Patel ar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the...Patel ar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament(MPFL) reconstruction. Foreseeably, an increasing number of revision surgeries of the reconstructed MPFL will be seen in upcoming years. In this paper, the causes of failed MPFL reconstruction are analyzed:(1) incorrect surgical indication or inappropriate surgical technique/patient selection;(2) a technical error; and(3) an incorrect assessment of the concomitant risk factors for instability. An understanding of the anatomy and biomechanics of the MPFL and cautiousness with the imaging techniques while favoring clinical over radiological findings and the use of common sense to determine the adequate surgical technique for each particular case, are critical to minimizing MPFL surgery failure. Additionally, our approach to dealing with failure after primary MPFL reconstruction is also presented.展开更多
AIM： To determine the distance between the branching point of the left colic artery （LCA） and the inferior mesenteric artery （IMA） by computed tomography （CT） scanning, for preoperative evaluation before laparo...AIM： To determine the distance between the branching point of the left colic artery （LCA） and the inferior mesenteric artery （IMA） by computed tomography （CT） scanning, for preoperative evaluation before laparoscopic colorectal operation. METHODS： From February 2004 to May 2005, 100 patients （63 men, 37 women） underwent angiography performed with a 16-scanner multi-detector row CT unit （Toshiba, Aquilion 16）. All images were analyzed on a workstation （AZE Ltd, Virtual Place Advance 300）. The distance from the root of the IMA to the bifurcation of the LCA was measured by curved multi-planar reconstruction on a workstation. RESULTS： The IMA could be visualized in all the cases, but the LCA was missing in two patients. The mean distance from the root of the IMA to the root of the LCA was 42.0 mm （range, 23.2-75.0 mm）. There were no differences in gender, arterial branching types, body weight, height, and body mass index. CONCLUSION： Volume-rendered 3D-CT is helpful to assess the vascular branching anatomy for laparoscopic surgery.展开更多
[目的]通过对骨性髋臼指数的研究,能够对发育性髋关节脱位(developmental dislocation of the hip,DDH)的不同病理类型做出客观的评价,并针对DDH的病理类型为选择合适的髋臼矫形术式提供理论依据。[方法]2003年6月～2005年4月对57例有...[目的]通过对骨性髋臼指数的研究,能够对发育性髋关节脱位(developmental dislocation of the hip,DDH)的不同病理类型做出客观的评价,并针对DDH的病理类型为选择合适的髋臼矫形术式提供理论依据。[方法]2003年6月～2005年4月对57例有记录资料的单侧髋关节进行了研究。年龄1岁6个月～6岁,平均3岁2个月;其中男15例,女42例;右髋37例,左髋20例。入选正常髋关节均符合统一的标准:(1)无髋部疼痛症状;(2)髋关节外展不受限;(3)Trendelenburg征阴性;(4)望远镜征阴性;(5)X线表现:①Shenton线连续性好;②股骨头位于Perkin方格内下象限;③髋臼指数小于22°。患儿仰卧,双下肢完全伸展,双足并拢,垂直于检查床。检查前确保无骨盆倾斜及膝关节、髋关节屈曲。扫描数据传输至3D工作站,使用表面遮盖显示法(shaded surface display,SSD),去除所有的软组织影及伪影,进行髋臼骨组织三维重建。以双侧髋臼"Y"型软骨中点o点连线为轴线,旋转骨盆从0(前侧髋臼缘)至90°(外上方髋臼缘)至180°(后侧髋臼缘),每旋转10°,得到一个截面,测量这个截面的髋臼指数并记录数据。[结果]0～180°反映的是过轴线水平面以上骨性髋臼的整体形态,其中髋臼前外侧缘(0～40°)的骨性髋臼指数95%参考值范围依次为:48.4°±7.82°,40.1°±15.41°,35.1°±15.44°,26.6°±10.07°,22.6°±6.66°;髋臼外上缘(50°～120°)的骨性髋臼指数95%参考值范围依次为:20.6°±5.57°,19.6°±5.45°,19.1°±5.23°,18.9°±6.82°,19.6°±6.33°,20.9°±8.21°,22.4°±9.64°,24.2°±11.35°;髋臼后外侧缘(130°～180°)的骨性髋臼指数95%参考值范围依次为:26.0°±12.70°,30.1°±15.68°,35.7°±16.78°,41.3°±15.93°,49.8°±14.74°,55.3°±10.07°。外上缘髋臼指数分布间距范围窄且曲线平滑,前外侧缘髋臼指数分布范围及后外侧缘髋臼指数分布间距范围较宽且曲线较倾斜。[结论]本研究介绍了一种对骨性髋臼形态�展开更多
文摘Patel ar instability is a common clinical problem encountered by orthopedic surgeons specializing in the knee. For patients with chronic lateral patellar instability, the standard surgical approach is to stabilize the patella through a medial patellofemoral ligament(MPFL) reconstruction. Foreseeably, an increasing number of revision surgeries of the reconstructed MPFL will be seen in upcoming years. In this paper, the causes of failed MPFL reconstruction are analyzed:(1) incorrect surgical indication or inappropriate surgical technique/patient selection;(2) a technical error; and(3) an incorrect assessment of the concomitant risk factors for instability. An understanding of the anatomy and biomechanics of the MPFL and cautiousness with the imaging techniques while favoring clinical over radiological findings and the use of common sense to determine the adequate surgical technique for each particular case, are critical to minimizing MPFL surgery failure. Additionally, our approach to dealing with failure after primary MPFL reconstruction is also presented.
基金Supported by Kobayashi Magobe Memorial Medical Foundation
文摘AIM： To determine the distance between the branching point of the left colic artery （LCA） and the inferior mesenteric artery （IMA） by computed tomography （CT） scanning, for preoperative evaluation before laparoscopic colorectal operation. METHODS： From February 2004 to May 2005, 100 patients （63 men, 37 women） underwent angiography performed with a 16-scanner multi-detector row CT unit （Toshiba, Aquilion 16）. All images were analyzed on a workstation （AZE Ltd, Virtual Place Advance 300）. The distance from the root of the IMA to the bifurcation of the LCA was measured by curved multi-planar reconstruction on a workstation. RESULTS： The IMA could be visualized in all the cases, but the LCA was missing in two patients. The mean distance from the root of the IMA to the root of the LCA was 42.0 mm （range, 23.2-75.0 mm）. There were no differences in gender, arterial branching types, body weight, height, and body mass index. CONCLUSION： Volume-rendered 3D-CT is helpful to assess the vascular branching anatomy for laparoscopic surgery.
文摘[目的]通过对骨性髋臼指数的研究,能够对发育性髋关节脱位(developmental dislocation of the hip,DDH)的不同病理类型做出客观的评价,并针对DDH的病理类型为选择合适的髋臼矫形术式提供理论依据。[方法]2003年6月～2005年4月对57例有记录资料的单侧髋关节进行了研究。年龄1岁6个月～6岁,平均3岁2个月;其中男15例,女42例;右髋37例,左髋20例。入选正常髋关节均符合统一的标准:(1)无髋部疼痛症状;(2)髋关节外展不受限;(3)Trendelenburg征阴性;(4)望远镜征阴性;(5)X线表现:①Shenton线连续性好;②股骨头位于Perkin方格内下象限;③髋臼指数小于22°。患儿仰卧,双下肢完全伸展,双足并拢,垂直于检查床。检查前确保无骨盆倾斜及膝关节、髋关节屈曲。扫描数据传输至3D工作站,使用表面遮盖显示法(shaded surface display,SSD),去除所有的软组织影及伪影,进行髋臼骨组织三维重建。以双侧髋臼"Y"型软骨中点o点连线为轴线,旋转骨盆从0(前侧髋臼缘)至90°(外上方髋臼缘)至180°(后侧髋臼缘),每旋转10°,得到一个截面,测量这个截面的髋臼指数并记录数据。[结果]0～180°反映的是过轴线水平面以上骨性髋臼的整体形态,其中髋臼前外侧缘(0～40°)的骨性髋臼指数95%参考值范围依次为:48.4°±7.82°,40.1°±15.41°,35.1°±15.44°,26.6°±10.07°,22.6°±6.66°;髋臼外上缘(50°～120°)的骨性髋臼指数95%参考值范围依次为:20.6°±5.57°,19.6°±5.45°,19.1°±5.23°,18.9°±6.82°,19.6°±6.33°,20.9°±8.21°,22.4°±9.64°,24.2°±11.35°;髋臼后外侧缘(130°～180°)的骨性髋臼指数95%参考值范围依次为:26.0°±12.70°,30.1°±15.68°,35.7°±16.78°,41.3°±15.93°,49.8°±14.74°,55.3°±10.07°。外上缘髋臼指数分布间距范围窄且曲线平滑,前外侧缘髋臼指数分布范围及后外侧缘髋臼指数分布间距范围较宽且曲线较倾斜。[结论]本研究介绍了一种对骨性髋臼形态�
