简介：由阳光等在我们证明近似近似方法forDC功能的集中的这篇论文求婚了[6]。我们的分析也允许对待准确方法。Wethen在DC功能的第二个部件是可辨的并且提供证明了我们的方法的效率的一些计算经验的情况中建议有趣的结果。

简介：Objective:Toinvestigatetheindication,perioperativeannouncements,selectionofprosthesisandclinicalresultsofshoulderhemiarthroplastyforthetreatmentofcomplexproximalhumeralfractures.Methods:Atotalof55patientswhosufferedfromcom-plexproximalhumeralfracturesweretreatedbyshoulderhemiarthroplasty.Themeanagewas55.6yearsandmeanfollow-upperiodwas25.1months.Thescoringsystemmodi-ficationforhemiarthroplasty(SSMH)hadbeenadoptedforevaluationatthelatestfollow-up.Results:Thepainwasobviouslyrelievedinallpatients.Fiftypatientswerepainlessand5patientshadslightpain.Themeanrangeofmotionwas100°(90°-110°)inabduction,95°(80°-100°)inforwardflexion,35°(30°-40°)inextemalrotationandinternalrotationwasconfinedatL2level(L1-L3).ThemeanSSMHscorewas27.9(24-29).Fiftypatients(90.1%)weresatisfiedwiththeclinicaloutcome.Conclusions:Shoulderhemiarthroplastyisaneffectivemethodtotreatcomplexproximalhumeralfractures.Theproperselectionofpatientsandprosthesis,goodoperationskillandenoughfunctionalexercisearethekeypointsofsuccessfultreatment.

简介：AbstractProximal tibiofibular instability is a rare condition for which treatment is poorly codified. A 21-year-old patient, a leisure sportswoman, presented a post-traumatic anterolateral instability of the proximal tibiofibular articulation without cartilage lesion. We propose an original surgical technique based on a review of the literature that combines an anatomical ligamentoplasty of the proximal tibiofibular joint and a proximal fibular diaphyseal osteotomy to reduce the distal tibiofibular mechanical stresses. This original technique allows a favorable evolution with recovery of professional and sports activities at 6 months.

简介：Theeffectofage-relatedbonelossonthestructuralcapacityoftheproximalfemurwereinvestigatedbyFiniteElementAnalysis(FEA).Fourbonelosspatternswereconsidered.Thesewere'uniformcorticalboneloss','neckcorticalboneloss','intertrochantericcorticalboneloss'and'uniformtrabecularboneloss'.Theresultsshowthatthetwo'non-uniformcorticalboneloss'patternsaremoredangerousthanthe'uniformcorticalboneloss'pattern,andthatthecorticalbonelossinintertrochantericregionisassociatedwithagreaterreductionincorticalfailureloadthanthecorticalbonelossinthefemoralneck.Thetrabecularbonelosscausesalimiteddecreaseinbothcorticalfailureandtrabecularfailureloads.Thisresearchshouldbehelpfultotheclinicalassessmentoffemurfractureriskduetoage-relatedboneloss.

简介：Toinvestigatethemorphologicalchangesofspermatozoaintheproximalvasdeferensaftervasectomy.Methods:Proxinalvasdeferensfluidswerecollectedfrom79fertilemen(groupA)and64vasectomizedmen(groupB)duringtheoperationsofvasectomyorvasovasostomy.SpermmorphologyintheproximalvasdeferenswasanalyzedafterstainingwiththemodifiedPapanicolaoumethod.Results:ThepercentageofspeImatozoawithanormalovalheadfromgroupB(50.7%±21.7%)wassignificantlylowerthanthatofgroupA(75.2%±11.1%).ThedataingroupAwassimilartothoseofnormalsemenandthereforerepresentsthephysiologicalconditionoftheproximalvasdeferensspermoffertilemen.TherewerenosignificantdifferencesinthepercentagesofnormalovalheadsingroupBwiththetimesincevasectomy.Condusion:Aftervasectomy,thespermatozoaintheproximalvasdefereusandepididymiswerecontinuouslydegeneratingandbeingreplenishedbyspenmatozoacomingfromtestis.Theobviousmorphologicaldegenerationoccurredinthespermtailandspermatozoawithasmalloralheadandamorphousheadswereincreased.(AsianJAndrof1999Jun;1:61-65)

简介：AbstractPurpose:No therapeutic consensus has been established about proximal ruptures of the rectus femoris muscle. The objective of this literature review is to determine a therapeutic course of action.Methods:We conducted a literature review on the PubMed database using the following keywords (in French and English, respectively): "quadriceps/quadriceps", "droit antérieur/rectus femoris", "proximal/proximal", "chirurgie/surgical", "avulsion/avulsion". We collected 266 articles, 36 of them were selected, which were related to our topic: proximal rupture of the anterior rectus femoris. Patients with a proximal rupture of the rectus femoris, minor or major patient of traumatic origin were included in this study. Patients injured at another lesion level, or non-traumatic lesions of the proximal rectus femoris (tendinitis without ruptures, tumor or others) were excluded. For each patient, the indications, the type of treatment and the functional result were analyzed, with the time to recovery and the level of recovery from sports and professional activities (same sport/profession or not, same level or not) as the main criterion of judgment. Fisher exact test was used for statistical comparison.Results:The aims of conservative treatment are to be pain free for the patient, to fight hematoma and to rehabilitate the injury as quickly as possible. The surgical techniques are varied, with most consisting of either a reinsertion of the musculo-tendon stump or a resection of the scar tissue with myo-tendino-aponeurotic suture in place. The functional results are good for the majority of the treatments proposed, but the conservative treatment has a shorter recovery time (3 months vs. 4 months for the best surgical results). Highly displaced bone avulsion is the only indication for first-line surgical treatment.Conslusion:The main disadvantage of conservative treatment is the risk of residual pain beyond 3 months (10%), justifying an MRI to guide secondary surgical treatment. We propose a treatment plan for proximal rupture of the proximal rectus femoris rupture.

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简介：Recently,aclassoflogarithmic-quadraticproximal(LQP)methodswasintro-ducedbyAuslender,TeboulleandBen-Tiba.Theinexactversionsofthesemethodssolvethesub-problemsineachiterationapproximately.Inthispaper,wepresentapracticalinexactnesscriterionfortheinexactversionofthesemethods.

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简介：这研究试图调查trabecular的地区性的变化，以及决定在trabecular之间的关系词法参数和大腿骨的头的机械参数词法、机械的参数。从有折断的近似腿节的病人的七个大腿骨的头用一个micro-CT系统被扫描。每个大腿骨的头根据trabecular取向被划分成12个分区。一\(125\，\hbox{公里}^{3}\)trabecular立方的模型从每个分区被重建。81个trabecular模型的一个总数被重建，除了从在外科期间的二个大腿骨的头的三个破坏分区。Trabecular词法参数，即trabecular分离(Tb.Sp)，trabecular厚度(Tb.Th)，特定的骨头表面(BS/BV)，骨头体积部分(BV/TV)，结构的模型索引(SMI)，和anisotropy(DA)的度被测量。微有限的元素分析被执行让每个立方体获得明显的幼仔模量，织物水平von协定在1%下面强调分发沿着三个直角的方向的压缩紧张分别地。结果在词法参数揭示了重要地区性的变化(\(P)。沿着trabecular取向的幼仔moduli比沿着另外的二个方向的那些显著地高。一般来说，trabecular在中间的区域的机械性质是比在侧面的区域的那些低的。沿着trabecular取向的Trabecular机械参数显著地与BS/BV，BV/TV，Tb.Th，和DA被相关。在这研究，在有近似腿节骨折的病人的大腿骨的头的微结构特征和机械性质的地区性的变化彻底地在组织水平被调查。这研究的结果将帮助阐明为减少破裂风险和发展中的治疗策略为的大腿骨的头骨折的机制老。

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简介：AbstractPre-contoured anatomical locking plates were designed to address the clinical need of fixing small epiphyseal segments with a larger number of screws. Those plates match the contour and shape of a variety of bones allowing for optimal buttress properties. The aim of this manuscript is to highlight the benefits of applying proximal humerus locking plates in the fixation of lower extremity bones. Although designed for the proximal humerus, the low-profile plate shape and anatomic contour also provides versatile use in certain areas of the lower extremity. This technical narrative highlights the versatile and reliable use of this plate for other anatomical areas than the one to which it has been originally conceived.

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简介：Thisisareportofanonrandomizedcomparisonoftreatmentresultsof139patientswithstageIB,HAandproximalIIBcarcinomaoftheuterinecervixtreatedbyradiationaloneand113treatedwithacombinationofradiationandsurgery.Thefive-yeartumorfreeacturialsurvivalforthepatientswithstageIBeitherwithirradiationalone(RT)orcombinedwithsurgery(RS)wasapproximately87%.ForstageⅡthetumorfreeactuarialfive-yearsurvival79%withpatientsofRS,and76%withRT.Inthe113patientstreatedwithRStherewere18(16%).Inthe139patientstreatedbyRTtherewere18(13%)recurrencesofpelvic,4localrecurrences,11combinedwithparametrial,andfreeparametrialrecurrences.Therewasnosignificantdifferenceinthesurvivalandrecurrencerateofthepatientstreatedwitheithermethod.Majorcomplicationswerecomparableinbothgroups(RTapproximately25%andRSapproximately10%),but2/3ofthosecomplicationsrecoveredwithoutsequelae.Themostfrequentminor

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简介：AbstractPost-burn contractures are common entities seen in developing countries. There are multiple reasons for the development of contractures, most are preventable. In extensive contractures, a strategic plan is necessary to release all contractures and yet not antagonize post-operative positions. It is also necessary to be cost-effective and minimize the number of surgeries needed. Conventionally the release sequence in extensive burn contractures is proximal to distal. In this case report, we discuss an unusual sequence where we released distal contractures before the proximal to achieve optimum results. A 3-year-old child with post-burn contracture of hand, wrist, elbow, and axilla was treated in 2 stages, with the release of wrist contracture and cover with pedicled abdominal flap in the first stage and division of pedicled flap with the release of axilla and elbow contracture in the second stage. Thus, the release of all contractures was achieved without antagonizing post-operative positions and minimized the number of surgeries. A case-based approach may be crucial in making a strategic surgical plan to minimize the rehabilitation phase, rather than following known dictums.

简介：AbstractWide-awake local anesthesia has many advantages. We describe a new method to use wide-awake local anesthesia with more flexibility. A 32-year-old man with a severe right-hand contracture after an iatrogenic tourniquet accident during an anterolateral thigh flap for a partial hand amputation underwent contracture release using external fixation after proximal row carpectomy and subsequent tenolysis. We performed most of the tenolysis procedure under general anesthesia and the final stage with an intra-operative assessment of active finger movement and dissection under local anesthesia. He regained his grip strength 2.5 years post-injury. General anesthesia is useful to treat a surgical site with extensive hard scars, whereas local anesthesia is useful for adjusting tension in an awake patient. The indication for wide-awake surgery is yet to be established; our method of combining general and local anesthesia in the tenolysis procedure illustrates the possibilities in expanding this method.

简介：AbstractIntracapsular fractures of the proximal femur are one of the most common fractures of the lower limbs. Most cases require osteosynthesis with suitable implants, and intraoperative positioning of the patient on the fracture table is a prerequisite to facilitate fracture manipulation, traction, reduction and fluoroscopy assessment. However, positioning the limbs of bilateral above-knee amputees for internal fixation of related proximal femoral fractures is a difficult task, which requires customized inventory for effective limb positioning and fracture manipulation. This study reported a rare case following a crush injury of bilateral lower limb in a road traffic accident, and described some technical tips of acute femoral neck fractures in bilateral above-knee amputation. The patient was managed with immediate guillotine amputation and later secondary wound closure followed by internal fixation of the right-sided femoral neck fracture with multiple cancellous cannulated screws.

简介：AbstractBackground:The optimal treatment for large impacted proximal ureteral stones remains controversial. The aim of this study was to evaluate the efficacy, safety, and potential complications of mini-percutaneous nephrolithotomy (MPCNL) and retroperitoneal laparoscopic ureterolithotomy (RPLU) in the treatment of impacted proximal ureteral stones with size greater than 15 mm.Methods:A total of 268 patients with impacted proximal ureteral stones greater than 15 mm who received MPCNL or RPLU procedures were enrolled consecutively between January 2014 and January 2019. Data on surgical outcomes and complications were collected and analyzed.Results:Demographic and ureteral stone characteristics found between these two groups were not significantly different. The surgical success rate (139/142, 97.9% vs. 121/126, 96.0%, P = 0.595) and stone-free rate after 1 month (139/142, 97.9% vs. 119/126, 94.4%, P = 0.245) of RPLU group were marginally higher than that of the MPCNL group, but there was no significant difference. There was no significant difference in the drop of hemoglobin between the two groups (0.8 ± 0.6 vs. 0.4 ± 0. 2 g/dL, P = 0.621). The mean operative time (68.2 ± 12.5 vs. 87.2 ± 16.8 min, P = 0.041), post-operative analgesics usage (2/121, 1.7% vs. 13/139, 9.4%, P = 0.017), length of hospital stay after surgery (2.2 ± 0.6 vs. 4.8 ± 0.9 days, P < 0.001), double J stent time (3.2 ± 0.5 vs. 3.9 ± 0.8 days, P = 0.027), time of catheterization (1.1 ± 0.3 vs. 3.5 ± 0.5 days, P < 0.001), and time of drainage tube (2.3 ± 0.3 vs. 4.6 ± 0.6 days, P < 0.001) of MPCNL group were significantly shorter than that of the RPLU group. The complication rate was similar between the two groups (20/121, 16.5% vs. 31/139, 22.3%, P = 0.242).Conclusions:MPCNL and RPLU have similar surgical success and stone clearance in treating impacted proximal ureteral stones greater than 15 mm, while patients undergoing MPCNL had a lower post-operative pain rate and a faster recovery.