the degree of chest wall deformity. The steel plate was removed 2 years after surgery.ResultsAll the operations were successfully completed, the average operation time was 63.9±15.8 min, the amount of bleeding was 19.8±8.8 mL, and the duration of postoperative hospitalization was 4.6±1.6 d. The adverse events included intercostal artery injury (n=2), pneumothorax (n=4), pleural effusion (n=3) and skin rupture (n=1). And there were 29 patients of moderate pain (numerical rating scale 4-6 points) on the first day after surgery, but no patient was asked to remove the steel palate due to intolerable discomfort. All patients were followed up after plate placement. Of the 51 patients, the plates were removed in 37 patients until 2 years after placement, and the duration of postoperative hospitalization was 1.4±0.5 d. After 33 (1-48) months of routine follow-up after the removal of the plate, 22 patients achieved excellent outcomes and 9 patients with good outcomes. Besides, there were 5 patients with fair outcome and 1 patient with poor outcome. No adverse effect was found in growth and development after the steel plate placement.ConclusionMinimally invasive weaving technique is a safe, feasible, effective and individualized operation for pectus carinatum with substantial thoracic reconstruction.