〖GK3!3〗〖HT5”H〗摘要:目的:探討復合鼻小柱側面皮瓣法治療完全性單側唇裂的療效。方法:自2003年3月至2007年10月采用復合鼻小柱側面皮瓣法治療完全性單側唇裂24例。結果: 24例均成功,唇弓形態滿意,唇峰降至水平位置,兩側鼻翼基底位于同一水平線上,唇紅豐滿、自然,上唇松動,瘢痕不明顯。3例鼻小柱側面皮瓣出現表皮糜爛,換藥后痊愈。隨訪9例,最短4月,最長15月,平均83個月。結論: 復合鼻小柱側面皮瓣法充分利用周圍有限的組織,解決了完全性唇裂唇峰不易下降至水平、縫合張力大等問題,具有以往傳統方法不具有的優勢,但尚需要病例的積累和時間的驗證。
The American Academy of Orthopaedic Surgeons (AAOS) released the updated Evidence-Based Clinical Practice Guideline for the Management of Rotator Cuff Injuries in August 2025. The guideline provides 25 recommendations and 4 consensus statements across diagnosis, treatment decision-making, biologic interventions, and postoperative rehabilitation, with the strength of each recommendation graded according to the quality of supporting evidence. The updated guideline highlights several key advances, including establishing CT as an important adjunctive imaging modality, providing specific recommendations on repair strategies for high-grade partial-thickness rotator cuff tears, and clearly restricting the use of platelet-rich plasma and marrow stimulation in rotator cuff repair, as well as limiting the application of prolotherapy in the treatment of full-thickness rotator cuff tears. In addition, the guideline emphasizes the potential benefits of early mobilization in patients with small to medium-sized tears.
Objective To explore the factors influencing the Constant-Murley score at 3 months after arthroscopic rotator cuff repair, and to provide evidence for early identification of patients at risk of poor recovery and for the development of individualized rehabilitation protocols. Methods Using a convenience sampling method, 146 patients with rotator cuff injury who underwent arthroscopic rotator cuff repair between May 2025 and August 2025 were enrolled. There were 68 males and 78 females, with ages ranging from 41 to 74 years (mean, 56.2 years). At 3 months postoperatively, shoulder function was assessed using the Constant-Murley score, pain intensity was evaluated with the visual analogue scale (VAS) score, exercise adherence was measured with the Orthopedic Patient Functional Exercise Compliance Scale, and active shoulder forward flexion and abduction ranges were recorded. The independent variables included gender, age, body mass index (BMI), affected side, smoking history, alcohol consumption, educational level, acromial type, hypertension, diabetes mellitus, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, as well as postoperative acromiohumeral distance, VAS score, and the Orthopedic Patient Functional Exercise Compliance Scale score. The dependent variable was the 3-month Constant-Murley score. Univariate analysis and multiple linear regression were performed to identify influencing factors associated with the Constant-Murley score. Results At 3 months postoperatively, the acromiohumeral distance ranged from 6 to 16 mm (mean, 9.19 mm); VAS scores ranged from 0 to 6 (mean, 3.2); Orthopedic Patient Functional Exercise Compliance Scale scores ranged from 20 to 70 (mean, 50.1); Constant-Murley scores ranged from 35 to 100 (mean, 73.7); active forward flexion ranged from 55° to 180° (mean, 128.84°); and active abduction ranged from 25° to 170° (mean, 122.81°). Univariate analysis showed that smoking history, educational level, acromial type, hypertension, diabetes mellitus, BMI, VAS score, and Orthopedic Patient Functional Exercise Compliance Scale score were significantly associated with the 3-month Constant-Murley score (P<0.05). Multiple linear regression revealed that hypertension, diabetes mellitus, and higher VAS score were independent risk factors for Constant-Murley score (P<0.05), while a higher BMI and Orthopedic Patient Functional Exercise Compliance Scale score were protective factors for Constant-Murley score (P<0.05). Conclusion Overall, shoulder function recovered well at 3 months after rotator cuff repair, but there remains room for further improvement. Clinicians should emphasize perioperative management of patients with comorbid chronic diseases, strengthen pain intervention, and promote exercise adherence in order to optimize early postoperative functional recovery.