Analysis Of Orthopedic Treatment Strategies For PDP

BACKGROUD AND OBJECTIVE:Pachydermoperiostosis(PDP),which is clinical rare,was first seen in 1868 on the case of the two brothers reported by Friedeich.Then in 1935 Touraine,Solente and Gole clear it as an independent disease(Touraine-Solente-Gole syndrome),named pachydermoperiostosis(PDP),and divided it into primary type and secondary type.With the improvement of medical level,research of PDP has made some progress.It was reported in 2008 that 15 prostaglandin dehydrogenase deficiency caused by HPGD gene mutation can cause the disease,type 1(PHOARI).It was reported in 2012 that prostaglandin transporter defects caused by SLC02A1 gene mutation can cause the disease,type 2(PHOAR2).Harbison integrated x-ray examination and clinical features of the PDP to divided PDP into three types:(1)completeform,bone and skin are both involved;(2)incompleteform,mainly bone involvement;frusteform,mainly skin involved.In 1966,the disease was first reported in China.PDP is characterized by skin hypertrophy,periosteal thickening,clubbing and cuffs vertices gyrata.It is mainly seen in men,many has family history and is often outbreak after puberty.The disease progresses several years to several decades into a quiescent state,and is self-limiting.PDP cases are rare,there is no effective treatment,mainly for symptomatic treatment,such as rest,physical therapy,taking salicylic acid drugs,corticosteroids,joint swelling and pain can have a temporary effect,but all treatment can not change the progress of disease.PURPOSETo understand the clinical features,diagnostic points and treatment of PDP.To evaluate the clinical effect of orthopedic surgery combined with medical treatment on PDP.To provide experience and ideas for the diagnosis and treatment of such rare diseases.RESEARCH METHODS:Analysis using(1)simple surgical resection of thickening skin,reduce wrinkles,conventional dressing,to achieve the purpose of plastic surgery.To observe the clinical efficacy of 1 case of PDP patients treated in our hospital in September 2016.(2)simple surgical resection of thickening skin,reduce the wrinkles,postoperative conventional dressing,plus preoperative and postoperative routine oral isotretinoin,to observe the clinical efficacy the same patient treated in our hospital in February 2017(3)double eyelid plasty,and remove part of the upper eyelid skin,to correct the ptosis caused by PDP,observe the long-term clinical efficacy.And review the relevant literature.To observe the clinical data of patient with PDP who was treated in Shandong Provincial Hospital from September 2016 to February 2017,and compare the surgical healing of the two cases,long-term effect and correction of ptosis.To evaluate the effectiveness of orthopedic treatment strategies in patients with PDP.RESULTS:Three operations:① simple surgical resection of thickening skin,reduce wrinkles,postoperative conventional dressing,surgical sebaceous glands secrete strong,the fourth day after the amount of the Ministry of knife edge infection,continue dressing,7 days after the stitches,there are still some Infection,discharge,told:continue dressing,coated with more than 100 states.Surgical plastic surgery is good.② simple surgical resection of thickening skin,reduce wrinkles,postoperative conventional dressing,plus preoperative and postoperative routine oral isotretinoin,postoperative wound healing good,discharged.Surgical plastic surgery is good.③ double eyelid plasty,and remove part of the upper eyelid skin,patients with moderate ptosis improved significantly.CONCLUSION:There is no standardized treatment program for PDP currently.In this paper,we summed up theorthopedic treatment strategy for PDP,through the effect observation of multiple treatment of PDP cases and literature analysis.For the face-based skin thickening,the formation of coarse folds,leonine face,cuffs vertices gyrata caused by PDP.Seriously affect the appearance,can be improved by means of plastic surgery.Combined with routine oral isotretinoin which can reduce the excessive secretion of sebaceous glands,reduce the risk of infection.Double eyelid plasty,and remove part of the upper eyelid skin,PDP patients achieve good results in terms of eye appearance and function.We hope to provide some clinical ideas for comprehensive treatment of PDP.