UNASSIGNED: Atlantoaxial dislocation patients with neurological defects require surgery. Sometimes, release surgery is necessary for irreducible atlantoaxial dislocation to further achieve reduction. Whether release surgery is essential relies on the surgeon\'s experience and lacks objective reference criteria. To evaluate the value of atlantoaxial joint inclination angle (AAJI) in sagittal and coronal planes and reduction index (RI) in the surgical approach selection for atlantoaxial dislocation.
UNASSIGNED: Retrospectively analyzed 87 cases (42 males and 45 females, 9-89 years) of atlantoaxial dislocation from January 2011 to November 2020. In addition, 40 individuals without atlantoaxial dislocation were selected as the control group. Imaging parameters were compared between the two groups. According to surgical methods, the experiment group was divided into two groups including Group A(release surgery group) and Group B (conventional operation group). The parameters were measured based on CT and x-ray. The relevant imaging parameters and clinical scores, including the AAJI in sagittal and coronal planes, the atlas-dens interval (ADI) before and after traction, the RI, and JOA scores were measured and analyzed.
UNASSIGNED: The sagittal and coronal atlantoaxial joint inclination angles(SAAJI and CAAJI) in the control group were 7.91 ± 0.42(L), 7.99 ± 0.39°(R), 12.92 ± 0.41°(L), 12.97 ± 0.37°(R), in A were 28.94 ± 1.46°(L), 28.57 ± 1.55°(R), 27.41 ± 1.29°(L), 27.84 ± 1.55°(R), and in B were 16.16 ± 0.95°(L), 16.80 ± 1.00°(R), 24.60 ± 0.84°(L), 24.92 ± 0.93°(R) respectively. Statistical analysis showed that there was a statistical difference in the SAAJI between the control group and the experiment group (P < 0.01), as well as between groups A and B (P < 0.01). The RI in groups A and B was 27.78 ± 1.46% and 48.60 ± 1.22% respectively, and there was also a significant difference between the two groups (P < 0.01). There was negative correlation between SAAJI and RI.
UNASSIGNED: The SAAJI and RI can be used as objective imaging indexes to evaluate the reducibility of atlantoaxial dislocation. And these parameters could further guide the selection of surgery methods. When the RI is smaller than 48.60% and SAAJI is bigger than 28.94°, anterior release may be required.

OBJECTIVE: To investigate the clinical efficacy of a modified paramedian lower lip-submandibular approach for maxillary (subtotal) total resection.
METHODS: Eleven patients of maxillary tumors underwent maxillary (subtotal) total resection through the modified paramedian lower lip-submandibular approach. Clinical follow-up visits were conducted to evaluate appearance restoration, facial nerve functional status, parotid gland functional status, and orbital region complication.
RESULTS: During the follow-up period of 6-36 months, the appearance of all 11 patients recovered well. All cases presented hidden scars. No facial nerve and parotid duct injury, lower eyelid edema, lower eyelid ectropion, or epiphora in all cases was observed.
CONCLUSIONS: Applying modified paramedian lower lip-submandibular approach to maxillary (subtotal) total resection effectively reduces incidence of orbital region complications including lower eyelid edema, lower eyelid ectropion, and epiphora, which often occur to traditional approach. The modified approach produces more subtle scars than other methods and should be applied to treatment of maxillary (subtotal) total resection.
目的 探讨一种新的改良下唇旁正中-颌下入路在上颌骨（次）全切除术中的应用价值。方法 对11例上颌骨肿瘤患者采用改良下唇旁正中-颌下入路进行上颌骨（次）全切除术。术后对患者面形恢复、面神经及腮腺功能状态、眶区并发症等进行分析。结果 随访6~36个月，所有患者面形恢复良好，切口瘢痕隐蔽，均无面神经、腮腺导管损伤症状，也无下睑水肿、睑外翻、溢泪等眶区并发症。结论 改良下唇旁正中-颌下入路行上颌骨（次）全切除术可有效降低下睑水肿、睑外翻、溢泪等眶区并发症的发生率，且切口瘢痕隐蔽，未增加其他并发症的发生，值得临床推广。.

OBJECTIVE: To investigate the advantages and effectiveness of anterior neurovascular interval approach for fixation of ulna coronoid process fracture.
METHODS: Between February 2011 and April 2015, 8 patients with ulna coronoid process fracture were treated with open reduction and internal fixation by anterior neurovascular interval approach. There were 5 males and 3 females, aged from 14 to 62 years (mean, 34 years). Fractures were caused by falling in 5 cases, traffic accident in 2 cases, and crashing in 1 case. The time between injury and operation was 1-6 days (mean, 3.5 days). According to Adams classification, there were 4 cases of type II, 1 case of type III, 2 cases of type IV, and 1 case of type V. In 1 patient with joint instability, lateral collateral ligament repair was given through another incision after fixation of coroniod fracture and the hinged external fixator, and plast splin was used to fix in the other patients; function exercise was done after removal of external fixtion.
RESULTS: All incisions healed by first intention, and no complications of neurovascular injury and deep infection occurred. All patients were followed up 6-48 months (mean, 22 months). The healing time of fracture was 8-15 weeks (mean, 12.6 weeks). Mild myositis ossificans occurred in 1 case. The flexionextension arc of the elbow was (125.00±7.07)° and the forearm rotation was (135.00±7.07)°, showing no significant difference when compared with those of normal side[(126.88±7.53)° and (139.38±8.21)°] (t=0.469, P=0.654; t=2.198, P=0.054). According to Morrey\'s scale, the results were excellent in 6 cases, good in 2 cases; the excellent and good rate was 100%.
CONCLUSIONS: Anterior neurovascular interval approach for reduction and internal fixation of ulna coroniod fractures has the advantages of simple operation, less trauma, and larger operative field. It can be used alone or combined with other surgical approaches.
UNASSIGNED: 探讨采用肘前侧神经血管间隙入路行内固定术治疗尺骨冠状突骨折的优势及疗效。.
UNASSIGNED: 2011年2月-2015月4月，收治8例尺骨冠状突骨折患者。男5例，女3例；年龄14～62岁，平均34岁。致伤原因：摔伤5例，交通事故伤2例，重物砸伤1例。受伤至手术时间1～6 d，平均3.5 d。骨折根据Adams等的分型标准：Ⅱ型4例，Ⅲ型1例，Ⅳ型2例，Ⅴ型1例。术中采用肘前侧神经血管间隙入路后，行骨折复位内固定。其中1例合并关节不稳定者，另作切口行侧副韧带修复术，予以铰链式外固定架固定；其余患者术后采用石膏外固定。拆除外固定物后行肘关节功能锻炼。.
UNASSIGNED: 术后切口均Ⅰ期愈合，无血管、神经损伤以及深部感染等并发症发生。患者均获随访，随访时间6～48个月，平均22个月。X线片复查示患者骨折均愈合，愈合时间8～15周，平均12.6周。1例发生轻度骨化性肌炎。末次随访时，患侧肘关节屈伸活动度为（125.00±7.07）°、前臂旋转活动度为（135.00±7.07）°，与健侧（126.88±7.53）、（139.38±8.21）°比较，差异均无统计学意义（t=0.469，P=0.654；t=2.198，P=0.054）。根据Morrey等肘关节功能评定标准评价，获优6例、良2例，优良率100%。.
UNASSIGNED: 对于尺骨冠状突骨折，采用肘前侧神经血管间隙入路行骨折复位内固定术，具有操作简便、创伤小、暴露清晰等优点，并且可联合其他手术入路使用。.