Publications by authors named "Yong-Jun Rui"

28 Publications

  • Page 1 of 1

Changes in local bone mineral density can guide the treatment plan for patients with rupture of the anterior cruciate ligament.

Ann Palliat Med 2021 Jun 31;10(6):6388-6398. Epub 2021 May 31.

Department of Traumatic Orthopedics, Wuxi Ninth People's Hospital affiliated to Soochow University, Wuxi, China.

Background: Many factors affect the outcomes of anterior cruciate ligament (ACL) reconstruction surgery. However, few studies have examined the effects of local bone conditions on the reconstruction of the ACL. This study investigated the changes in the local bone mineral density (BMD) of the knee after rupture of the ACL with the view of using this information to guide treatment options.

Methods: Patients with ACL rupture treated in our department from January 2017 to April 2019 were enrolled in this study. Prior to surgery, local BMD measurements were obtained from all patients and used to determine the appropriate method of ligament fixation. If the local BMD of the affected knee was not significantly lower than that of the healthy side, extrusion fixation was conducted. If the BMD was significantly lower than that of the healthy knee, suspension fixation was applied. The conditions of tunnel cutting or screw splitting, and tunnel enlargement or screw pull-out were observed during the surgery. The post-surgical function of the knee joint was evaluated regularly by physical examination, imaging data, the IKDC scale score, and the Lysholm score.

Results: A total of 80 patients with unilateral ACL rupture were included. There were 64 males and 16 females. Decreased BMD was observed in the affected knee compared to the healthy knee for 68 patients. Patients with an ACL history of more than 3 months had lower BMD compared to patients with a history of less than 3 months. Tunnel enlargement and screw pull-out occurred in 2 patients, screw splitting occurred in 1 patient. The fixation mode was adjusted in real-time during the surgery for 3 patients. All patients were followed up for at least 12 months (mean 20.65±5.12 months). The IKDC score increased from 43.07±2.66 pre-surgery to 89.17±3.28 at the final follow-up, and similarly, the Lysholm score increased from 43.49±2.38 pre-surgery to 89.67±2.97 post-surgery.

Conclusions: The measurement of local BMD before surgery may play a significant role in guiding the type of graft fixation. It is recommended that patients undergo surgical reconstruction within 3 months after injury.
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http://dx.doi.org/10.21037/apm-21-741DOI Listing
June 2021

Reconstruction of Wassel IV-D radial polydactyly with a boot-shaped neurovascular island flap: A Consecutive series of 91 thumbs.

J Plast Reconstr Aesthet Surg 2020 Oct 26;73(10):1801-1805. Epub 2020 May 26.

Department of Hand Surgery, Wuxi No. 9 People's Hospital affiliated to Soochow University, Wuxi, China. Electronic address:

Introduction: Reconstruction of Wassel IV-D radial polydactyly is challenging and requires a custom strategy dependent on the relative size and shape of the radial and ulnar duplicates. Herein, we describe a technique using a boot-shaped neurovascular island flap and review our outcomes.

Methods: Ninety-one consecutive patients had reconstruction with a boot-shaped neurovascular island flap. The flap was dissected out from the thumb to be removed. Specific flap modifications were inclusion of the lateral nail fold, Bruner incisions dorsally and volarly to reduce scarring at the interphalangeal (IP) joint and also complete mobilization of the island flap on its pedicle to allow easier inset. A flexor pollicis longus and extensor tendon rebalancing technique was used to correct the deviation of the reconstructed thumb IP joint.

Results: All boot-shaped neurovascular island flaps survived with good contour, shape, and symmetry. The average follow-up period was 25 months (range 6-60 months). Using the Japanese Society for Surgery of the Hand (JSSH) score for classification of outcomes, seven cases were classified as excellent and 84 cases as good. The median JSSH score was 18. The median Kapandji score for opposition was 9 (range 8-10).

Conclusion: Using a boot-shaped neurovascular island flap completely mobilized on its pedicle with a custom strategy for each radial duplicate, good outcomes can be achieved in reconstruction of Wassel IV-D radial polydactyly.

Level Of Evidence: Therapeutic Level IV.
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http://dx.doi.org/10.1016/j.bjps.2020.05.071DOI Listing
October 2020

Clinical observation of C3-type patellar fractures treated by operation methods with or without a turned-over patella.

Injury 2019 Apr 18;50(4):966-972. Epub 2019 Mar 18.

Department of Orthopaedics, Wuxi the Ninth People's Hospital Affiliated to Suzhou University, 214062, China. Electronic address:

Objective: To evaluate the clinical efficacy of operation methods with or without a turned-over patella for treatment of C3-type patellar fractures.

Methods: A total of 68 patients with C3-type patellar fractures undergoing open reduction and internal fixation were retrospectively selected and treated with a turned-over patella surgery (turned-over patella group, n = 30) or conventional therapy without turning over the patella (conventional group, n = 38). The intraoperative and postoperative indicators of the two groups were assessed and comparatively analyzed.

Results: The bedridden time was significantly shorter in the turned-over patella group than in the conventional group (P = 0.002), while the range of motion (ROM) of knee joint was significantly higher in the turned-over patella group (P = 0.044). The Lysholm score was slightly higher in the turned-over patella group than in the conventional group, but the difference was not statistically significant (P = 0.055). No significant difference was observed between the two groups in terms of the operation time (P = 0.096), intraoperative blood loss (P = 0.543), time of weight bearing (P = 0.312), fracture healing time (P = 0.272), or complications (P = 1).

Conclusion: The turned-over patella operation method exhibited some superiority to conventional reduction-fixation approach for treatment of C3-type patellar fractures in terms of efficacy and safety by enlarging the ROM of the knee joint and promoting functional recovery.
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http://dx.doi.org/10.1016/j.injury.2019.03.028DOI Listing
April 2019

The protective effect of Irisin against ischemia-reperfusion injury after perforator flap grafting in rats.

Injury 2018 Dec 28;49(12):2147-2153. Epub 2018 Sep 28.

Soochow University, Soochow, Jiangsu, China; Department of Hand Surgery, Wuxi No. 9 People's Hospital Affiliated Soochow University, Wuxi, Jiangsu, China. Electronic address:

Background: Ischemia-reperfusion injury is one of the reasons for failure of flap grafting. In the present study, we investigated the protective effect of irisin on the survival of perforator flaps in rats.

Methods: A total of 48 adult Sprague-Dawley rats were divided into 2 groups and subjected to vascular clipping of perforator flap. Rats in the experimental group (n = 24) received daily tail intravenous injection of irisin (2 ng/g) for 3 days, while the rest rats in the control group (n = 24) received injection of saline solution of the same dose. On the 7th post-operative day, the surviving area of the flaps were recorded as the percentage of the total flap area. Histology study with haematoxylin and eosin staining were performed in all flaps. Flaps were also evaluated with lead oxide-gelatine-enhanced flap angiography. Immunohistochemical study was performed to evaluate the expression of ErG, a marker of vascular endothelial cells. The tissue of "choke vessels" was excised for quantification of p-Akt/Akt by western blot assay on the 7th post-operative day.

Results: On the 7th post-operative day, the percentage of surviving flap area was significantly larger in the rats with irisin administration (experimental group), compared with the control group (P = 0.011). The density of microvessels was significantly higher in the experimental group (P = 0.03) in the histological study and angiography, with a higher expression level of ErG in the immunochemical study (P = 0.01). The p-Akt/Akt was also higher in the experimental group in Western blotting analysis (P < 0.001).

Conclusion: Irisin has a beneficial effect on protecting perforator flaps from ischemic-reperfusion injury following the flap grafting surgery. It was potentially achieved by promoting proliferation of vascular endothelial cells after flap revascularization. Upregulation of the PI3K/Akt signaling pathway was potentially related with this process.
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http://dx.doi.org/10.1016/j.injury.2018.09.054DOI Listing
December 2018

RETRACTED: An analysis of factors predicting failure after single digit replantation.

J Hand Surg Eur Vol 2019 05 2;44(4):NP2-NP7. Epub 2018 May 2.

Department of Hand Surgery, Wuxi No.9 People's Hospital Affiliated to Soochow University, Wuxi, China.

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http://dx.doi.org/10.1177/1753193418773256DOI Listing
May 2019

Outcomes of modified trapeziectomy with ligament reconstruction tendon interposition for the treatment of advanced thumb carpometacarpal arthritis: Two-year follow-up.

Medicine (Baltimore) 2018 Mar;97(13):e0235

Department of Hand Surgery, Wuxi No. 9 People's Hospital Affiliated to Soochow University, Wuxi, China.

Numerous arthroplasty techniques had been reported for the treatment of thumb carpometacarpal (CMC) joint osteoarthritis. The purpose of our study is to evaluate long-term clinical and radiographic outcomes of patients who underwent modified trapeziectomy with ligament reconstruction tendon interposition (LRTI).Our retrospective study included 20 consecutive patients with advanced thumb CMC arthritis receiving modified trapeziectomy with LRTI (20 thumbs). For clinical evaluation, we assessed visual analogue scale (VAS), Disabilities of the Arm, Shoulder and Hand (DASH) scores and Kapandji index. Additionally, the grip, pinch power and waist flexion power, radial and volar abduction angle were evaluated, As for radiologic evaluation, we just estimated height of the trapezial space.We took 2-year follow-up. All patients showed decreased VAS from 6.8 preoperatively to 1.4. Mean DASH and Kapandji scores were improved from 52.2 preoperatively to 21.6 and from 6.4 preoperatively to 7.4, respectively. Compared to preoperative range of motion (ROM) for radial abduction and volar abduction, both markedly increased at 2-year follow-up (from 61.2 to 80.1, from 60.6 to 78.3, respectively). Besides, mean power improved from 15.9 preoperatively to 21.7 kg at 2-year follow-up for grip power, from 1.9 preoperatively to 3.5 kg at 2-year follow-up for tip pinch; however, mean waist flexion power showed no significant change from 20.5 preoperatively to 19.7 kg at 2-year follow-up. Notably, there was no significant sinking in height of the trapezial space from 10.0 preoperatively to 9.6 mm at 2-year follow-up. NO case had a complication at final follow-up.Modified trapeziectomy with LRTI treating thumb CMC arthritis in Eaton stage III-IV had a satisfactory efficacy. This new procedure is able to provides enough support for thumb to prevents thumb sinking.
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http://dx.doi.org/10.1097/MD.0000000000010235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895363PMC
March 2018

Successfully treating hand primary tuberculous synovitis by synovectomy combined antituberculous therapy: A case report.

Medicine (Baltimore) 2018 Feb;97(8):e9938

Department of Hand Surgery, Wuxi NO.9 People's Hospital Affiliated to Soochow University, Wuxi, China.

Rationale: Primary tuberculous infection in hand and wrist is a rare disease. Few articles reported on hand primary tuberculous synovitis.

Patient Concerns: A 68-year-old Chinese male, without history of tuberculosis (TB), had complained of pain and swelling in right palm and little finger for 3 months. Patient came to our hospital on 9th Oct 2016. X-ray just showed soft tissue swelling in little finger. Magnetic resonance imaging (MRI) showed synovitis around flexor tendon of little finger, volar palm, and carpal tunnel. Notably, it also implied nodular images in little finger sizing 5 mm × 11 mm. Laboratory tests revealed C-reactive protein (CRP): 22 mg/L, erythrocyte sedimentation rate (ESR): 49 mm/h, and white blood cells (WBC): 11.8 × 10/L.

Diagnoses: He was diagnosed with primary hand tuberculous synovitis.

Interventions: The patient received aspiration biopsy in right palm guided by ultrasound on 13rd Oct and pathological examination indicated Mycobacterium tuberculosis (MTB) infection. We performed radical synovetomy and collected abnormal tissue for pathological examination on 18th Oct. Finally, result showed MTB infection, which was the same with the result of first pathological examination. Then, this patient received antituberculous treatment.

Outcomes: One year after operation, pain and swelling relieve and no recurrence of the clinical symptoms happened.

Lessons: Primary tuberculous synovitis of hand and wrist is rare, MTB infection should be considered as an infectious agent, especially in developing countries. Radical synovectomy and antituberculous treatment regain a satisfactory outcome.
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http://dx.doi.org/10.1097/MD.0000000000009938DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842005PMC
February 2018

Left extensive infection in the forearm caused by whitlow infected by mycobacterium tuberculosis: A case report.

Medicine (Baltimore) 2017 Dec;96(48):e8992

Department of Hand Surgery, Wuxi No. 9 People's Hospital Affiliated to Soochow University, Wuxi, China.

Introduction: Whitlow is a common disease in clinic, characterized by pain and swelling of finger. However, few articles had reported on extensive infection in the forearm caused by whitlow infected by mycobacterium tuberculosis (MTB).

Patient Concerns: A 70-year-old Chinese female complained of fester in back of left hand for 5 days. She had a history of recurrent whitlow for 14 months and pulmonary tuberculosis (TB). She received treatment in another hospital due to whitlow on July 2016. Then she was treated with incision and drainage. However, whitlow presented again several times before coming to our hospital. She came to our hospital on September 7, 2017 and x-ray of forearm showed that radius, ulna, and carpal were eroded.

Diagnoses: She was diagnosed with left extensive infection in the forearm caused by whitlow infection by MTB.

Interventions: Considering her serious and extensive condition, we performed left forearm amputation on September 12, 2017. We collected some soft tissue cut down during surgery and conducted pathological examination. Finally, pathological result showed MTB infection. Then that patient was treated with antituberculosis therapy.

Outcomes: Up to now, illness condition has not progressed. A recent x-ray of forearm showed no osteolysis in humerus.

Conclusions: Extensive infection in the forearm after recurrent whitlow infection by MTB is rare. So when we face recurrent whitlow, a rapid diagnosis and treatment are required to prevent complications. This case reminds us that recurrent whitlow is dangerous. Attention must be paid to recurrent whitlow. If necessary, amputation should be considered.
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http://dx.doi.org/10.1097/MD.0000000000008992DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728815PMC
December 2017

Bilateral femoral posterior neurocutaneous perforater flap successfully treating Fournier gangrene: A case report.

Medicine (Baltimore) 2017 Nov;96(46):e8720

Department of Hand Surgery, Wuxi NO.9 People's Hospital Affiliated to Soochow University, Wuxi, China.

Rationale: Necrotizing fasciitis (NF), characterized by widespread fascial necrosis, is a rare disease in clinic. Fournier gangrene (FG) is a special type of NF involved of perineum and scrotum. To our knowledge, no article has reported on bilateral femoral posterior neurocutaneous perforater flap treating for FG.

Patient Concerns: A 61-year-old Chinese male complained of perineal skin necrosis for 19 days. The patient received treatment in other hospital due to chronic bronchitis on April 15th and body temperature ranged from 38 to 39 °C. Then he received antiinfection therapy. Perianal cutaneous occurred mild necrosis on May 08th. And the necrosis generally deteriorated. He came to our hospital for treating necrosis in area of perineum and scrotum on May 28th.

Diagnoses: He was diagnosed with FG and chronic bronchitis.

Interventions: The patient underwent debridement on June 2nd and received bilateral femoral posterior neurocutaneous perforater flap on June 29th. Besides, the patient was treated with whole-body nutrition support and antibiotic treatment.

Outcomes: One week after the 2nd operation, the flap showed normal color. The result shows good outcome and no recurrence of the clinical symptoms occur till now.

Lessons: FG is rare. Bilateral femoral posterior neurocutaneous perforater flap is an effective procedure to treat FG. The outcome of combined therapy is satisfactory.
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http://dx.doi.org/10.1097/MD.0000000000008720DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704857PMC
November 2017

Muscle fiber types composition and type identified endplate morphology of forepaw intrinsic muscles in the rat.

J Muscle Res Cell Motil 2016 06 26;37(3):95-100. Epub 2016 Jul 26.

Department of Hand Surgery, Wuxi Number 9 People's Hospital Affiliated to Soochow University, Wuxi, 214062, Jiangsu, People's Republic of China.

The failure to accept reinnervation is considered to be one of the reasons for the poor motor functional recovery of intrinsic hand muscles (IHMs) after nerve injury. Rat could be a suitable model to be used in simulating motor function recovery of the IHMs after nerve injury as to the similarities in function and anatomy of the muscles between human and rat. However, few studies have reported the muscle fiber types composition and endplate morphologic characteristics of intrinsic forepaw muscles (IFMs) in the rat. In this study, the myosin heavy chain isoforms and acetylcholine receptors were stained by immunofluorescence to show the muscle fiber types composition and endplates on type-identified fibers of the lumbrical muscles (LMs), interosseus muscles (IMs), abductor digiti minimi (AM) and flexor pollicis brevis (FM) in rat forepaw. The majority of IFMs fibers were labeled positively for fast-switch fiber. However, the IMs were composed of only slow-switch fiber. With the exception of the IMs, the other IFMs had a part of hybrid fibers. Two-dimensional morphological characteristics of endplates on I and IIa muscle fiber had no significant differences among the IFMs. The LMs is the most suitable IFMs of rat to stimulate reinnervation of the IHMs after nerve injury. Gaining greater insight into the muscle fiber types composition and endplate morphology in the IFMs of rat may help understand the pathological and functional changes of IFMs in rat model stimulating reinnervation of IHMs after peripheral nerve injury.
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http://dx.doi.org/10.1007/s10974-016-9450-8DOI Listing
June 2016

Modified Great Toe Wraparound Flap with Preservation of Plantar Triangular Flap for Reconstruction of Degloving Injuries of the Thumb and Fingers: Long-Term Follow-Up.

Plast Reconstr Surg 2016 Jul;138(1):155-163

Wuxi, People's Republic of China; and Miami, Fla.

Background: The purpose of this article is to report the authors' experience with the use of the modified great toe wraparound flap with preservation of a plantar triangular flap for reconstructing degloving injuries of the thumb and fingers.

Methods: Between 2007 and 2012, 31 patients underwent reconstruction with 37 flaps. Twenty-seven patients underwent reconstruction with 31 flaps for a degloved thumb and fingers, and four patients underwent reconstruction with six flaps for degloved fingers only. A modified great toe wraparound flap with second toe medial toe hemipulp flap on a common pedicle was used for reconstruction of degloved fingers in four patients. Twelve patients had long-term follow-up, with a mean duration of 5 years (range, 2 to 8 years).

Results: All flaps survived. The contour of the reconstructed digits was similar to the contralateral one. In patients with long-term follow-up, mean two-point discrimination of reconstructed digits was 6.2 mm (range, 3 to 8 mm). Mean Disabilities of the Arm, Shoulder and Hand questionnaire score was 0.8 ± 1.0. Mean Michigan Hand Outcomes Questionnaire score was 87.3 ± 3.7. Mean Foot and Ankle Disability Index score was 95.5 ± 2.7. The width of the preserved plantar triangular flap expanded from 35 percent to 67 percent of the width of the great toe and completely covered the weight-bearing area.

Conclusions: Reconstruction of degloved thumb and fingers with a modified great toe wraparound flap, preserving a plantar triangular flap, results in excellent contour and functional outcome. Donor-site morbidity in the foot was minimal.

Clinical Question/level Of Evidence: Therapeutic, IV.
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http://dx.doi.org/10.1097/PRS.0000000000002301DOI Listing
July 2016

Prognostic value of long noncoding RNA MALAT1 in various carcinomas: evidence from nine studies.

Tumour Biol 2016 Jan 18;37(1):1211-5. Epub 2015 Aug 18.

Department of Orthopedics, The Ninth People's Hospital of Wuxi City, The Affiliated Wuxi Hospital of Soochow University, No. 999 Liangxi Road, Wuxi, Jiangsu, 214062, China.

RNA-sequencing technology is progressing day by day. Numerous researches have showed that long noncoding RNAs (lncRNAs) play oncogenic or tumor suppressor roles in tumor biological processes. To our knowledge, many studies have identified a lot of lncRNAs with aberrant expression in several types of cancers. Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), a newly discovered lncRNA, has been reported that is overexpressed in several types of cancers. But the clinical value of MALAT1 in cancers remains unclear. Therefore, in this present study, we aimed to investigate potential clinical application role of MALAT1 as a prognostic biomarker in malignant tumors. We performed a detailed search in PubMed, Embase, Medline, and Cochrane Library until July 2015. According to the inclusion and exclusion criteria, nine studies with a total of 941 patients were selected to explore the relationship between high expression of MALAT1 and overall survival in cancers. The result showed that overexpression of MALAT1 could predict poor overall survival (OS) in cancer patients, with pooled hazard ratio (HR) of 1.90 [95 % confidence interval (CI) 1.68-2.16, P < 0.0001]. In conclusion, the present meta-analysis demonstrated that high expression of MALAT1 might be served as a novel prognostic biomarker in different types of cancers.
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http://dx.doi.org/10.1007/s13277-015-3915-zDOI Listing
January 2016

[Risk factors of the failure in digit replantation].

Zhongguo Gu Shang 2015 May;28(5):429-32

Objective: To explore the relative factors on the failure in digit replantation in order to take preventions to control the risk factors.

Methods: From January 2013 to December 2013, 236 consecutive patients (311 fingers) underwent digit replantation were collected to analyze retrospectively, involving 183 males and 53 females with an average age of 34.5 years old ranging from 2 to 62 years old (6 cases under 6 years old and 230 cases elder than 6 years old). There were 51 thumbs, 87 index fingers, 78 middle fingers, 63 ring fings and 32 little thumbs. Forty cases(forty fings) who were failured as the observation group, the others as the control group. The factors of age, gender, finger, cause of injury, smoking history, ischemia duration, plane of division, condition of venous drainage and condition of arterial repair we assessed.

Results: All 236 cases with 311 fingers were replanted, 40 fingers were failured after operation. The relative factors on the failure in digit replantation included smoking history, cause of injury, plane of division, condition of venous drainage and condition of arterial repair (P< 0.05). There were no significant correlation between the failure and age, gender, finger and ischemia duration (P>0.05).

Conclusion: Smoking history, causes of injury, plane of division, condition of venous drainage and condition of arterial repair are risks of failure in digit replantation. Before choosing the type of operation, it should be think about the patient's general conditions, injury status, grasp firmly the operative indications and actively carry out surgical treatment.
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May 2015

Delayed treatment of unstable proximal interphalangeal joint fracture-dislocations with a dynamic external fixator.

Injury 2015 Oct 20;46(10):1938-44. Epub 2015 Jun 20.

Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL, USA. Electronic address:

Background: Fracture-dislocations of the proximal interphalangeal joint (PIPJ) remain a challenging problem to treat. Although there are a number of papers describing the use of dynamic external fixators and force couples for treatment of unstable PIPJ fracture-dislocations acutely, the literature is scarce on delayed treatment of PIPJ fracture-dislocations, where malunion of the articular surface may theoretically compromise postoperative range of motion (ROM) at the PIPJ. The purpose of this study was to evaluate the effectiveness of dynamic distraction external fixation (DDEF) for the delayed treatment of PIPJ fracture-dislocations at least 3 weeks after the inciting injury.

Methods: Ten consecutive patients were treated with delayed DDEF between 2010 and 2013. Postoperative ROM at the PIPJ was measured. Disabilities of the Arm, Shoulder and Hand (DASH) score and Michigan Hand Outcomes Questionnaire were administered to all patients postoperatively.

Results: Mean time from injury to surgery was 27.5 days. The mean follow-up period was 23.7 months (range 10-36). The mean active ROM at the PIPJ on final postoperative follow-up was 83.9° (range 52-100). None of the patients experienced pin-tract infections. Mean DASH score was 3.7+3.4 and mean Michigan Hand Outcomes Questionnaire score was 97.3+3.0. All patients returned to work and resumed normal activities.

Conclusions: Delayed treatment of unstable PIPJ fracture-dislocations with a DDEF is effective in restoring function to the PIPJ. Nascent malunion of the PIPJ articular surface does not compromise postoperative outcomes and the joint surface undergoes remodelling over time to restore a smooth and functional articular surface.
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http://dx.doi.org/10.1016/j.injury.2015.06.027DOI Listing
October 2015

Innervated Digital Artery Perforator Propeller Flap for Reconstruction of Lateral Oblique Fingertip Defects.

J Hand Surg Am 2015 Jul 4;40(7):1382-8. Epub 2015 May 4.

Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL. Electronic address:

Purpose: To report our experience with the use of a digital artery perforator propeller flap based on a constant distal perforator in the middle phalanx for resurfacing of lateral oblique fingertip amputations.

Methods: Twelve fingertips in 10 patients underwent reconstruction, with a mean follow-up of 8 months (range, 8-12 mo). The size of the flaps ranged from 2.5 × 1.5 cm to 3.0 × 2.0 cm.

Results: All flaps survived entirely and restored a rounded fingertip contour. Mean static 2-point discrimination was 5 mm (range, 4-6 mm). With the exception of 1 patient with an amputation at the distal interphalangeal joint, the distal interphalangeal joint was preserved in all patients and had 30° to 60° of motion at final follow-up. No patients complained of cold intolerance or residual joint contracture. No hooked nail deformity occurred in patients who had remaining nailbed.

Conclusions: The digital artery perforator propeller flap is particularly suited to coverage of a lateral oblique fingertip defect, because only a 90° rotation is required when inset, and the bulk of the flap serves to restore the rounded contour of the fingertip. The skin over the entire dorsal surface of the middle phalanx can be elevated as a flap, providing adequate tissue to resurface the defect and restore a rounded contour to the fingertip.

Type Of Study/level Of Evidence: Therapeutic IV.
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http://dx.doi.org/10.1016/j.jhsa.2015.03.024DOI Listing
July 2015

Effect of c-erbB2 overexpression on prognosis in osteosarcoma: evidence from eight studies.

Tumour Biol 2014 Sep 5;35(9):8939-43. Epub 2014 Jun 5.

Department of Orthopedics, The Ninth People's Hospital of Wuxi City, The Affiliated Wuxi Hospital of Soochow University, No.999 Liangxi Road, Wuxi, Jiangsu Province, 214062, China.

C-erbB2 (HER-2/neu) plays an important role in the progression of several types of cancer by increasing tumor growth, migration, invasion, and metastasis and is associated with poor disease prognosis. Numerous studies examining the relationship between c-erbB2 expression and prognostic impact in patients with osteosarcoma have yielded inconclusive results. We therefore conducted a meta-analysis to provide a comprehensive evaluation of the prognostic role of c-erbB2 expression on 5-year survival, which compared the positive and negative expression of c-erbB2 in patients of the available studies. A detailed search was made in PubMed for relevant original articles published in English. Finally, a total of eight studies with 411 osteosarcoma patients were involved to estimate the relationship between c-erbB2 expression and 5-year overall survival. Positive expressions of c-erbB2 predicted poorer survival in osteosarcoma with the pooled RR of 1.53 (95 % CI 1.20-1.94, P = 0.0006). In conclusion, the findings from this present meta-analysis suggest that c-erbB2 overexpression is related to poor prognostic of osteosarcoma and can be a useful clinical prognostic factor for those patients.
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http://dx.doi.org/10.1007/s13277-014-2165-9DOI Listing
September 2014

Shortage of paediatricians in China.

Lancet 2014 Mar;383(9921):954

Wuxi Number 9 People's Hospital Affiliated Soochow University, Wuxi Jiangsu, 214062, China.

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http://dx.doi.org/10.1016/S0140-6736(14)60482-7DOI Listing
March 2014

Minimally invasive plate osteosynthesis for distal radius fractures.

Indian J Orthop 2014 Jan;48(1):20-4

Department of Orthopaedics, Wuxi Hand Surgery Hospital, Wuxi 214062, China.

Background: Fractures of distal radius are common injury in all age groups. Cast treatment with or without close reduction is a viable option. However, the results are often unsatisfactory with restricted function. The open reduction and internal fixation often results in extensive soft tissue dissection and associated high rates of infect and delayed/nonunion. The distractor/external fixator have reported good functional and anatomical results but the incidence of pin traction infection nerve injury and cosmedic deformity are high. We introduced a modified operative technique for minimally invasive plate osteosynthesis (MIPO) for distal radial fracture and evaluated the functional outcomes and complications.

Materials And Methods: 22 distal radial fractures (10 left, 12 right) were treated using the MIPO technique and two small incisions with a palmar locking plate from August 2009 to August 2010. The wrist function was assessed according to Dienst wrist rating system, and postoperative complications were recorded.

Results: According to Dienst wrist rating system, 13 patients showed excellent results, 6 cases showed good results and 3 patients had moderate results. No patient had poor results. Thus, the excellent and good rate was 86.4%. One patient had anesthesia in the thenar eminence and this symptom disappeared after 3 months. One patient had delayed healing in the proximal wrist crease. Two patients had mild pain on the ulnar side of the wrist and two patients had limited wrist joint function.

Conclusion: The MIPO technique by using two small palmar incisions is safe and effective for treatment of distal radial fractures.
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http://dx.doi.org/10.4103/0019-5413.125483DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931148PMC
January 2014

Stem cell therapy for the treatment of parasitic infections: is it far away?

Parasitol Res 2014 Feb 26;113(2):607-12. Epub 2013 Nov 26.

Department of Laboratory, The Ninth People's Hospital of Wuxi City, No.999 Liangxi Road, Wuxi, Jiangsu Province, 214062, China.

Stem cell therapy is an interventional treatment that introduces new cells into damaged tissues, which help in treating many diseases and injuries. It has been proved that stem cell therapy is effective for the treatment of cancers, diabetes mellitus, Parkinson's disease, Huntington's disease, cardiovascular diseases, neurological disorders, and many other diseases. Recently, stem cell therapy has been introduced to treat parasitic infections. The culture supernatant of mesenchymal stem cells (MSCs) is found to inhibit activation and proliferation of macrophages induced by the soluble egg antigen of Schistosoma japonicum, and MSC treatment relieves S. japonicum-induced liver injury and fibrosis in mouse models. In addition, transplantation of MSCs into naïve mice is able to confer host resistance against malaria, and MSCs are reported to play an important role in host protective immune responses against malaria by modulating regulatory T cells. In mouse models of Chagas disease, bone marrow mononuclear cell has been shown effective in reducing inflammation and fibrosis in mice infected with Trypanosoma cruzi, and transplantation of the bone marrow mononuclear cells prevents and reverses the right ventricular dilatation induced by T. cruzi infection in mice. Preliminary clinical trials demonstrate that transplantation of bone marrow derived-cells may become an important therapeutic modality in the management of end-stage heart diseases associated with Chagas disease. Based on these exciting results, it is considered by stating that it is firmly believed that, within the next few years, we will be able to find the best animal models and the appropriate stem cell type, stem cell number, injection route, and disease state that will result in possible benefits for the patients with parasitic infections, and stem cell therapy, although at an initial stage currently, will become a real therapeutic option for parasitic diseases.
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http://dx.doi.org/10.1007/s00436-013-3689-4DOI Listing
February 2014

[Application of thenar perforator flaps for the narrow cicatricial contracture at thumb and the first web].

Zhonghua Zheng Xing Wai Ke Za Zhi 2013 May;29(3):181-3

Objective: To discuss the therapeutic effect of thenar perforator flaps for the narrow cicatricial contracture at thumb and the first web.

Methods: From Aug. 2010 to Jan. 2012, 9 cases with narrow cicatricial contracture at thumb and the first web, were treated. The defect size after releasing the contracture ranged from 8 mm x 20 mm to 15 cm x 30 mm. The bilateral thenar perforator flaps beside the wound were designed which size was 10 mm x 25 mm to 15 mm x 35 mm. The wounds at donor sites were closed directly.

Results: All the 9 flaps survived completely with primary healing. The patients were followed up for 6-18 months. The flaps had soft texture and good appearance. The shape of flaps and function of the fingers were satisfied after 6-18 months of follow-up. There was no scar contracture at incisions in thenar. The thumb motion was really normal. The abduction of first web was 70 degrees - 90 degrees degrees.

Conclusions: The thenar perforator flaps is one of the ideal methods for the treatment of narrow cicatricial contracture at thumb and the first web. The main artery is not sacrified.
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May 2013

[Treatment of refractory sinus in the lower leg with modified VSD technique].

Zhongguo Gu Shang 2012 Oct;25(10):861-3

Department of Orthopaedics, the 9th People 's Hospital of Wuxi, Hospital of Hand Surgery, Jiangsu, China.

Objective: To investigate the effects of modified vacuum sealing drainage (VSD) technique in treating refractory sinus in the lower leg.

Methods: From January 2010 to December 2011, 11 patients with refractory sinus in the lower leg, including 7 males and 4 females, with an average age of 34.5 years (ranged,23 to 56). These patients were treated with modified VSD technique after thorough cleaning sinus and continuous washing. After 14 to 21 days of treatment, removed VSD and re-debrided the sinus and sutured wound.

Results: Infections got control after operation, sinus in the lower leg healed. All patients were followed up from 6 to 14 months with an average of 10 months, no recidivations were found.

Conclusion: Modified VSD technique is an effective method in the treatment of stubborn sinus in the lower leg.
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October 2012

[Application of V-Y flap pedicled with superior malleolus cutaneous branch for small skin defect at the dorsal side of foot].

Zhonghua Zheng Xing Wai Ke Za Zhi 2011 Jul;27(4):266-8

Department of Hand Surgery, Wuxi Hand Surgery Hospital, Wuxi 214061, China.

Objective: To investigate the therapeutic effect of V-Y flap pedicled with superior malleolus cutaneous branch for small skin defect at the dorsal side of foot.

Methods: From Aug. 2008 to Aug. 2010, 9 cases with skin defects at the dorsal side of feet were treated by V-Y flaps pedicled with superior malleolus cutaneous branch. The flap size ranged from 6.0 cm x 5.5 cm to 12.0 cm x 6.5 cm. The defects at the donor sites were closed directly.

Results: All flaps survived completely. 9 cases were followed up for 6-12 months after operation. The flaps had good texture and color match. The 2-point discrimination distance at the flap was 10-14 mm. The function of ankle was normal.

Conclusions: The V-Y flap pedicled with superior malleolus cutaneous branch is ideal for the treatment of small skin defect at the dorsal side of foot.
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July 2011

[Repair of soft tissue defect at finger tip with square island flap pedicled with skin perforator of digital artery on the distal interphalangeal joint].

Zhonghua Zheng Xing Wai Ke Za Zhi 2011 May;27(3):204-7

Department of Hand Surgery, Wuxi Hand Surgery Hospital, Wuxi 214062, China.

Objective: To investigate the repair of soft tissue defect at finger tip with square island flap pedicled with skin perforator of digital artery on the distal interphalangeal joint (DIP).

Methods: From Jun. 2009 to Mar. 2010, 15 cases with soft tissue defects at 15 fingers tip were treated with this island flaps. The flap size ranged from 1.2 cm x 0.8 cm to 2. 0 cm x 3.0 cm. The defects at donor sites were covered with skin grafts from forearm.

Results: All the flaps and skin grafts survived. 10 fingers in 10 cases were followed up for 6-12 months. The color, texture and contour of the flaps were good. The two-point discrimination distance was 5-6 mm on the directed island flaps, and 7-10 mm on the reverse island flaps. No obvious functional problem was found in DIP motion. The hand function was assessed as excellent in 8 fingers, good in 1 finger and medium in 1 finger.

Conclusions: The main artery and nerve will not be sacrificed when the island flap is used. The operative procedures are easily performed for the treatment of fingertip skin defect.
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May 2011

[Repair of thumb tip defect with thumb island flaps at ulnar side by V-Y advancement].

Zhonghua Zheng Xing Wai Ke Za Zhi 2010 Nov;26(6):414-6

Department of Hand Surgery, Wuxi Hand Surgery Hospital, Wuxi 214062, China.

Objective: To investigate the method for treatment of thumb tip defect.

Methods: The thumb tip defect was treated with thumb island flaps at ulnar side by V-Y advancement. The flap size ranged from 1.4 cm x 2.0 cm approximately 1.4 cmx 2.5 cm. The wounds at donor sites were covered by skin grafts.

Results: From March 2007 to October 2009, 10 cases of thumb tip defects were treated. All the flaps and skin grafts were survived with primary healing. The patients were followed up for 6-18 months with both satisfactory functional and cosmetic results. The two-point discrimination was 5-6 mm at the thumb tip.

Conclusions: The thumb tip defect can be successfully repaired with thumb island flaps at ulnar side by V-Y advancement.
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November 2010

Composite flexion splint for the stiff hand.

J Hand Ther 2011 Jan-Mar;24(1):66-8. Epub 2010 Dec 16.

Wuxi Hand Surgery and Orthopedic Hospital, Jiangsu, China.

The ability to make a full fist and grasp objects is a necessary motion for many everyday activities. For this reason, therapists continually create and modify splints in an attempt to achieve composite flexion in the hand. In this article, the authors describe their static progressive splinting approach to improve composite flexion in patients with hand stiffness due to trauma.
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http://dx.doi.org/10.1016/j.jht.2010.09.068DOI Listing
April 2011

[A case-crossover study on occupational acute hand trauma].

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2007 Dec;25(12):747-9

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December 2007

[The clinical experience in transplantation of the anterolateral femoral skin flap].

Zhonghua Zheng Xing Wai Ke Za Zhi 2005 Nov;21(6):418-20

Wuxi Hand Surgery Hospital, China.

Objective: To introduce the clinical experience in transplantation of the anterolateral femoral skin flap.

Methods: A total of 625 anterolateral femoral skin flaps in 600 patients were transplanted from 1988 to 2003. The retrospective analysis was carried out in all the cases as to the flap pedicle, the vascular variations, the surgical procedures and modifications, and the adaptation for a cutaneous-branch-absent flap.

Results: The 625 flaps were transferred except 7 cancelled in the operation. Postoperatively, 17 cases encountered vascular complications, 10 of which survived completely with successful vessel exploration, 3 cases had partial necrosis, and 4 cases had complete necrosis. The survival rate was 97.8%. 545 flaps were pedicled with the descending branch or lateral branches; 45 flaps with the transverse branch or the high-site anterolateral cutaneous artery, 10 cases with the descending-transverse branch, 18 cases with other vessels. 7 cases were found cutaneous-branch-absent. The vessel variation rate of the flap was 4.06%.

Conclusions: The anterolateral femoral skin flap has less variation of its pedicle and high success rate of operation. It is an ideal choice for repair of soft tissue defects in the extremities.
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November 2005

Microsurgical treatment for bilateral thumb defect: five case reports.

Microsurgery 2003 ;23(6):547-54

Department of Hand Surgery, Hua Shan Hospital, Fudan University, Shanghai, People's Republic of China.

The authors present a new and efficient treatment for reconstruction of bilateral defective thumbs by different configured toe-tissues transplantations in a single stage, including bilateral second-toe transfer in 2 cases, bilateral hallux wrap-around flap transfer in 1 case, bilateral modified hallux wrap-around flap transfer in 1 case, and combined second toe with island flap with neurovascular pedicles from the proximal and dorsal aspect of the index finger transfer in 1 case. In total, eight transferred tissues survived uneventfully after circulation monitor and medicine administration according to the rules of microsurgery, and in two other transferred toe tissues, temporary circulation crises occurred. Over a 1-year follow-up, the satisfactory appearance and excellent function of the reconstructed bilateral thumbs were noted. For ensuring the success of the procedure, the authors emphasize the establishment of a double artery supply and venous return-flow systems and the modification of the hallux wrap-around flap dissection and tendon repair. Meanwhile, three-stage systemically functional rehabilitations also improved functional restoration of reconstructed thumbs.
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http://dx.doi.org/10.1002/micr.10213DOI Listing
April 2004
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