1
|
Liu ZB, Li Q, Liu WX, Li XH, Ma K, Huo YB, Wang JG, Wang QH, Yu YD. Comparison of Clinical Effects of the Modified Masquelet Technique and Kirschner Wire External Fixation-Assisted Autogenous Bone Transplantation in the Treatment of Segmental Metacarpophalangeal Bone Defects. Int J Gen Med 2022; 15:1619-1635. [PMID: 35210833 PMCID: PMC8858955 DOI: 10.2147/ijgm.s343617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/24/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The present study aims to explore the (1) clinical effects of the modified Masquelet technique, whose improved Masquelet technique innovates the in vitro plasticity of the bone cement module and prefabricated hollow design, and the Kirschner wire external fixation-assisted autologous bone transplantation technique in the treatment of segmental metacarpophalangeal bone defects and (2) the differences between the two techniques. Methods The clinical data of 32 patients with segmental metacarpophalangeal bone defects (15 patients treated with the modified Masquelet technique and 17 patients treated with the self-made Kirschner wire external fixation technique) admitted to our department between January 2012 and January 2020 were retrospectively analyzed. The postoperative bone healing time, hand function, and complications were compared between the two groups. Results The two groups were comparable; there were no significant differences in age, sex, length of bone defect, and time from injury to operation between the two groups (P > 0.05). All patients were followed up with for 6–24 months (average = 13.7 months), and all patients with segmental metacarpophalangeal bone defects achieved fracture healing. The postoperative hospital stay, fracture healing time, functionary scores of the affected limb, and incidence of severe complications were better in the modified group than in the external fixation group (P < 0.05). Conclusion Compared with the Kirschner wire external fixation stent assisted autologous bone transplantation, the improved Masquelet technique has the advantages of simple operation, fast healing, accurate effect, wide indications, and less complications, making it more worthy of clinical promotion.
Collapse
Affiliation(s)
- Zeng-Bing Liu
- Department of Hand and Foot Surgeries, The No. 4 People’s Hospital of Hengshui, Hengshui, 053000, People’s Republic of China
- Correspondence: Zeng-Bing Liu, Department of Hand and Foot Surgeries, The No. 4 People’s Hospital of Hengshui, No. 485 of Xinhua West Road, Taocheng District, Hengshui, 053000, People’s Republic of China, Tel +86 318 2173010, Email
| | - Qiang Li
- Department of Hand and Foot Surgeries, The No. 4 People’s Hospital of Hengshui, Hengshui, 053000, People’s Republic of China
| | - Wen-Xia Liu
- Department of Hand and Foot Surgeries, The No. 4 People’s Hospital of Hengshui, Hengshui, 053000, People’s Republic of China
| | - Xin-Hai Li
- Department of Hand and Foot Surgeries, The No. 4 People’s Hospital of Hengshui, Hengshui, 053000, People’s Republic of China
| | - Kai Ma
- Department of Hand and Foot Surgeries, The No. 4 People’s Hospital of Hengshui, Hengshui, 053000, People’s Republic of China
| | - Yu-Bao Huo
- Department of Hand and Foot Surgeries, The No. 4 People’s Hospital of Hengshui, Hengshui, 053000, People’s Republic of China
| | - Jin-Guang Wang
- Department of Hand and Foot Surgeries, The No. 4 People’s Hospital of Hengshui, Hengshui, 053000, People’s Republic of China
| | - Qing-He Wang
- Department of Hand and Foot Surgeries, The No. 4 People’s Hospital of Hengshui, Hengshui, 053000, People’s Republic of China
| | - Ya-Dong Yu
- Department of Hand Surgeries, The Third Hospital of Hebei Medical University, Shijiazhuang, 050000, People’s Republic of China
| |
Collapse
|
2
|
Rao R, Gornbein J, Afshar Y, Platt LD, DeVore GR, Krakow D. A new biometric: In utero growth curves for metacarpal and phalangeal lengths reveal an embryonic patterning ratio. Prenat Diagn 2019; 39:200-208. [PMID: 30488473 DOI: 10.1002/pd.5397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The objectives of this study are to develop gestational age-specific growth curves for fetal third metacarpal and phalangeal lengths and to determine if fetal hand proportion is established in utero. METHODS This prospective cross-sectional study used 2D ultrasound across gestational ages 12 to 39 weeks to evaluate the third fetal metacarpal and phalangeal measurements. Gestational age-specific reference growth curves were developed. Associations between continuous variables were assessed using Spearman correlations (rs ) and restricted cubic splines. A nonlinear biologic regression model was used to predict metacarpal and phalangeal lengths as a function of gestational age. Measurements derived from five cases of thanatophoric dysplasia were used to determine if brachydactyly could be objectified. RESULTS Fetal metacarpal and phalangeal lengths are highly correlated across gestational age (rs = 0.96, P < 0.001). The mean fetal metacarpal to phalangeal ratio is constant from gestational age 15 to 39 weeks (rs = -0.07, P = 0.49). Third-digit metacarpal and phalangeal lengths in thanatophoric dysplasia showed brachydactyly in all cases (5/5), and none of the cases (0/5) demonstrated a normal metacarpal to phalangeal ratio of 0.49. CONCLUSION We present gestational age-specific reference growth curves for fetal third metacarpal and phalangeal lengths, which may be used to detect brachydactyly. We demonstrate a prenatal metacarpal to phalangeal ratio of 1:2.
Collapse
Affiliation(s)
- Rashmi Rao
- Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jeffrey Gornbein
- Department of Biomathematics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Yalda Afshar
- Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Lawrence D Platt
- Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Center for Fetal Medicine and Women's Ultrasound, Los Angeles, CA, USA
| | - Greggory R DeVore
- Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Deborah Krakow
- Department of Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Center for Fetal Medicine and Women's Ultrasound, Los Angeles, CA, USA
| |
Collapse
|
3
|
Qin L, Lou G, Guo L, Zhang Y, Wang H, Wang L, Hou Q, Liu H, Li X, Liao S. Targeted next-generation sequencing-based molecular diagnosis of congenital hand malformations in Chinese population. Sci Rep 2018; 8:12721. [PMID: 30143665 PMCID: PMC6109141 DOI: 10.1038/s41598-018-30940-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 08/04/2018] [Indexed: 01/01/2023] Open
Abstract
Congenital hand malformations is rare and characterized by hand deformities. It is highly heterogeneous, both clinically and genetically, which complicates the identification of causative genes and mutations. Recently, targeted next-generation (NGS) sequencing has been successfully used for the detection of heterogeneous diseases, and the use of NGS also has contributed significantly in evaluating the etiology of heterogeneous disease. Here, we employed targeted NGS to screen 248 genes involved in genetic skeletal disorders, including congenital hand malformations. Three pathogenic mutations located in the GJA1, ROR2 and TBX5 genes were detected in three large Chinese families with congenital hand malformations. Two novel mutations were reported, and a known causative mutation was verified in this Chinese population. This is also the first report that the same panel of targeted NGS was employed to perform molecular diagnosis of different subtypes of congenital hand malformations. Our study supported the application of a targeted NGS panel as an effective tool to detect the genetic cause for heterogeneous diseases in clinical diagnosis.
Collapse
Affiliation(s)
- Litao Qin
- Medical Genetic Institute of Henan Province, Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Guiyu Lou
- Medical Genetic Institute of Henan Province, Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Liangjie Guo
- Medical Genetic Institute of Henan Province, Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yuwei Zhang
- Medical Genetic Institute of Henan Province, Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Hongdan Wang
- Medical Genetic Institute of Henan Province, Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Li Wang
- Medical Genetic Institute of Henan Province, Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qiaofang Hou
- Medical Genetic Institute of Henan Province, Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Hongyan Liu
- Medical Genetic Institute of Henan Province, Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xichuan Li
- Department of Immunology, Tianjin Medical University, Tianjin, China.
| | - Shixiu Liao
- Medical Genetic Institute of Henan Province, Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| |
Collapse
|