ObjectiveTo observe the clinical features of retinal arterial occlusion (RAO) in youth.MethodsThis is a retrospective case review. Nine patients (9 eyes) with RAO were enrolled in this study. There were 6 males (6 eyes) and 3 females (3 eyes). The average age was (14.22±3.93) years. The best-corrected visual acuity (BCVA), indirect ophthalmoscopy, fundus color photography and fundus fluorescein angiography were performed. All patients underwent systemic evaluation including blood routine, erythrocyte sedimentation rate, blood lipids, vasculitis screening, homocysteine level, antiphospholipid antibody, blood coagulation, neck vascular ultrasound, and cardiac color ultrasound and electrocardiogram examination. All patients received oxygen therapy, blood medications and symptomatic treatment. Meanwhile, the patients with autoimmune diseases were received systemic glucocorticoid therapy. The follow-up was ranged from 6 to 12 months. The visual acuity and fundus change before and after treatment were compared.Resultsamong 9 patients, one patient had systemic lupus erythematosus, one patient had congenital heart disease, one patient had hypergammaglobulinemia, and carotid artery color ultrasonography showed that the internal carotid artery vessels faltered in 2 cases. The BCVA was 0.01 - 0.12. Among 9 eyes, there were 5 eyes (55.6%) with retinal branch artery occlusion (BRAO), 2 eyes (22.2%) with central retinal artery occlusion (CRAO), 2 eyes (22.2%) with ciliary retinal artery occlusion (CLAO). CRAO eyes showed positive RAPD (relative afferent pupillary defect), fine retinal artery and the corresponding vein, pale white retinal edema in posterior area and macular cherry-red spot. BRAO eyes manifested as inferior temporal artery occlusion and pale white retinal edema around them. CLAO eyes showed temporal ligulate grey-white retinal edema. At the last follow-up, BCVA improved and retinal vessels returned to normal in 7 eyes (77.8%); BCVA unchanged and no improvement in fundus in 2 eyes (22.2%).ConclusionAdolescent RAO is mostly partial occlusion, the prognosis is generally good after early active treatment.
Objective To study the effect of microtraumatic treatment of postoperative recurrent bone cysts in juvenile patients. Methods FromDecember 1984 to December 2003, 36 cases of postoperative recurrent bone cysts after focal curettage and bone graft included 19 males and 17 females, aging 9-21 years-with an average of 15 years. The size of bone cyst ranged from 2.5 cm×6.0 cm to 3.5 cm×13.0 cm with an average of 3.0 cm×8.0 cm. The locations were proximal humerus in 18 cases, humeral shaft in 10 and femoral trochanteric region in 8. The focal curette and bonegraft were given once in 23 cases, twice in 10 cases and 3 times in 3 cases. The interval between recurrence and microtraumatic treatment was 5-13 months (6.5 months on average). The posteroanterior and lateral X-ray films were takento determine the location, range and feature of the focus. Under local anesthesia, 2 canulated needles were used; one was used to aspirate the contents of the cyst, the other was used to inject hydrocortisone acetate. The dose was determined according to the range of the focus. The treatment was repeated every 3.54 months until the focus healed. Results All patients were followed up from 3 to 18 years with an average of 5 years. The microtraumatic treatment was repeated 3-11 times with an average of 6 times. Twenty-six cases healed completely, 6 cases healed significantly, and 4 cases healed partially. No local or general complications occurred during the treatment. Conclusion This microtraumatic method for the treatment of postoperative recurrent bone cyst in juvenile patients has following advantages : less pain, easy manipulation, no hospitalization, low cost and definite effect.
ObjectiveTo observe the clinical efficacy of minimally invasive vitreous surgery (MIVS) for special rhegmatogenous retinal detachment (RRD) in children and adolescents.MethodsA retrospective clinical comparative study. Fourteen eyes with special type of RRD in 14 children and adolescents who received the MIVS treatment from January 2014 to January 2019 in Ophthalmology Department of The First Affiliated Hospital Ophthalmology of Air Force Military Medical University, were included in this study. Among them, 8 eyes from 8 males and 6 eyes from 6 females. The age of them ranged from 5 to 17, with the mean age of 12.64±4.11 years. The course of disease was ranged from 1 d to 1 year, and the average of it was 30 d. All the eyes developed the special type RRD, including pseudophakic and aphakic retinal detachment, giant retinal tear with retinal detachment, choroidal detachment associated with retinal detachment, and RRD with ocular dysplasia. In the 14 eyes, there was 2 eyes with retinal detachment in 1 quadrant, 4 eyes in 2 quadrants, 1 eye in 3 quadrants and 7 eyes in total 4 quadrants. All the eyes were treated with 23G or 25G MIVS and filled with irrigation solution, air and silicone oil. In addition, 10.4 months' follow-up for average after surgery were taken to observe the occurrence of retinal reattachment, BCVA and related complications in the eyes.ResultsIn the 14 eyes, 13 (92.9%) of them attained retinal reattachment and 1 eye (7.1%) got a poor retinal reattachment after one operation. At the last follow-up, all the 14 eyes (100.0%) attained retinal reattachment and 5 of them at the filling state of silicone oil. The vision of 8 eyes (57.1%) were improved, 4 eyes (28.6%) have no notable changes and 2 eyes decreased (14.3%). During the operation, iatrogenic retinal breaks were occurred in 1 eye, and silicone oil entered underneath the retina in 1 eye. After the operation, 1 eye suffered a relapse of retinal detachment after the removal of silicone oil and then were filled with it again.ConclusionsMIVS is a safe and effective way to treat the special type RRD among the children and adolescents. The rate of retinal reattachment is 92.9% after one surgery and 100.0% at the last follow-up. Therefore, MIVS can help most of eyes with special type RRD to get a stable and improved vision.
Objective To explore the influencing factors of internet game addiction among middle school students. Methods Students from a certain district in Sichuan between September 2022 and March 2023 were included as participants. Basic information such as gender, age, whether the subjects were only children, place of residence, parental education, and subjective economic status were investigated. The nine-item Internet Gaming Disorder Scale-short form was used to investigate whether participants had internet game addiction, and the Berkman-Syme Social Network Index was used to evaluate the participants’ social level. Multiple linear regression analysis was used to conduct multivariate analysis to explore the influencing factors of internet game addiction. Results A total of 594 questionnaires were distributed, and 592 valid questionnaires were ultimately obtained. The detection rate of internet game addiction was 12.0%. Multiple linear regression analysis showed that gender (t=?8.281, P<0.001), age (t=3.211, P=0.001), subjective economic status in the region (t=2.025, P=0.043), and social level (t=?4.239, P<0.001) were the influencing factors of online game addiction. Due to the P value was close to the set test level (0.05), subjective economic status in the region was not considered an influencing factor of internet game addiction. Conclusion Teenagers with male gender, older age, and lower social skills are more likely to develop addiction to internet games.
ObjectiveTo discuss the effectiveness of arthroscopic treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture in adolescents by using double heads compressive cannulated screw fixation.MethodsTwenty-four patients with ACL tibial eminence avulsion fractures were treated by arthroscopic reduction and internal fixation with double heads compressive cannulated screw fixation between June 2014 and June 2017. There were 15 males and 9 females with an average age of 12.3 years (range, 5-18 years). The body mass index was 19.3-26.4 kg/m2 (mean, 23.3 kg/m2). The injury causes included traffic accident injury in 10 cases, sports injury in 8 cases, and falling injury in 6 cases. According to the Meyers-McKeever classification, there were 19 cases of type Ⅱ and 5 cases of type Ⅲa. All patients’ drawer test and pivot shift test were positive. The interval between injury and operation was 3-14 days (mean, 6.2 days). During the follow-up period, the fracture healing condition of patients were determined by X-ray examination; Lysholm score, International Knee literature Committee (IKDC) score, and Tegner score were used to evaluate the knee function.ResultsPrimary healing of incision was obtained in all patients after operation. All the 24 patients were followed up 6-32 months (mean, 16.4 months). At 6 weeks after operation, 3 patients had difficulty in knee flexion. After the release of the knee joint by manipulation, the knee joint function recovered normally at 6 months after operation. At last follow-up, the X-ray films showed that all the fractures healed and no epiphyseal dysplasia, knee joint deformity, or leg length discrepancy occurred. The Lysholm score, IKDC score, and Tegner score were improved from preoperative 44.3±5.4, 43.7±4.4, and 3.0±1.3 to postoperative 93.1±4.3, 94.6±3.3, and 8.1±1.2, the differences were all significant (t=25.152, P=0.000; t=28.634, P=0.000; t=13.226, P=0.000).ConclusionThe arthroscopic reduction and internal fixation with double heads compressive cannulated screw in treatment of ACL tibial avulsion fracture (Meyers-McKeever type Ⅱ and Ⅲ) in adolescents has so many advantages, such as minimal trauma, simple operation, firm fixation, little effect on the epiphyseal plate, and has a good joint function recovery.
ObjectiveTo develop a smart orthosis personalized management system for the treatment of patients with adolescent idiopathic scoliosis (AIS) and to evaluate the feasibility and efficiency through clinical preliminary applications.MethodsThe smart orthosis personalized management system consists of a wireless force monitor, a WeChat Mini Program, a cloud-based storage system, and a website backstage management system. Twenty-two patients with AIS who underwent orthosis treatment and met the selection criteria between March 2020 and December 2020 were enrolled. The follow-up time was 4 months. The parameters used to evaluate patients’ compliance were as follows (back and lumbar): baseline force value, measured force value, force compliance (measured force value/baseline force value×100%), measured wearing time (wearing time of force value was more than 0 N), and time compliance (measured wearing time/prescribed wearing time×100%), in which the prescribed wearing time was 23 hours/day. The baseline force values were measured at initiation, while the measured force value, measured wearing time, force compliance, and time compliance were measured during follow-up. The differences of these parameters between back and lumbar, and the differences among these parameters at 1, 2, 3, and 4 months after orthosis wearing were analyzed.ResultsThe average measured force value of 22 patients (back and lumbar) was (0.83±0.34) N, the average force compliance was 68.5%±17.9%, the average measured wearing time was (15.4±1.7) hours, and the average time compliance was 66.9%±7.7%. The baseline force value and measured force value of back were significantly higher than those of lumbar (P<0.05); the measured wearing time, force compliance, and time compliance between back and lumbar showed no significant difference (P>0.05). The measured force value, measured wearing time, force compliance, and time compliance at 1 month after wearing were significantly lower than those at 2, 3, and 4 months after orthosis wearing (P<0.05), no significant difference was found among 2, 3, and 4 months after orthosis wearing (P>0.05). At different time points after wearing, the measured force value of back were significantly higher than that of lumbar (P<0.05), while there was no significant difference between back and lumbar on the other parameters (P>0.05).ConclusionThe smart orthosis personalized management system has high feasibility to treat AIS, and can improve the compliance of such patients with orthosis wearing.
Objective To analyze the cl inical results of different surgical approaches in treating hallux valgus deformity in children and adolescents. Methods From April 2000 to April 2007, 18 cases of hallux valgus deformity (30 feet) were treated. According to different ages, they were divided into children group ( 10 years) and adolescent group (11-18 years). In children group, 4 female patients included 2 bilateral and 2 unilateral hallux valgus deformity (2 left feet, 4 right feet). Each patient underwent a combination of Austin osteotomy and McBride procedure. The American Orthopaedic Foot and AnkleSociety-Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) score was 55.0 ± 15.0, and the visual analogue scale (VAS) score was 6.0 ± 2.0. The hallux valgus angle (HVA) and 1st-2nd intermetatarso-phalangeal angle (IMA) were (35.0 ± 4.0)° and (14.4 ± 2.0)°. In adolescent group, 14 patients included 3 males (4 feet) and 11 females (20 feet), 10 bilateral and 4 unilateral hallux valgus deformity (10 left feet, 14 right feet). Each patient underwent the modified Mitchell osteotomy. The AOFAS-HMI score was 55.6 ± 14.0, and the VAS score was 7.0 ± 1.0. The HVA and IMA were (38.5 ± 5.0)° and (15.0 ± 3.0)°. Results All incisions healed primarily. The patients of two groups were followed up 12-32 months (21 months on average). In adolescent group, pain of metatarsophalangeal joint occurred in 1 case and the symptom disappeared after 3-month physical therapy; 1 case recurred after 21 months of operation and achieved satisfactory results after Lapidus operation. In children group, the AOFASHMI score was 92.1 ± 5.0, the VAS score was 1.0 ± 0.6, HVA was (14.7 ± 3.0)°, and IMA was (5.5 ± 2.0)°; showing significant differences (P lt; 0.05) when compared with those before operation. In adolescent group, the AOFAS-HMI score was 90.0 ± 6.0, the VAS score was 1.0 ± 0.6, HVA was (13.7 ± 3.0)°, and IMA was (6.8 ± 2.0)°; showing significant differences (P lt; 0.05) when compared with those before operation. Conclusion It has the advantages of rapid bone heal ing, short course of treatment, and less compl ication to treat hallux valgus deformity in children with a combination of Austin osteotomy and McBride procedure and in adolescent with the modified Mitchell osteotomy.
ObjectiveTo evaluate the effectiveness of Ilizarov technique combined with soft tissue release and muscle strength balance in the treatment of spastic clubfoot in adolescents with cerebral palsy.MethodsA retrospective analysis of clinical data of 29 cases (33 feet) of cerebral palsy spastic clubfoot deformity conformed to the selection criteria between June 2011 and September 2016. Among them, 17 were male (20 feet) and 12 were female (13 feet) with an age range from 13 to 28 years (mean, 17.6 years). According to Diméglio classification, 19 feet were rated as gradeⅡ and 14 feet as grade Ⅲ. All patients were treated with soft tissue release and muscle balance, while using Ilizarov technique to correct varus deformity. Began to gradually adjust the external fixator after 5-7 days of operation, until to reach satisfactory foot ankle form. Orthopedic brace was used after removal of external fixator, and the wearing time gradually reduced to completely abandon the brace.ResultsAll 29 patients (33 feet) were followed up 12-22 months with an average of 18 months. All patients restored line plantar foot without needle infection and nerve or vessel injury. One foot had a mild relapse of deformity at 6 months after removal of external fixator, and the gait restored to normal after symptomatic treatment. The rest of 32 feet had no deformity recurrence during the follow-up. At last follow-up, International Club Foot Study Group (ICFSG) score (5.21±3.91) was significantly lower than the preoperative score (36.73±4.80), and the difference was significant (t=47.227, P=0.000). The results were excellent in 27 feet, good in 3 feet, and fair in 3 feet, and the excellent and good rate was 90.91%. The patients were very satisfied in 27 feet and satisfied in 6 feet by self-evaluation of effectiveness.ConclusionIlizarov technique is effective in treatment of clubfoot. And it is also a feasible method to treat spastic clubfoot in adolescents with cerebral palsy when combined with appropriate soft tissue surgery according to the patient’s symptoms and signs.
目的:觀察在青少年脊柱側凸患者中術前實施綜合性呼吸操鍛煉的臨床效果方法:選取46例伴有不同程度肺功能障礙的青少年脊柱側彎患者作為研究對象,對其自入院后第一天即開始實施綜合性呼吸操鍛煉,觀察術前肺功能的變化情況及術后肺部并發癥的發生情況。結果:鍛煉后患者肺活量(VC)、肺容量(TLC)、用力肺活量(FVC)、最大通氣量(MVV),等肺功能指標較鍛煉前有明顯改善,差異具有統計學意義(Plt;0.05);術后血氧飽和度gt;95%;無肺部并發癥發生。結論:入院后即進行綜合性呼吸操鍛煉能在近期有效改善患者肺功能,提高患者對脊柱矯形手術的耐受力,對預防和減少術后肺部感染以及呼吸功能不全的發生有積極作用。