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    find Author "邵江波" 2 results
    • 銀屑病并發臀部巨大黏液腺癌一例

      目的報告1例銀屑病并發臀部巨大黏液腺癌治療方法及效果。 方法2014年2月收治1例64歲銀屑病并發臀部巨大黏液腺癌男性患者。入院檢查見左側臀部腫物,大小約15 cm×10 cm,呈菜花樣生長,伴大量膠凍樣滲出。盆腔MRI提示左臀部皮膚區見不規則團狀異常信號影,病變累及盆底雙側肛提肌及直腸后壁。分期行乙狀結腸雙腔造瘺術、腫瘤切除及會陰直腸肛管切除術、近端直腸閉合術以及游離植皮修復術。 結果術后患者獲隨訪3個月,其狀態良好,植皮成活,創面愈合良好。 結論對于銀屑病并發肛周黏液腺癌,可選擇腹會陰聯合擴大切除術,并采用全厚皮片植皮修復腫瘤切除后的創面,可獲得較好療效。

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    • PROCEDURE OF RECONSTRUCTING TRANSVERSE ARCH OF THE FOREFOOT BY TRANSFERING TENDONS FOR CORRECTING HALLUX VALGUS

      ObjectiveTo explore the effectiveness of the procedure of reconstructing the transverse arch of the forefoot by anastomosing adductor hallucis and abductor hallucis tendons in correcting hallux valgus. MethodsA retrospective analysis was made on the clinical data from 28 patients (40 feet) with hallux valgus treated with the procedure of reconstructing the transverse arch of the forefoot by anastomosing adductor hallucis and abductor hallucis tendons between January 2010 and January 2014. There were 3 males (6 feet) and 25 females (34 feet), with an average age of 51.7 years (range, 20-71 years). The unilateral foot was involved in 16 cases and bilateral feet in 12 cases. The mean disease duration was 8.9 years (range, 1-30 years). All the cases had pain of the first metacarpophalangeal joint; 22 feet had collapsed transverse arch of the forefoot combined with plantar callus, and 8 feet had collapsed transverse arch of the forefoot combined with hammer toe deformity. American Orthopaedic Foot and Ankle Society (AOFAS) score was 59.07±8.49. Preoperative X-ray showed that the hallux valgus angle (HVA) was (33.68±8.10)°, and the intermetatarsal angle (IMA) was (15.60±4.07)°. According to classification of the hallux valgus by Mann, 9 feet were rated as mild, 23 feet as moderate, and 8 feet as severe. ResultsSuperficial infection of incision occurred in 1 case (1 foot) after surgery, and healing by first intention was obtained in the others. Two cases (3 feet) had numbness in the toes. All of 28 cases were followed up from 6 months to 4 years (1.8 years on average). Based on the AOFAS score, the results were excellent in 24 feet, good in 9 feet, fair in 4 feet, and poor in 3 feet, and the excellent and good rate was 82.5%. At last follow-up, the HVA, IMA, and AOFAS score were (15.10±5.28)°, (9.05±2.42)°, and 86.03±7.45 respectively, showing significant differences compared with preoperative ones (P=0.00). The collapsed transverse arch of the forefoot was recovered to some extent, plantar callus disappeared (14 feet), or decreased (8 feet). Recurrence of hallux valgus deformity was observed in 2 cases (3 feet) at 2 and 3 months after surgery respectively, and no hallux varus was found. ConclusionThis procedure not only can effectively reduce the increased hallux valgus angle, and narrow the angle between the 1st and 2nd metatarsal, but also can relocate the sesamoid system, reconstruct the transverse arch of the forefoot, and effectively restore the physiological anatomy structure and biological function of the forefoot.

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  • 松坂南