We report our experience of using double or multiple looped sutures for primary tenorrhaphy combined with early active mobilization. In 46 patients involving 51 fingers with flexor tendon lacerations, double threads of the looped nylon suture were placed to repair injured FDP or FDS tendons, or three threads of looped nylon suture were made to repair the FDP tendons. Using White's (1956) criteria, the results were good or excellent in 76.5% of fingers. The double and multiple looped sutures are of sufficient strength to sustain early motion, and cause little disturbance in the circulation. Satisfactory function following primary tendon repair can be expected with these new techniques.
OBJECTThe object of this study was to review the effectiveness in treating severe and rigid scoliosis with posterioronly spinal release combined with derotation, translation, segmental correction, and an in situ rod-contouring technique.METHODSTwenty-eight patients with severe and rigid scoliosis (Cobb angle > 70° and flexibility < 30%) were retrospectively enrolled between June 2008 and June 2010. The average age of the patients was 17.1 years old (range 12–22 years old), 18 were female, and 10 were male. Etiological diagnoses were idiopathic in 24 patients, neuromuscular in 2 patients, and Marfan syndrome in 2 patients. All patients underwent posterior spinal release, derotation, translation, segmental correction, and an in situ rod-contouring technique. The scoliosis Cobb angle in the coronal plane, kyphosis Cobb angle, apex vertebral translation, and trunk shift were evaluated preoperatively and postoperatively.RESULTSThe average operative time was 241.8 ± 32.1 minutes and estimated blood loss was 780.5 ± 132.6 ml. The average scoliosis Cobb angle in the coronal plane was corrected from 85.7° (range 77°–94°) preoperatively to 33.1° (range 21°–52°) postoperatively, with a correction ratio of 61.3%. The average kyphosis Cobb angle was 64.5° (range 59°–83°) preoperatively, which was decreased to 42.6° (range 34°–58°) postoperatively, with a correction ratio of 33.9%. After an average of 24 months of follow-up (range 13–30 months), no major complications were observed in these patients, except screw pullout of the upper thoracic vertebrae in 2 patients and screw penetration into the apical vertebrae in 1 patient.CONCLUSIONSPosterior spinal release combined with derotation, translation, segmental correction, and an in situ rod-contouring technique has proved to be a promising new technique for rigid scoliosis, significantly correcting the scoliosis and accompanied by fewer complications.
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