Objective To investigate the development made in the reparation and reconstruction of the postburn deformity and functional disability in the advanced-stage patients. Methods Based on the reviewedliterature at home and abroad and combined with our clinical experience, the new reparative and reconstructive techniques for the patients with advanced stagedeformity and functional disability were evaluated. Results The reparative and reconstructive microsurgical techniques achieved a significantdevelopment in treating the following pathologic changes after burn: deformity due to proliferation and contracture of the scars, severe hand deformity, defects occurring in the muscle tendons and nerves due to electricity burn, and defects occurring in the long tubular bones of the extremities. Concl usion Although there has been a great achievement in this field, there is still a hard task of finding out newer therapeutic approaches and achieving more effective results in the future.
Objective To evaluate the effect of reconstruction withautograft implantation in total hip arthroplasty(THA) with regional acetabular deficiency. Methods From 1991 to 2000, 39 cases of THA with acetabular deficiency were conducted. Autogenous bone implantation was used to reconstruct the deficient acetabulum. Of the 39 patients, 25 were males and 14 were females. The age ranged from 34 to 62(45.2 on average). There were21 cases of developmental dysplasia resulted deficiency, 14 cases of fracture of femoral neck complicated with head necrosis(10 hips) and fracture of acetabulum(4 hips). The resected femoral heads or autologous ilium were made the wedgeshaped graft and implanted into the deficient acetabulum, which included 12 cases with cement THA and 27 with cementless THA.Of all the cases, 24 were followed up 2 to 10 years(6.7 years on average). Harris scores before operation were 18 to 50(38.1 on average). Results The limbs were lengthened by 2.4 cm on average. No serious complications were observed in these patients. Comparedwith the scores before the operation, the average Harris scores after the operation were 92.1(Plt;0.01)and 86.3(Plt;0.05) in the one-year and the latest follow-up respectively. The rates for the good were 91.7% and 83.3% in the one-year and the latest follow-up respectively.Conclusion The acetabular reconstruction with autograft in THA will bring better stability in those patients with acetabular deficiency. It is of significance in maintaining a long-term function in the replaced hip.
Objective To evaluate the clinical effect of Halo-vest in treatment of unstable upper cervical spine. Methods From March 1997 to October 2002, 16 cases of unstable upper cervical spineswere treated and immobilized by Halovest, aged from 14 to 53 years. There were 3 cases of isolated Jefferson fractures, 4 cases of isolated Hangman fractures and 1 case of Anderson type Ⅱ fracture. The 8 cases were immobilized for 3-4 months by Halovest. There were 3 cases of old odontoid fractures with dislocations treated by occipitocervical plate fixation and fusion, 1 case of C1 malignant tumor by posterior resection and internal fixation, 2 cases of C2 malignant tumor by anterior resection, fusion, and internal fixation; these cases were immobilized by Halo-vest during surgery. There were 1 case of C2,3 tuberculosis were treated by anterior debridement and fusion, and 1 case of gooseneck deformity by anterior decompression, fusion and screw fixation after resection of C2-7 , the 2 cases were immobilized for 3 months by Halo-vest.Of 16 cases, there were 8 cases accompanied with spinal cord syndrome. Results Fifteen cases were followed up 6 months to 5 years. Anterior arch ununion and posteriorarch osseous healing occurred in 1 case of Jefferson fracture. Other fractures and embedded bones became osseous fusion. One case of C2 malignant tumorrecurred 8 months after operation. Spinal cord syndrome of all patients disappeared. Conclusion Halo-vest immobilization is an effective method for conservative treatment and stable reconstruction of unstable upper cervical spine.