Twelve cases (13 hips) of congenital dislocation of hip (CDH)in a group above the age of six were treated by Chiari pelvic osteotomy from Jan. 1991 to Dec. 1992. The results following operative treatment rated as good in 85 percents according to the clinical and radiologic examinations. The indications, and the results with the operation as the functional reconstuction of the hip concerned were discussed.
Acetabuloplasty was used to treat 62 cases (76 hips) of congenital dislocation of hip in older children, with a period of follow-up for 1 to 7 years. The good results from operation rated 81.7 percent. It was considered that this type of operation could fulfil the physiological requirements, as the femoral head replaced into the acetabulum would accomplish the following benefits from establishing a stable joint, reducing the lumbar lordosis and minimizing development of hip and low back pain. The technique ...
【摘要】 目的 观察综合疗法治疗大龄儿童弱视的疗效。 方法 回顾分析2008年1月-2010年10月在我院初诊并经综合治疗的8～13岁弱视儿童62例85只眼的临床资料。治疗前最佳矫正视力0.1~0.7，平均0.46±0.17。观察患者经弱视综合治疗后视力、空间对比敏感度及立体视提升效果。 结果 治疗后视力正常22例31只眼（36.5%），进步29例39只眼（45.9%），无效11例15只眼（17.6%）；总有效率82.4%，与治疗前相比，差异有统计学意义（Plt;0.001）。空间对比敏感度基本正常11例16只眼（18.8%），进步43例58只眼（68.2%），无效8例11只眼（12.9%）。弱视眼在1.5、3、6三个低空间频率的对比敏感度值与治疗前相比提升有统计学意义（Plt;0.001）；在12和18两个高空间频率，对比敏感度值与治疗前相比提升无统计学意义（Pgt;0.05）。立体视锐度正常12例（19.4%），进步26例（41.9%），无效24例（38.7%），立体视锐度与治疗前相比提升具有统计学意义（Plt;0.001）。 结论 综合疗法治疗大龄儿童弱视能取得令人较为满意的疗效，患儿视力显著提升，低到中等频率空间对比敏感度及立体视锐度也有较大提升。【Abstract】 Objective To explore the therapeutic effect of comprehensive therapy on elder children with amblyopia. Methods The clinical data of 62 patients (85 eyes) with amblyopia who underwent the comprehensive therapy between January 2008 and October 2010 were retrospectively analyzed. The best-corrected visual acuity was 0.1-0.7 (mean 0.46±0.17) before the treatment. The visual acuity, spatial contrast sensitivity and stereoacuity of the patients after the treatment were observed. Results After the comprehensive therapy, the visual acuity was normal in 22 patients (31 eyes, 36.5%), improved in 29 patients (39 eyes, 45.9%), invalid in 11 patients (15 eyes, 17.6%). The total effective rate was 82.4% which was differed significantly from that before the treatment (Plt;0.001). The spatial contrast sensitivity was almost normal in 11 patients (16 eyes, 18.8%), improved in 43 patients (58 eyes, 68.2%), and invalid in 8 patients (11 eyes, 12.9%). The examination of spatial contrast sensitivity showed that the improvement was only statistically significant when frequency equates 1.5, 3, or 6 (Plt;0.001) compared with those before the treatment; while no statistically significant improvement was observed in higher frequencies of 12, 18 (Pgt;0.05). The stereoacuity was normal in 12 patients (19.4%), improved in 26 (41.9%), and invalid in 24 (38.7%); the difference in stereoacuity before and after the treatment was significant (Plt;0.001). Conclusion The therapeutic effect of comprehensive therapy is good: the visual acuity of the patients improves obviously, and the low to middle spatial contrast sensitivity and stereoacuity improve apparently.
ObjectiveTo evaluate the effectiveness of titanium elastic nails for severe displaced proximal humeral fractures in older children. MethodsBetween April 2009 and July 2012, 31 cases of severe displaced proximal humeral fractures were treated with closed or open reduction and fixation with 2 titanium elastic nails, and the clinical data were retrospectively analyzed. There were 23 boys and 8 girls, aged from 10 to 15 years (mean, 12.8 years). The causes of injury were sports injury (16 cases), traffic accident (11 cases), and falling from height (4 cases). The interval from injury to operation was 6 hours to 7 days (mean, 72 hours). According to Neer-Horwitz classification, 17 cases were rated as type III fracture and 14 cases as type IV fracture. There were 21 cases of metaphyseal fractures and 10 cases of epiphyseal fractures. ResultsSatisfactory reduction of fracture and stable fixation were obtained in all patients (closed reduction in 23 cases and open reduction in 8 cases). Primary healing was achieved in all incisions; no infection and neurovascular injury occurred. All patients were followed up 12-36 months with an average of 20 months. X-ray films showed that all fractures healed at 7-10 weeks (mean, 8 weeks). During follow-up, no disturbance of development or angulation deformity caused by premature physeal closure or bone bridge formation was observed. At last follow-up, the average Neer score of the shoulder was 95.7 (range, 83-100). The appearance and motion of the shoulder were normal. There was no significant difference in the upper extremity length between affected side and contralateral side[(67.68±2.56) cm vs. (67.61±2.54) cm; t=-1.867,P=0.072]. ConclusionTitanium elastic nails for severe displaced humeral fractures in older children is a safe and effective method with a low complication incidence.
Objective To compare the effectiveness of titanium elastic nail (TEN) and locking compression plate fixation in treating femoral subtrochanteric fracture in older children. Methods Between April 2015 and September 2016, 35 older children (aged 7-13 years) with femoral subtrochanteric fractures were treated, the clinical data were retrospectively reviewed. TEN fixation was used in 19 cases (group A) and locking compression plate fixation in 16 cases (group B). There was no significant difference in age, gender, sides, fracture causes, type of fracture, and time from injury to operation between 2 groups (P>0.05). The fluoroscopy times, operation time, intraoperative blood loss, fracture healing time were recorded and compared between 2 groups. The limb function was evaluated according to the Sanders scores and Flynnet al. outcome score. Results All the patients were followed up 6-24 months (mean, 11.46 months). The operation time, intraoperative blood loss, and fracture healing time of group A were significantly less than those of group B, but the fluoroscopy times of group A was significantly more than that of group B (P<0.05). All the fractures were healed, no breakage of screw, infection of deep tissue, nerve injury, osteonecrosis of the femoral head, or other complication occurred. At last follow-up, according to the Sanders scores, the results were excellent in 14 cases, good in 4 cases, and fair in 1 case in group A with an excellent and good rate of 94.74%; the results were excellent in 12 cases, good in 3 cases, and fair in 1 case in group B with an excellent and good rate of 93.75%; showing no significant difference between 2 groups (χ2=0.400, P=0.980). According to the Flynn et al. outcome score, the results were excellent in 13 cases, good in 5 cases, and fair in 1 case in group A with an excellent and good rate of 94.74%; the results were excellent in 11 cases, good in 3 cases, and fair in 2 cases in group B with an excellent and good rate of 87.50%; showing no significant difference between 2 groups (χ2=0.748, P=0.688). Conclusion Both TEN and locking compression plate have satisfactory outcomes for treating pediatric femoral subtrochanteric fractures. TEN method has minimally trauma, security, and faster fracture healing when compared with locking compression plate.
Objective To compare the effectiveness of open reduction and internal fixation with plate and closed reduction and internal fixation with Kirschner wire (K-wire) in the treatment of intra-articular displaced calcaneal fractures in older children. MethodsA clinical data of 35 older children (37 feet) with intra-articular displaced calcaneal fractures who were admitted between November 2014 and November 2020 and met the selection criteria were retrospectively analyzed. Among them, 19 cases (20 feet) underwent open reduction and internal fixation with plate (plate group), and 16 cases (17 feet) underwent closed reduction and internal fixation with K-wire (K-wire group). There was no significant difference in gender, age, cause of injury, side and type of fracture, and time from injury to admission, and preoperative calcaneal Gissane angle and Böhler angle (P>0.05). The postoperative calcaneal Gissane angle, Böhler angle, complications, and fracture healing were compared between the two groups. The ankle function was evaluated based on the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring system. Results Incision necrosis occurred in 1 foot in the plate group after operation, which healed after symptomatic treatment; the other incisions in the two groups healed by first intention. All children were followed up 12-39 months (mean, 19 months). X-ray films showed that the fractures in both groups healed; the healing time was (2.65±0.71) months in the plate group and (2.24±1.38) months in the K-wire group respectively, with no significant difference (t=1.161, P=0.253). At last follow-up, the calcaneal Gissane angle and Böhler angle returned to normal; and the difference between pre- and post-operation in the two group was significant (P<0.05), but there was no significant difference between the two groups in the difference between before and after operation (P>0.05). In the plate group, the plate was removed at 11-22 months after operation (mean, 16.8 months). At last follow-up, the AOFAS ankle-hindfoot score in the plate group was 91.2±5.1, which was significantly higher than that in the K-wire group (86.9±6.1) (t=2.316, P=0.027). The ankle function was rated as excellent in 15 feet, good in 4 feet, and fair in 1 foot in the plate group, and excellent in 14 feet and good in 3 feet in the K-wire group, and the difference between the two groups was not significant (Z=1.712, P=0.092). ConclusionFor intra-articular displaced calcaneal fracture in older children, the open reduction and internal fixation with plate and closed reduction and internal fixation with K-wire can achieve good effectiveness, but the former has better recovery of ankle function.