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25 June 2011, Volume 15 Issue 26 Previous Issue    Next Issue

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Epidural injection of collagenase into a goat model of lumbar disc degeneration Zhu Wei-hong, Zhu Hai-bo, Ma Nan, Xie Pin-liang, Deng Hong-zhen, Zhu Jian-min 2011, 15 (26):  4751-4754.  doi: 10.3969/j.issn.1673-8225.2011.26.001 Abstract ( 101 )   PDF (1330KB) ( 538 )   Save BACKGROUND: The mechanism of epidural injection of collagenase to treat lumbar disc degeneration is still unclear. OBJECTIVE: To assess the mechanism of epidural injection of collagenase in animal models of lumbar disc degeneration. METHODS: Six adult sheep were excessively pressed with steel plate and L1/L2, L3/L4 segments were injected with 0.5 mL absolute alcohol to prepare lumbar disc degeneration models. Two weeks after epidural injection of collagenase, the sheep was killed to take the disc for electronic microscope observation. RESULTS AND CONCLUSION: The electronic microscope showed that there were some fissures in the fibrous ring of the degenerated intervertebral disk, collagen fibers discs were dissolved, non-degenerative discs were unchanged. Collagenase can enter degenerated intervertebral disc and directly dissolve nucleus pulposus tissue. Related Articles | Metrics

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Biomechanical effect of simulative percutaneous vertebroplasty on adjacent vertebras: A finite element analysis about thoracolumbar osteoporotic vertebra compression fracture Fei Qi, Wang Bing-qiang, Yang Yong, Tang Hai, Li Jin-jun, Wang Yi-peng, Li Dong 2011, 15 (26):  4757-4762.  doi: 10.3969/j.issn.1673-8225.2011.26.003 Abstract ( 82 )   PDF (1524KB) ( 404 )   Save BACKGROUND: Is adjacent vertebral fracture following percutaneous vertebroplasty (PVP) a development process of osteoporosis or caused by enhanced bone cement and PVP? OBJECTIVE: To explore the biomechanical effects on adjacent vertebras of thoracolumbar osteoporotic vertebra compression fracture (OVCF) after simulative PVP by using finite element analysis. METHODS: T10-L2 segment data were obtained from CT scans of an old female with single T12 OVCF. A three-dimensional finite element model of thoracolumbar spine (T10-L2) and simulative PVP models (via single and double transpedicular approach) were built in the Mimics and the ABAQUS software. The stress on the vertebra, disc and endplate under axial pressure (0.3, 1.0, 4.0 MPa) were analyzed. RESULTS AND CONCLUSION: The three-dimensional finite element models of thoracolumbar OVCF and simulative PVP models were successfully built. The stresses were increased as axial pressure increased. In the model of simulative PVP, the stress augmentation scope on adjacent vertebras and discs did not increase. The maximum Von Mises stress on adjacent vertebras had no significant changes. Postoperative adjacent vertebral fractures after PVP may be poorly related to the changes of biomechanical effects on adjacent vertebras of thoracolumbar OVCF. Related Articles | Metrics

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Finite element simulation of three-dimensional correction in the treatment of congenital scoliosis caused by hemivertebrae Liu Shao-hua, Zhang Hong-qi, Guo Chao-feng, Tang Ming-xing, Wang Yu-xiang, Deng Ang 2011, 15 (26):  4763-4767.  doi: 10.3969/j.issn.1673-8225.2011.26.004 Abstract ( 127 )   PDF (576KB) ( 348 )   Save BACKGROUND: For the surgical treatment of congenital scoliosis caused by hemivertebrae, the choice of anterior, posterior approach and long, short segment fixation, is mainly based on clinical experience of doctors. The biomechanical studies are insufficient. There are no reports about finite element modeling and simulating on congenital scoliosis caused by hemivertebrae. OBJECTIVE: To establish an individual three-dimensional finite element model to simulate three-dimensional correction surgery, and to investigate correction effectiveness and biological characteristics with different surgical methods. METHODS: A finite element model of a congenital scoliosis caused by hemivertebrae was constructed using finite element software, and then the individual finite element model was applied to simulate hemivertebra resection with different instrumentation strategies, and pull out the correction effects. RESULTS AND CONCLUSION: Posterior instrumented fusion was better than anterior instrumented fusion after hemivertebrae resection, especially for the kyphosis angle correction, and the ratio was all above 50%; and the differences between posterior short-segment fixation and long-segment after hemivertebrae resection were not obvious within 5°. The surgical simulations showed that posterior short-segment fixation with hemivertebrae resection is the better treatment strategy, which can obtain satisfactory corrective rate with fewer fixed segments for the congenital scoliosis patient caused by hemivertebrae. Related Articles | Metrics

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Realization on registration and navigation module of the surgery system for avascular necrosis of the femoral head Zhang Jian-guo, Yang Qing-ming 2011, 15 (26):  4768-4772.  doi: 10.3969/j.issn.1673-8225.2011.26.005 Abstract ( 173 )   PDF (635KB) ( 391 )   Save BACKGROUND: Traditional treatment for femoral head necrosis is debridement surgery. This surgery is difficult to clear the lesions completely and easy to damage the normal tissue. The image guided surgery improves surgical quality by medical images, tracking system and virtual display. OBJECTIVE: To construct a mathematical model of the femur and then develop a surgery system for avascular necrosis of femoral head. METHODS: On the basis of MC algorithm, a mathematical model of the femur is constructed. Point data were fitted to geometric primitives by using geometric features including point-based registration and surface-based registration. The interactive function between two-dimensional and three-dimensional image is realized. RESULTS AND CONCLUSION: Experiments shows that the surgery system for avascular necrosis of the femoral head developed in this paper meets the requirements of orthopedic surgery because its error is less than 3 mm. Related Articles | Metrics

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Radiological and functional evaluation during total knee replacement without patellar resurfacing Li Feng, Zhang Ke, Liu Yan, Tian Hua, Lou Si-quan 2011, 15 (26):  4773-4776.  doi: 10.3969/j.issn.1673-8225.2011.26.006 Abstract ( 167 )   PDF (525KB) ( 403 )   Save BACKGROUND: Controversy remains as to whether or not to resurface the patella in total knee replacement. OBJECTIVE: To investigate the clinical and radiological results of the patella in patients with total knee replacement without patellar resurfacing. METHODS: Thirty-nine patients (48 knees) with osteoarthritis and rheumatoid arthritis underwent total knee replacement without patellar resurfacing. RESULTS AND CONCLUSION: Thirty-six knees (75%) were evaluated as grades Ⅲ and Ⅳ of cartilage Outerbridge classification. HSS score and Feller patella score improved postoperatively. Five of the 48 knee (10%) complained of anterior knee pain, and the patella pathological level reached grade Ⅳ. Selective total knee replacement without patellar resurfacing can lead to reduction of patellofemoral complications and acquire good patellofemoral tracking. Related Articles | Metrics

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Erythromycin and alendronate inhibition of wear particles influences macrophage secretion of interleukin 1, interleukin 2, and tumor necrosis factor alpha Cui Xue-sheng,Tian Feng, Shi Yu-ze, Zhang Shuai, Jin Qun-hua 2011, 15 (26):  4777-4780.  doi: 10.3969/j.issn.1673-8225.2011.26.007 Abstract ( 154 )   PDF (580KB) ( 320 )   Save BACKGROUND: Alendronate has an anti-bone resorption effect which is realized through its inhibitory effect on osteoclasts. Recently, it is confirmed that erythromycin plays a direct role against osteoclasts. OBJECTIVE: To detect the effects of erythromycin and alendronate inhibited titanium (Ti) particles on interleukin 1(IL-1), IL-6 and tumor necrosis factor alpha (TNF-a) secreted from macrophages. METHODS: Mouse peritoneal macrophages were separated and cultured, and then divided into erythromycin and alendronate groups. Each group was then divided into six subgroups. Erythromycin group: Group A was treated with macrophages alone, group B with macrophage+Ti particles, group C with macrophage+Ti particles+erythromycin (1μg/L), group D with macrophage+Ti particles+erythromycin (10 μg/L), group E with macrophage+Ti particles+erythromycin (100 μg/L), group F with macrophage+Ti particles+erythromycin (1 000 μg/L). The subgroups and dose of the alendronate group was the same as the erythromycin group. After 24 hours, the levels of IL-1, IL-6 and TNF-a in culture supernatant was detected by enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION: The levels of IL-1, IL-6 and TNF-a were much higher in groups B than those in other groups (P < 0 .05). The levels of IL-1, IL-6 and TNF-a were much lower in groups F than those in groups C (P < 0.05). The same dose of alendronate and erythromycin were not statistically significant (P > 0.05). It was shown that the Ti particles could stimulate macrophages to excrete a great amount of TNF-a ,IL-l and IL-6. Eythromycin and alendronate could significantly inhibit the production of IL-1, IL-6 and TNF-a secreted by Ti particles induced macrophages in a dose dependent manner. Related Articles | Metrics

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Comparison of different fixations of great trochanteric fragments in bipolar femoral head replacement for elderly patients with unstable intertrochanteric fractures Xie Qing-yun, Zhang Bo, Quan Yi, Pan Xian-ming, Ma Ze-hui, Kang Xia, Liu Xi-lin 2011, 15 (26):  4781-4784.  doi: 10.3969/j.issn.1673-8225.2011.26.008 Abstract ( 95 )   PDF (594KB) ( 351 )   Save BACKGROUND: Steel wires for fixation of intertrochanteric fractures are widely applied in total hip replacement. However, this method can aggravate severe osteoporotic fractures or cannot fix all the bone blocks. OBJECTIVE: To evaluate the clinical results of different fixation methods of great trochanter fragments in bipolar femoral head replacement for the treatment of unstable intertrochanteric fractures in elderly patients. METHODS: Thirty-four cases of unstable intertrochanteric fracture were treated with bipolar femoral head replacement. Of 34 patients, 19 cases were fixed by steel wires for fragment of trochanter, 15 cases were fixed by Ethibond Excel Polyester Sutures. The operation time, bleeding, clinical results and conditions after operations were recorded and analyzed. RESULTS AND CONCLUSION: All the fractures were healed. No fracture displacement, no loosen, dislocation sinking or fracture of the prosthesis was found in the followed-up cases. There was no significant difference between two groups in a Harris score (P > 0.01). All the patients could self-care and be satisfied with no pain and dysfunction. There were less bleeding and shorter operation time in the Ethibond Excel Polyester Sutures fixed cases than steel wires fixed cases (P< 0.01). Using Ethibond Excel Polyester Sutures to fix great trochanter fragments is effective for management of unstable intertrochanteric fracture especially with osteoporosis in the elderly. Related Articles | Metrics

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Femoral head autograft for acetabular reconstruction in cementless total hip arthroplasty for developmental hip dysplasia Gao Wei-qiang, Chen Jing-yong, Cheng Jun, Li Zhong, Chi Lei-ting 2011, 15 (26):  4785-4787.  doi: 10.3969/j.issn.1673-8225.2011.26.009 Abstract ( 106 )   PDF (439KB) ( 299 )   Save BACKGROUND: Patients with Crowe Ⅱ, Ⅲ, Ⅳ type of hip dysplasia have poorly developed true acetabulum and often present with lateral wall defects due to femoral head erosion, so most patients require autologous bone graft and artificial acetabular reconstruction. OBJECTIVE: To evaluate the clinical effect of bulk femoral head autograft for acetabular reconstruction in cementless total hip arthroplasty (THA) for developmental hip dysplasia (DDH). METHODS: From March 2007 to November 2009, THA was performed for 15 patients (15 hips) with osteoarthritis secondary to DDH. The length difference was (2.7±0.8) cm between two lower limbs of the unilateral DDH patients. The Harris scores were (41.6±12.8) points preoperatively. The standard procedure of THA was performed in 15 patients (15 hips), the structural femoral head autograft for restoring normal level of rotating center of the acetabulum in other patients. RESULTS AND CONCLUSION: The incision healed by first intention in all patients. The duration of follow-up ranged from 1 to 2years (average 1 year). The X-ray films showed bony healing between the grafted bone and the ilium in all patients. At last follow-up, the length difference was (0.8±0.3) cm between two lower limbs and the Harris score was (89.3±6.5) points, showing statistically differences (P < 0.05) when compared with preoperation. The X-ray films showed no signs of dislocation, absorption and collapse of the grafted bone. THA combined with structural femoral head autograft for patients with osteoarthritis secondary to DDH can obtain favorable results. This method can restore normal level of rotating center of the acetabulum, provide reliable acetabular fixation, and restore acetabular bone stock in patients with Crowe type Ⅱ and type Ⅲ DDH. Related Articles | Metrics

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Cemented bipolar hemiarthroplasty for osteoporotic femoral neck fracture Liu Zhen-yu, Qian Rui, Xiao Shi-liang, Cai Xing-jian, Zhou Jian-guo, Zeng Fang-jun, Zeng Guang-xuan 2011, 15 (26):  4788-4790.  doi: 10.3969/j.issn.1673-8225.2011.26.010 Abstract ( 144 )   PDF (573KB) ( 343 )   Save BACKGROUND: The elderly commonly have their special physical characteristics of osteoporosis and poor tolerance to surgery. There are the higher complications and more mortality with femoral neck fracture in the elderly. OBJECTIVE: To investigate the cemented bipolar hemiarthroplasty effect on osteoporotic femoral neck fractures in the elderly. METHODS: Thirty-nine senior patients with osteoporotic femoral neck fractures admitted to the Department of Orthopaedics, People’s Hospital of Ganzhou City from May 2006 to March 2009, were selected and all the patients received cemented bipolar hemiarthroplasty. RESULTS AND CONCLUSION: All the 39 cases were followed up for 10 to 34 months. The Harris hip function scores were 92.5±6.8 and 93.2±5.6 respectively at 6 and 12 months after cemented bipolar hemiarthroplasty, which were significantly higher than that (42.5±9.8) preoperatively (P < 0.01). Imaging examination showed that the location of all femoral prostheses was unchanged, no loosing or sinking. The final follow-up showed no aseptic loosening could be diagnosed with imaging findings or no requirement for renovation was found as well as non-limited pelvic osteolysis. The cemented bipolar hemiarthroplasty can reduce complications and lower mortality rates for the elderly with osteoporotic femoral neck fractures in a better way. Related Articles | Metrics

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Peri-operative rehabilitation of simultaneous bilateral total knee arthroplasty versus unilateral total knee arthroplasty Liu Jie, Xu Ling, Shen Jie-min, Chen Xu-lin, Zhou Yan, Zheng Min, Fu Xiao-wei, Yu Xia-lin, Zhang Zhong-nan 2011, 15 (26):  4791.  doi: 10.3969/j.issn.1673-8225.2011.26.011 Abstract ( 148 )   PDF (482KB) ( 464 )   Save BACKGROUND: There are few reports concerning the peri-operative rehabilitation of two-team simultaneous bilateral total knee arthroplasty (SBTKA) in patients with bilateral end-stage degenerative osteoarthritis (OA) of the knee. OBJECTIVE: To compare the peri-operative rehabilitation outcomes of OA patients undergoing SBTKA and unilateral TKA (UTKA). METHODS: The experiment group composed of 59 OA patients (118 knees) undergoing SBTKA had been given same rehabilitation as the control group that had 80 OA patients undergoing UTKA. The results were compared. RESULTS AND CONCLUSION: In the experiment group, preoperative flexion deformity angle was decreased 5°-22° (averagely 11.2°); postoperatively, the average muscle strength increased 0.8 degree to 5; Average range of motion was ≥95° (110°±15°). Patients were able to walk more than 500 m and go up and down more than 10 stairs without pain or swelling. Upon discharge, average HSS score increased. There was no obvious difference in rehabilitation outcome between the two groups at 3 months after operation. Perioperative rehabilitation with SBTKA can reduce bone loss and postoperative complications, improve patients’ functional recovery, but there is no difference in peri-operative rehabilitation outcome between OA patients undergoing SBTKA or UTKA. Related Articles | Metrics

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Application of “cocktail wine” in pain relief after total knee arthroplasty Li Heng, Sui Fu-ge, Zhang Ning-ning, Wang Qun, Wang Dong-jun, Wang Qiang, He Xiao-feng 2011, 15 (26):  4795-4797.  doi: 10.3969/j.issn.1673-8225.2011.26.012 Abstract ( 331 )   PDF (459KB) ( 629 )   Save BACKGROUND: “Cocktail wine” therapy is a new way for pain relief after total knee arthroplasty with fewer side effects. OBJECTIVE: To observe the early efficacy of postoperative periarticular injection of multimodal analgesia(“cocktail wine” treatment) after total knee arthroplasty. METHODS: Twenty-six patients undergoing unilateral total knee arthroplasty had the same treatment of pain relief perioperatively. All the cases were injected with the “cocktail wine” intraoperatively. The postoperative visual analogue scale (VAS) of pain, the range of motion of knee joint and wound complications were analyzed versus the preoperative data. RESULTS AND CONCLUSION: All the patients did not take the medicine of parenteral opiods, and there were significant improvement in pain VAS during rest and exercise for 1-3 days postoperatively. Time for active straight leg lifting was 2.5 days postoperatively in average. During the 2nd and 3rd days postoperatively, the average knee joint activities were 45° and 55°, and no wound complications occurred. These demonstrated that the periarticular injection of analgesia can reduce the scores of the VAS during rest and exercise and improve the activity of knee joints in the early stage, and it is simple, practical, safe and effective. Related Articles | Metrics

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Feasibility of adult cervical pedicle screw in the lumbar spine of young children Li Xian-ling, Zhang Qin-ming, Li Xian-jin, Zhang Xue-jun, Li Cheng-xin, Sun Lin, Lu Shou-yan, Zhang Kun-ya, Yu Feng-zhang, Qi Xin-yu, Sun Bao-sheng 2011, 15 (26):  4798-4803.  doi: 10.3969/j.issn.1673-8225.2011.26.013 Abstract ( 143 )   PDF (650KB) ( 314 )   Save BACKGROUND: Because the vertebrae of children aged 1 to 3 years are not fully mature, there is no specific pedicle screw for children. At present, the existing pedicle screw with the smallest diameter is for adult cervical lateral mass or pedicle screw fixation. OBJECTIVE: To compare the biomechanical changes of adult cervical pedicle screw used in cervical pedicle fixation of adult pigs and lumbar pedicle fixation of young pigs. METHODS: C3-6 segments for six fresh adult pigs and lumbar spinal specimens from six 8-week-old young pigs were selected to prepare 54 single vertebrae with 108 pedicles. Adult cervical pedicle screw was placed into the prepared pedicles, and the maximum axial pull-out strength was detected using biomechanical methods. RESULTS AND CONCLUSION: The maximum axial pull-out strength of the cervical specimen was lower than that of the lumbar specimen, but there was no significant difference (P > 0.05). The mean pull-out strength of L1 was significantly lower than that of L3 (P < 0.05). The mean pull-out strength of C5 was significantly higher than that of C3 (P < 0.05). There was a significant difference between the bone marrow density of the cervical and lumbar specimens (P < 0.01). From this study, we got the preliminary experimental foundation about applying adult cervical pedicle screw to the lumbar spine of young children from the viewpoint of axial pull-out strength. Related Articles | Metrics

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DVR system versus palm plate for internal fixation of C-type distal radius fractures Xun Jian-jun, Feng Jian-gang, Li Yan-fang 2011, 15 (26):  4804-4808.  doi: 10.3969/j.issn.1673-8225.2011.26.014 Abstract ( 203 )   PDF (560KB) ( 335 )   Save BACKGROUND: Looking at the current therapies for comminuted and unstable fractures of the distal radius, metal locking plate becomes prevalent. OBJECTIVE: To observe the effect of DVR system on internal fixation of C-type distal radius fractures classified according to AO classification . METHODS: Fifty-one patients with C-type distal radius fractures were assigned into two groups according to their will and economic conditions:DVR (n=27) receiving DVR system fixation and control group (n=24) undergoing palm plate fixation. The following parameters were compared between the two groups: time of operation, number of patients receiving intraoperative C-arm fluoroscopy, number of times to install bonding plates during the operation, occurrence of median neuritis, incidence of postoperative tenosynovitis, and time to recover wrist function. RESULTS AND CONCLUSION: The results of X-ray showed that all the cases in the DVR group were healed without infection, bone nonunion, plate loose and median neuritis. As compared with the control group, the excellent and good rates of wrist function recovery were higher in the DVR group according to Mcbride scoring (P < 0.001). It is indicated that it is simple, safe and reliable to treat C-type distal radius fractures with DVR system with good recovery of joint function. Related Articles | Metrics

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Effect and safety of percutaneous vertebroplasty and percutaneous kyphoplasty for thoracic and lumbar vertebral compression fractures: A Meta-analysis Shi Jian-guo, Sang Qing-hua 2011, 15 (26):  4809-4812.  doi: 10.3969/j.issn.1673-8225.2011.26.015 Abstract ( 79 )   PDF (703KB) ( 403 )   Save BACKGROUND: There are many clinical experiences for percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in treatment of thoracic and lumbar vertebral compression fractures; however, relevant evidence-based medicine studies are rare. OBJECTIVE: To systematically review and evaluate the effectiveness and safety of PVP and PKP for treating thoracic and lumbar vertebral compression fractures. METHODS: Chinese studies were sought and included in the review if they were randomized controlled trials concerning PVP versus PKP for thoracic and lumbar vertebral compression fractures. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross-checking. Divergences of opinion were settled by discussion or consulted by the expert. Data were processed by RevMan 5.0. RESULTS AND CONCLUSION: Seven studies involving 398 patients met the inclusion criteria. The baseline of patients’ characteristics was comparable in all the studies. The follow-up duration was 4 or 6 weeks. There was no significant difference to improve VAS score; but it was significant for the improvement of the Cobb angle (P < 0.001); Compared with PKP, the incidence of postoperative leakage of bone cement after PVP was lower (P = 0.05). Because of few studies and small samples, more high quality trials with large samples and longer following-up are proposed. Related Articles | Metrics

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Chinese herbs-aided arthroscopic surgery for knee osteoarthritis: A Meta-analysis Qian Ding-jun, Cheng Hao, Xiang Yi-ming 2011, 15 (26):  4813-4816.  doi: 10.3969/j.issn.1673-8225.2011.26.016 Abstract ( 80 )   PDF (568KB) ( 325 )   Save BACKGROUND: Since the ancient times the fumigation washing therapy with Chinese herbs are used to treat patients of knee osteoarthritis (KOA), nowadays domestic appeared many studies with Chinese herbs-aided arthroscopic surgery to treat KOA, but if the effectiveness is better than arthroscopic surgery alone, it is still lack of evidence. OBJECTIVE: To evaluate whether the Chinese herbs-aided arthroscopic surgery is superior to arthroscopic surgery alone, and in order to provide some references for rational treatment in the clinic. METHODS: A computer-based online search of Cochrane Library (Issue 1, 2010), Medline, CBM, VIP, CNKI and WANFANG DATA (from the data base building to the December, 2010) for the clinical randomized controlled trials of arthroscopic surgery alone and Chinese herbs-aided to treating KOA. Hand searching was also done to obtain any further information about the studies. After study selection, data collection, assessment and analyses were undertaken by two reviewers independently, and heterogeneous studies, we performed meta-analysis using RevMan 5.0 software. RESULTS AND CONCLUSION: Eleven studies involving 1 304 knee joint were included, and the level of quality of most studies were B. Meta-analysis indicated that the effectiveness of Chinese herbs-aided arthroscopic surgery is superior to alone (or combined with Western drugs), but there are no studies concerning relative dose and side effect. So we suggest the researchers to perform studies in this kind which should obey the unity of the evaluation standard design multicenter, large sample, double-blind controlled studies in order to support the results. Related Articles | Metrics

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Hand radiographs preprocessing and improved k-cosine algorithm in location method for phalangeal key points He Xiang-qian, Ran Long-ke, Tan Peng-cheng, Jin Jing 2011, 15 (26):  4817-4820.  doi: 10.3969/j.issn.1673-8225.2011.26.017 Abstract ( 143 )   PDF (656KB) ( 507 )   Save BACKGROUND: During the bone age assessment, binarization threshold selection is one of the most troubled factors, which is directly related to two-value image and accuracy location of the phalanx key points. OBJECTIVE: In order to solve the problems for binarization threshold selection and overcome the too slow speed for locating the key points of phalanx, to reach fast and accurate location for them. METHODS: In this paper, image preprocessing technique is presented and the second threshold algorithm on the base of OSTU threshold algorithm is also put forward respectively in the analysis of the skeletal age X-ray pictures. And the threshold obtained through this method is used to get binarization from the skeletal age X-ray pictures. Since k-cosine algorithm is very slow to locate the phalanx key points, an improved k-cosine algorithm is put forward to locate the phalanx key points, which is fast and accurate. RESULTS AND CONCLUSION: The experimental results show that the proposed method used to locate phalanx key points can reach satisfactory results in accuracy and speed. Related Articles | Metrics

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Biomechanical study on anterior decompression and non-fusion with dynamic cervical implant Hou Zhen-yang, Xu Yao-zeng, Gu Ye, Zhou Feng, Qian Zhong-lai, Jiang Wei-min, Yang Hui-lin 2011, 15 (26):  4821-4824.  doi: 10.3969/j.issn.1673-8225.2011.26.018 Abstract ( 132 )   PDF (522KB) ( 446 )   Save BACKGROUND: The anatomical design of the dynamic cervical implant (DCI) has similar biomechanical characteristics to the normal disc. The dynamic design has axial compliance and shock absorption. And the front teeth down fitting into the upper and lower vertebral bodies can get sufficient axial stability. OBJECTIVE: To compare the change of related cervical biomechanical properties between DCI non-fusion and anterior decompression and fusion. METHODS: A total of 6 adult human fresh cervical spinal specimens (C2-7) were randomly divided into A, B, C groups. Following intact specimens analysis, specimens in groups A, B, C were sequentially reconstructed at C5-6 segment with DCI, Cage and integrated anterior cervical plate cage benezech (PCB) implant. The range of movement (ROM) of the upper and lower cervical segments of C5-6 in 3 groups before and after surgery in biomechanical testing machine for 4 different physiological conditions and impose 2.0 N•m pure moment of couple was measured. RESULTS AND CONCLUSION: After 3 kinds of fixation, the ROM of the upper and lower cervical segments of C5-6 increased more or less than the ROM of the intact specimens and showed better stability. And the ROM of cervical spine after fixation of DCI was similar to that of intact condition. There were no statistical significance between the ROM of the upper and lower cervical segments of C5-6 after 3 kinds of fixation (P > 0.05). There was no significant influence for the ROM of the upper and lower cervical segments. To some extent, the DCI diminished the axial stress and maintained the ROM of the cervical spine effectively. Related Articles | Metrics

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Clinical application of pedicle screw fixation with autogenous morselized bone graft impaction in senile lumbar degeneration: A study of immediate biomechanical stability Zhong Zhi-hong, Li Jian, Zhang Ping, Yang Bo, Zhao Hong-pu 2011, 15 (26):  4825-4828.  doi: 10.3969/j.issn.1673-8225.2011.26.019 Abstract ( 108 )   PDF (502KB) ( 396 )   Save BACKGROUND: Autogenous bone graft combined with cage has been widely used in lumbar interbody fusion by the use of vertebral pedicle screw fixation. But there is still lack of reports about autogenous morselized bone graft impaction with vertebral pedicle screw fixation concerning the clinical application and biomechanical research. OBJECTIVE: To evaluate and compare the biomechanical stability properties of autogenous morselized bone graft impaction with vertebral pedicle screw fixation, cage with vertebral pedicle screw fixation, so as to provide theoretical basis and experiment guidance in clinical use of autogenous morselized bone graft impaction with vertebral pedicle screw fixation in PLIF. METHODS: Resin embedding method and graded facetectomy and discectomy were made to prepare spinal instability models. Experimental group used autogenous morselized bone graft impaction with vertebral pedicle screw fixation; control group used cage with vertebral pedicle screw fixation. The three-dimensional motion of specimens was tested in intacted state, instability state and fusion state, which the flexion, extension, bilateral bending and axial rotation loading were applied to the specimens and the range of motion (ROM) were determined by the three-dimensional laser scanner. RESULTS AND CONCLUSION: There was no significant difference in all stability indexes (ROM) between two groups in intact state (P > 0.05). Compared with the intact state, there was significant difference in all stability indexes in instable state between the two groups. After posterior lumbar interbody fusion, there was no significant difference in all stability indexes between two groups (P > 0.05). Both the autogenous morselized bone graft impaction with vertebral pedicle screw fixation and cage with vertebral pedicle screw fixation can improve the immediate biomechanical stability of the spine, and there is no statistical difference in spinal stability capacity between two groups. Related Articles | Metrics

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L4 vertebra stress relaxation and creep properties in ovariectomized rats with osteoporosis  Zhang Qiao, Zhang Zhong-jun, Li Xin-ying 2011, 15 (26):  4829-4832.  doi: 10.3969/j.issn.1673-8225.2011.26.020 Abstract ( 110 )   PDF (687KB) ( 402 )   Save BACKGROUND: For the prevention and treatment of osteoporosis, it is necessary to understand the relationships of the creep and stress relaxation of the spine with time in ovariectomized rats. OBJECTIVE: To observe the osteoporosis effects on the viscoelastic properties of load-bearing bone of ovariectomized female rats. METHODS: Forty-four Wistar female rats were divided into control and osteoporosis model groups. Rats in the model group were ovariectomized at 0 week. Stress relaxation trial with 1%/s strain rate and creep experiment with 0.01 MPa/s stress increasing rate. 100 data were collected within 7 200 seconds. RESULTS AND CONCLUSION: The amount of stress relaxation and creep on L4 segment within 7 200 seconds was higher in the control group than the model group (P < 0.05). The stress relaxation curve changed in logarithmic manner, and the creep curve changed in exponential manner. The viscoelastic properties of ovariectomized rats with osteoporosis have changes. Related Articles | Metrics

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Design and investigation of virtual three-dimensional display system of human anatomy  Luo Jia-lun, Liao Bing-xiu, Rao Yong-xing, Yang Chong, Tu La-gen 2011, 15 (26):  4833-4836.  doi: 10.3969/j.issn.1673-8225.2011.26.021 Abstract ( 61 )   PDF (546KB) ( 740 )   Save BACKGROUND: With developing computer technology, virtual technology enable students to observe the spatial three-dimensional structure, vibrant colors, clear hierarchy, the real texture, and with interactive interface, the establishment of virtual laboratories, and the abandonment of face to face teaching become possible. OBJECTIVE: We demonstrated human anatomy specimens by virtual three-dimensional technology, and made the clarity, texture, importation of the datas easier comparing to traditional two-dimensional modeling, ultimately to bring online-remote-education virtual anatomy laboratory into reality. METHODS: With self-developed semi-automatic three-dimensional specimen data importing hardware system (3DSDIMS), we make a full range importation of anatomical specimens to form a database. And we setup a display system with software (DSS) providing relevant documents, audio commentary and other material.  RESULTS AND CONCLUSION: The 3DSDIMS is functional and capable to convers a specimen into digital image data within five minutes. The data can directly input to the database and can provide demonstration through DSS for remote display. Compared with traditional two-dimensional animation picture, three-dimensional specimens display is easier to use, not consumption, easier to expand, three-dimensional virtual system has a good prospect of teaching in anatomy and medical science education. Related Articles | Metrics

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Application of shifted band-limited multiple fourier linear combiner in pre-estimation and filtering of human tremor Zhao Jie, Yang Bo, Li Jun-qiang, Yan Ji-hong, Zhu Yan-he 2011, 15 (26):  4837-4840.  doi: 10.3969/j.issn.1673-8225.2011.26.022 Abstract ( 94 )   PDF (577KB) ( 537 )   Save BACKGROUND: To suppress the human tremor, researchers all over the world devote themselves to develop a wearable tremor-suppression orthosis. OBJECTIVE: To introduce and modify commonly used Fourier linear combiner and a series of derived algorithms. METHODS: The weighted Fourier linear combiner was introduced into a new algorithm, shifted bandlimited multiple Fourier linear combiner. Iterative process could change as the object changed. A certain bandwidth constraint was set to ensure the filtering properties of the algorithm, limiting the bandwidth range. RESULTS AND CONCLUSION: The shifted bandlimited multiple Fourier linear combiner is more adaptive and accurate for the tremor filtering and estimation. Related Articles | Metrics

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Measuring the contrast resolution limits (threshold) of mesopic vision based on digital image processing technology Zhao Yuan, Zhao Min, Xie Zheng-xiang 2011, 15 (26):  4841-4844.  doi: 10.3969/j.issn.1673-8225.2011.26.023 Abstract ( 125 )   PDF (587KB) ( 363 )   Save BACKGROUND: In the optical field, the spectral luminous efficiency of eyes under scotopic vision photopic vision can be expressed as function values, but there is no uniform standard for mesopic vision. OBJECTIVE: To measure simultaneous contrast resolution limits (threshold) of human mesopic vision in different colors background and to approach the influential factors about different colors or different grays. METHODS: We selected 30 health volunteers who have normal corrected vision, no disease of the eyes and from 24 to 29 years of age, on MS WINDOWS operating system, and used modern digital image processing to measure. RESULTS AND CONCLUSION: We have got contrast resolution limits (threshold) on seven kinds of background, including gray ,red, blue, yellow, cyan, purple when gray level is from 30 to 60, and set up mathematic model. The measuring of simultaneous contrast resolution limits (threshold) of human mesopic vision suggests that they would change when different colors or different gray background. The simultaneous contrast resolutionlimits (threshold) is the minimal on gray background and the maximal on cyan background, as well as we set up corresponding mathematic models. Related Articles | Metrics

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Computer processing sleep data of two-channel electroencephalogram and one-channel electrooculogram by aperiodic waveform analysis Wang Guo-feng, Peng Xiao-hu 2011, 15 (26):  4845-4849.  doi: 10.3969/j.issn.1673-8225.2011.26.024 Abstract ( 96 )   PDF (560KB) ( 357 )   Save BACKGROUND: The sleep data are very large, and it is not satisfied with practice demand if the data cannot process by computer. However, the methods which are using at present have a disadvantage that the accuracy is comparatively low. OBJECTIVE: To investigate a new method for sleep stage classification only using electroencephalogram (EEG) and electrooculogram (EOG) based on aperiodic waveform analysis and genetic neural network of radial basis function (RBF). METHODS: Raw data including two-channel EEG and one-channel EOG recorded from eight subjects were obtained from Sleep-EDF database of PhysioBank, MIT. After digital filter with zero phase, raw data were analyzed by aperiodic waveform analysis to extract several parameters that were necessary for sleep stage classification. Then, preprocessed data as input for genetic neural network of RBF accepted training. Finally, test data were sent to trained neural network to validate. RESULTS AND CONCLUSION: The results obtained, on average 95.6% of agreement between the expert and the GA-ANN for six stages of vigilance, going beyond results of known literature (70%-90%), which possess high value in practice and maybe satisfy with research and clinical application. Related Articles | Metrics

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Signal processing in endocardial mapping system Chen Zhong-zhong, Zhu Jiao-ying, Su Zhi-jian, Xia Zhen-hong 2011, 15 (26):  4850-4853.  doi: 10.3969/j.issn.1673-8225.2011.26.025 Abstract ( 179 )   PDF (606KB) ( 360 )   Save BACKGROUND: Signal processing is one of the key technologies in endocardial mapping by using ordinary catheter, it must be designed base on its characteristics, but, excessive noise can not be eliminated through traditional methods. OBJECTIVE: To stimulate in vitro experiment and signal processing of endocardial mapping system. METHODS: Noise was reduced partly by using a developed voltage controlled constant current source device, and then experiment data were processed with digital signal processing tool of MATLAB. The signal processing including bandpass, extract envelope, wavelet denoising and median filtering; finally, distances were calculated and compared with actual values. RESULTS AND CONCLUSION: It shows that this process effectually reduces external noise and the interference of breath and heartbeat, and the relative error of mapping vectors is less than 7%. It proved that this process can be used in endocardial mapping system. Related Articles | Metrics

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Bone density changes during tibial plateau fracture healing in rabbits Wang Wei-bin, Han Da-cheng, Zhang Pei-xun, Zhang Hong-bo, Jiang Bao-guo 2011, 15 (26):  4854-4856.  doi: 10.3969/j.issn.1673-8225.2011.26.026 Abstract ( 100 )   PDF (446KB) ( 336 )   Save BACKGROUND: Though the tibial plateau fractures are common in clinic, the studies on the fracture healing mostly focus on the treatment, and the change of bone density in the healing process is seldom concerned. OBJECTIVE: To evaluate the bone density changes in the healing process of tibial plateau fractures in rabbits. METHODS: All experiments were performed on 18 New Zealand rabbits. The tibial plateau fractures were created by oblique osteotomy, reduced, and then fixed by screws. At selected time points after operation (1, 2, 3, 4, 6, and 8 weeks), the tibial specimens were harvested and the bone density of fracture zone was measured with a dual energy x-ray absorptiometry scanner (DEXA). Intact tibia specimens of three rabbits were measured as controls. RESULTS AND CONCLUSION: The bone mineral density of the fracture aera declined slightly in the first week after fracture compared with the control group. It rose significantly in the second week postoperatively and descended vigorously from the third week. Then the value of bone mineral density varied slightly, except a little high relatively in the fourth week and a little low in the eighth week. From the changes of bone density in the healing process, it showed that the bone mineral density and bone formation reached the peak at 2 weeks after fracture under the good reduction and fixation. Related Articles | Metrics

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Meaning of pH value of the knee joint fluid in the crystal formation of gout Xiao Ying, Zhang Si-rong, Tang Zhi-hong, Zou Guo-yao, Li Zheng, Liu Rui-duan, Liu Lei 2011, 15 (26):  4857-4859.  doi: 10.3969/j.issn.1673-8225.2011.26.027 Abstract ( 195 )   PDF (469KB) ( 755 )   Save BACKGROUND: There should be other factors influencing crystallization of gout besides increase of uric acid concentration OBJECTIVE: To explore the meaning of pH value of the knee joint fluid in the crystal formation of gout. METHODS: We tested and compared the pH values of experiment group (25 hyperuricemia patients, with gout crystals in joint fluid) and control group (15 hyperuricemia patients, without gout crystals in joint fluid). RESULTS AND CONCLUSION: The pH value of experiment group (7.8±0.2) was less than that of control group (8.6±0.3). The pH value of the knee joint fluid of patients with gout crystals in their knee joint was significantly lower than that of patients without gout crystals in their knee joint (P < 0.001). The lower pH value of the knee joint fluid, the more possibility of gout crystals. Low pH value of the knee joint fluid is one of the risk factors for crystallization of gout. Related Articles | Metrics

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Deep vein thrombosis after arthroplasty Zhang Jian-Hua, Qiu Nan-hai 2011, 15 (26):  4860-4863.  doi: 10.3969/j.issn.1673-8225.2011.26.028 Abstract ( 99 )   PDF (600KB) ( 439 )   Save BACKGROUND: The incidence of deep vein thrombosis (DVT) after knee replacement is 40% to 60%. The mortality of DVT-induced pulmonary embolism (PE) is 20% to 30%. OBJECTIVE: To expatiate the etiology and treatment of lower extremity DVT following knee replacement as well as DVT-induced PE. METHODS: A computer search of Wanfang and CNKI databases were retrieved for articles published between 2000 and 2010 using the keywords of “knee replacement, vein thrombosis, pulmonary embolism, etiology, prevention, treatment”. RESULTS AND CONCLUSION: Deep vein wall injury, slow blood flow and hypercoagulable state are three factors for vein thrombosis. High risk factors for lower extremity DVT include poor condition, other diseases, surgical trauma due to joint replacement, anesthesia method, operative time, fixation way and long-term bed rest. Lower extremity DVT and PE are the cause of high mobility and mortality in patients following joint replacement. Clinicians should perform a systematic assessment for DVT to take appropriate measures to minimize DVT incidence. Related Articles | Metrics

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Application of bone morphogenetic protein 7 in the orthopedics Shen Yi, Li Xiao-miao, Wang Wei-li 2011, 15 (26):  4864-4867.  doi: 10.3969/j.issn.1673-8225.2011.26.029 Abstract ( 152 )   PDF (609KB) ( 779 )   Save BACKGROUND: Bone morphogenetic protein (BMP) family have the unique ectopic osteoinduction activity. They are related with development of embryonic tissue, functions maintenance and organizational rebuilding. BMPs are important to osteoinduction activity. BMP7, one of BMPs, mainly in bone and kidney, is essential for development of embryonic tissue and organizational rebuilding. OBJECTIVE: To understand the expression and role of BMP7 in bone development and fracture healing. METHODS: BMPs relevant articles from Chinese biomedical literature database and Medline database 1990/2010 were retrieved. Then, the development of biology role and regulation path was studied. RESULTS AND CONCLUSION: With deeply research, BMP7 may play an important role in fracture healing, recessive osteoarthritis, relative osteoarthritis diseases. There are some evidences to indicate that BMPs are profit for prosthesis-bone interfacial osseointegration. Related Articles | Metrics

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Application of three-dimensional measurement techniques in orthodontics A Yi-jiang, Mi Cong-bo 2011, 15 (26):  4868-4871.  doi: 10.3969/j.issn.1673-8225.2011.26.030 Abstract ( 153 )   PDF (678KB) ( 534 )   Save BACKGROUND: Three-dimensional measurement techniques can help orthodontists to easily make correct diagnosis, treatment plan, treatment outcome prediction and assessment. OBJECTIVE: To discuss the application of three-dimensional measurement techniques in orthodontics. METHODS: Articles about the application of three-dimensional measurement techniques in orthodontics were retrieved from CNKI and PubMed with the key words of “three-dimensional measurement technique; orthodontic; malocclusion; facial deformity” in both Chinese and English from January 1997 and January 2010. Articles in the same circle published in the authoritative journals or recently published were included. Among 145 articles, 22 were selected in the final analysis. RESULTS AND CONCLUSION: There is increased awareness and application of three-dimensional measurement techniques in the orthodontic field, and three-dimensional measurement technique develops rapidly and has a place in orthodontics. Related Articles | Metrics

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Research progress in stability of pedicle screw Zhou Zi-hong, Cheng Li, Yin Qu-dong 2011, 15 (26):  4872-4875.  doi: 10.3969/j.issn.1673-8225.2011.26.031 Abstract ( 121 )   PDF (577KB) ( 343 )   Save BACKGROUND: Pedicle screw which passes through the three columns and has three-dimensional correction function, which has quickly become the standard posterior spinal internal fixation. But loss of correction and screw loosening often occurs in patients with osteoporosis, or screw has less stability in revision surgery and re-adjust of screw position. OBJECTIVE: To summarize and analyze the stability of pedicle screw, to introduce the methods of improving the stability of pedicle screw and its clinical applications. METHODS: A computer-based online search of PubMed database, CNKI database, VIP database was performed for related articles published between 1990 and 2010 with key words “bone nails, osteoporosis, revision, pedicle screw, stability” in English and Chinese. RESULTS AND CONCLUSION: The focus on increasing stability of pedicle screw is to increase screw withdrawal resistance. Screw augmented with bone cement or replaced with thicker, longer screws or special screws (hollow screw and expandable screw hole) can lead to increase in the absolute value of screw stability. Screws in the upper and the lower, the left and the right side with different connectors, different directions of placement will affect the stability of the entire device of pedicle screw, which is the change in the relative value of screw stability. Other methods are those such as improving structure of fixator, and adding with bone in screw-path, etc. Various methods have advantages and disadvantages, clinical application should be based on different situations to choose specific methods. In general for Osteoporosis below grade Ⅱ (Jikei grade), using thicker and longer screws, horizontal connection device and screws with stiff connection with rod. At the same time, screws in left and right, upper and down side placed with larger angle to increase the stability of pedicle screw is a safe and convenient way; for Osteoporosis grade Ⅱ or more , more reliable screw augmented method with bone cement or special screws to increase the stability of pedicle screw must be used. Related Articles | Metrics

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Artificial vertebral histocompatibility and mechanical properties Liang Sheng-wei, Huang Min-feng, Wang Xiang-peng 2011, 15 (26):  4876-4879.  doi: 10.3969/j.issn.1673-8225.2011.26.032 Abstract ( 104 )   PDF (531KB) ( 295 )   Save BACKGROUND: Recently, with the development of tissue engineering, the substitutes of the vertebral body are various. Scholars focus on not only restoration of vertebral height and stability, but also long-term fusion effect, biocompatibility and mechanical properties. OBJECTIVE: To analyze the histocompatibility and mechanical properties of artificial vertebral body. METHODS: A retrieve of CNKI for articles about biocompatibility and mechanical properties of artificial vertebral body was performed using the keywords of “artificial vertebral body, compatibility, biomechanics”. RESULTS AND CONCLUSION: The histocompatibility examination showed that nano-hydroxyapatite/polyamide 66 composites have similar composition and structure to human bone with good biocompatibility and osteogenic activity; can be biodegradable, and their degradation matches to osteogenic activity. The biomechanical studies demonstrated that nano-hydroxyapatite/polyamide 66 composites have good bioactivity, good axial compression load and excellent ability to branch out the intervertebral, meaning perfect mechanical properties. Bio-ceramic artificial vertebral body not only has good biocompatibility, but also plays a role in targeting location of vertebral tumors. After years of improvement, metal vertebral body can also meet the clinical requirements in biocompatibility. On the pros and cons of various types of artificial vertebral bodies, a large amount of studies and practices should be done, while in clinic, the selection of artificial vertebral body should be done according to the clinical need. Related Articles | Metrics

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Comparison between Kirschner wire and mini-plate internal fixation in the treatment of metacarpal and phalangeal fractures Hu Hong-yong, Han Tong-kun, Yang Min-jun, Dou Qing-yin 2011, 15 (26):  4880-4884.  doi: 10.3969/j.issn.1673-8225.2011.26.033 Abstract ( 160 )   PDF (602KB) ( 1492 )   Save BACKGROUND: With metacarpal and phalangeal fractures being more common clinical cases, surgical treatment with mini-plate fixation and Kirschner wire are the most widely used. How to rational use of internal fixation in treatment of metacarpal and phalangeal fracture according to the fracture site, type and so on in order to achieve the best efficacy is very important. OBJECTIVE: To compare retrospectively the treatment efficacies between Kirschner wire and mini-plate internal fixation for metacarpal and phalangeal fractures to provide clinical guidance. METHODS: Fifty-two patients with 74 Kirschner wire internal fixation and 38 patients with 49 mini-plate internal fixation were followed up. All patients were grouped and compared within the metacarpal, proximal phalanx and middle phalanx fracture. Healing period, functional recovery and situation of wound infection were evaluated. RESULTS AND CONCLUSION: Mini-plate internal fixation is superior in the treatment of metacarpal fractures. Kirschner wire is better in the treatment of proximal phalanx, and favorites to functional recovery of distal and proximal phalanx head fracture. Kirschner wire should be selected for the treatment of phalanx fracture whereas Kirschner wire is superior for certain kinds of injuries such as distal phalanx fracture, intra-articular fractures, and severe comminuted fractures. Related Articles | Metrics

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Effects of CO2 laser moxibustion on quality of life in patients with knee osteoarthritis: A double-blind randomized controlled trial Wu Fan, Zhang Hai-meng, Wang Li-zhen, Zhao Ling, Deng Hai-ping, Cheng Ke, Shen Xue-yong 2011, 15 (26):  4885-4890.  doi: 10.3969/j.issn.1673-8225.2011.26.034 Abstract ( 142 )   PDF (712KB) ( 449 )   Save BACKGROUND: Currently, there are only a few clinical reports on the efficacy of laser moxibustion for knee osteoarthritis, and most of them focus on pain and joint function improvement after treatment. The life quality of patients is rarely observed or reported only as a minor measurement. OBJECTIVE: To observe effects of CO2 laser moxibustion on quality of life in patients with knee osteoarthritis. METHODS: Thirty-one cases were included in accordance with the inclusion criteria and divided into a treatment group (15 cases, with CO2 laser moxibustion treatment on ST-35) and a control group (16 cases, without laser treatment) with a double-blind, randomized and controlled method. Patients of both groups received 20 minutes’ treatment, thrice a week and 4 weeks in total. RESULTS AND CONCLUSION: Scores of physical functioning (PF) in the treatment group was significantly improved after 4 weeks’ treatment as well as in the follow-up (P=0.031, P=0.006). Scores of bodily pain (BP) and general health (GH) in the treatment group was significantly superior in the follow-up compared with those before treatment (P=0.007, P=0.011). After 2 weeks’ treatment, scores of PF and role limitations-physical (RF) in the observation group was significantly superior to those in the control group (P=0.033). Significant difference was also presented in scores of PF in the follow-up between two groups (P=0.021). Scores of BP in the treatment group showed higher tendency of improvement than that of the control group (P=0.037). Compared with the control group, CO2 laser moxibustion treatment could better improve quality of life in patients with knee osteoarthritis in respect of bodily function and pain. Related Articles | Metrics

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Treatment of bone defects with autologous bone marrow transplantation combined with bone allograft Lin Jian-ping, Song Shi-feng, Li Zao-min, Chen Jian-fei, Wu Duo-neng, Xiao Hai-tao 2011, 15 (26):  4891-4894.  doi: 10.3969/j.issn.1673-8225.2011.26.035 Abstract ( 93 )   PDF (492KB) ( 355 )   Save BACKGROUND: Up to now, there are no reports about autologous bone marrow transplantation combined with bone allograft for fresh bone fractures and bone defects in China. OBJECTIVE: To investigate the mechanism of autologous bone marrow transplantation combined with bone allograft in the treatment of limb fractures. METHODS: Forty-two cases of limb fractures were randomly divided into three groups: combination group, bone allograft and autologous bone marrow transplantation groups. All patients underwent bone specific alkaline phosphatase (BSAP) and imaging follow-up to observe callus formation and fracture healing. RESULTS AND CONCLUSION: In the combination group, the rate of callus formation and activity of BSAP were both higher than those in the other two groups at 3, 4, 6 weeks after internal fixation (P < 0.01). The autologous bone marrow transplantation combined with bone allograft probably promotes the early-stage development of the callus, accelerates the bone healing, shorten the hospitalization staying. Related Articles | Metrics

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Clinical outcome of glucosamine hydrochloride combined with non-steroid anti-inflammatory drug for degenerative facet joint and low back pain Shi Rui, Liu Hao, Hu Tao, Ding Chen 2011, 15 (26):  4895-4898.  doi: 10.3969/j.issn.1673-8225.2011.26.036 Abstract ( 90 )   PDF (514KB) ( 443 )   Save BACKGROUND: Glucosamine hydrochloride in the treatment of knee osteoarthritis has been confirmed for its safety and reliability due to the function of inflammation control, repairing cartilage and improving joint function. However, glucosamine hydrochloride drugs combined with non-steroid anti-inflammatory drug (NSAID) for low back pain are rarely reported. OBJECTIVE: To evaluate the clinical effectiveness of glucosamine hydrochloride combined with NSAID for facet joint degeneration and low back pain. METHODS: A total of 35 patients with degenerative facet joints and low back pain were recruited and received oral administration of glucosamine hydrochloride 750 mg, twice a day, plus diclofenac sodium tablets 75 mg, once a day. The treatment lasted for 8 weeks. Oswestry disability index, visual analog score and SF-36 were used for evaluation prior to treatment, immdiately after treatment and 8 weeks after treatment. RESULTS AND CONCLUSION: Thirty-three patients completed the final follow-up. The male to female ratio was 1:2, and mean age was (41.2±10.3) years. After treatment, low back pain and leg pain symptoms, lumbar function and quality of life were significantly improved (P < 0.05). Glucosamine hydrochloride combined with low dose NSAID had its effectiveness for degenerative facet joints and low back pain. Related Articles | Metrics

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External fixation combined with minimally invasive plate fixation for complex tibial and fibular fracture Kang Guo-feng, Zhang Guang-ming, Wang Jian-wei, Liang Ying-jie, Bi Yan-nan 2011, 15 (26):  4899-4902.  doi: 10.3969/j.issn.1673-8225.2011.26.037 Abstract ( 155 )   PDF (644KB) ( 301 )   Save BACKGROUND: High-energy comminuted fracture of tibia and fibula is often associated with soft tissue injury, the improper reduction method during the operative process of internal fixation can cause secondary soft tissue damage, resulting in serious consequences such as: skin infection and necrosis, bone exposure, osteomyelitis, bone defects and others; Looking for a way both to achieve stable internal fixation, and avoid aggravated soft tissue damage is the object of study for orthopaedic surgeon. OBJECTIVE: To investigate the clinical therapeutic effect of external fixation combined with MIPO technology used in complex tibial and fibular fracture. METHODS: Retrospective analysis was used in 39 cases of complex comminuted fracture of tibia and fibula selected from Guangzhou First People’s Hospital Affiliated to Guangzhou Medical College. In the minimally invasive internal fixation surgery, the temporary external fixation assisted reduction technology combined with MIPO technology used in all cases, and be removed after internal fixed firmly. RESULTS AND CONCLUSION: All the 39 patients were followed up covering a period from 6 to 18 months with an average of 12 months. Results show the osteological healing of 36 cases reached grade A primary intention healing with slightly affected limb swelling; 2 cases of wound edge swelling, healing by scar; 1 case of acute osteomyelitis in 3 months, healing after conservative anti-inflammatory therapy; none appeared operatively fixator nail hole infection, screw loosening and incision infection, skin necrosis, exposed bones and tendons. According to AOFAS ankle score, at 6 months after plate implantation, the ankle joint recovery condition was as follows: excellent in 29 cases, good in 8 cases, fair in 2. Range of ankle flexion and extension was ≥ 30° in 29 cases, 20° to 30° in 8 cases, and 20° or less in 2 cases. Related Articles | Metrics

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Treatment of comminuted patellar fractures with absorbable suture and NT-PC-concentrator A Bu-du Sai-Mai-T, Huo Jian-jun, Xiao-Ke-lai-t Mai-su-mu, Zhao Yan, Bie-Ke-bo-song, A Bu-du-ka-ha-er, Jia Tian-peng 2011, 15 (26):  4903-4906.  doi: 10.3969/j.issn.1673-8225.2011.26.038 Abstract ( 121 )   PDF (648KB) ( 336 )   Save BACKGROUND: NT-PC-concentrator combined with absorbable suture can avoid displacement of fracture fragments in the internal fixation of patella fracture. OBJECTIVE: To investigate the clinical effects of stabilizing comminuted patellar fractures with internal fixation by absorbable suture with NT-PC-concentrator. METHODS: Fifty-three cases of fresh comminuted patellar fractures treated with internal fixation by absorbable suture with NT-PC-concentrator from October 2005 to December 2009. The demography of the 53 cases was as follow: 37 males and 16 females, ranging from 17 to 72 years old (a mean of 36.8 years old). According to AO classification, there were 8 cases of B3 and 45 cases of C2, C3. RESULTS AND CONCLUSION: Thirty-eight cases out of 53cases were followed up with a mean period of 8 months. All the 38 patients obtained bone union in 2-4 months. No case of implant loosening or refracture was found. Three cases of infected incision, 2 cases of postoperative Knee synovitis, and 1 cases of temporary aggravation of pre-existing osteoarthritis were documented as postoperative complication. Of the 38 cases, 30 cases were scored excellent under the Lysholm＆Gillquist score, 6 good and 2 fair. The excellent and good rate was 94.7%. Absorable suture has better characteristics of mechanism in treating communited patellar fracture. It keeps fracture sites closely apposed and can fix bone fragments reliably. The NT-PC fixation is characteristics by a dynamic tension band mechanism. It serves the role of reduction and fixation simultaneously and can facilitate early postoperative range of motion exercises. Related Articles | Metrics

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Vitamin D deficiency in winter related to bone loss of older people in northern China   Zhou Bo, Wang Xiao-hong, Guo Lian-ying, Xu Chao, Zhang Zhuo, Kan Zhi-ying 2011, 15 (26):  4907-4910.  doi: 10.3969/j.issn.1673-8225.2011.26.039 Abstract ( 93 )   PDF (692KB) ( 484 )   Save BACKGROUND: There are seasonal variations in vitamin D status of older people in northern China. Vitamin D status of older people is deficient in winter and spring. OBJECTIVE: To evaluate the effect of vitamin D deficiency in winter on bone loss in elderly people in Shenyang. METHODS: 100 healthy Han volunteers over 60 years old living in Shenyang were selected. Plasma 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), osteocalcin, calcium and phosphate, overnight fasting urine free deoxypyridinoline, calcium, phosphate and creatinine were analyzed in March 2000. Hip bone mineral density (BMD) was measured in March 2000 and in March 2005. RESULTS AND CONCLUSION: At baseline, mean plasma 25(OH)D concentration was (31.0±12.3) nmol/L; 25(OH)D concentration of 40% of subjects was < 25 nmol/L; mean PTH was (29.4±11.5) ng/L for all subjects and (34.6 ± 13.5) ng/L for the subjects with 25(OH)D concentration < 25 nmol/L; plasma 25(OH)D concentration was correlated negatively with PTH concentration (r=-0.479, P < 0.000 1). After 5 years, mean bone loss rate was (3.05±4.07)% at the femoral neck and (1.46±5.02)% at the trochanter. Bone loss rate at femoral neck was negatively correlated with plasma 25(OH)D concentration at baseline (r=-2.3, P=0.02) after adjustment for weight, height and age. Bone loss rate at femoral neck for the subjects with plasma 25(OH)D concentration < 25nmol/L was 103% higher than that of the subjects with plasma 25(OH)D concentrations > 25 nmol/L (F=7.206 2, P=0.008 5). No correlation was found between other markers and bone loss rate. In older populations who generally have a low vitamin D status, vitamin D deficiency is negatively contributed to their bone loss.     Related Articles | Metrics

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Three cases of screw loosening following anterior cervical plate fixation Xue Hou-jun, Lei Gao, Luo De-min, Pan Lei, Fang Guo-fang, Zhang Ding-cheng, Zhou Jian-he, Pan He-ke 2011, 15 (26):  4911-4914.  doi: 10.3969/j.issn.1673-8225.2011.26.040 Abstract ( 140 )   PDF (542KB) ( 566 )   Save BACKGROUND: Anterior cervical discectomy and subtotal vertebrectomy/titanium cage fixation are the main therapies for patients with poor outcomes of conservative treatment for cervical spondylosis or those with neurological symptoms of the nerve root following cervical injuries or vertebral fractures. OBJECTIVE: To conclude the reasons and preventive measures for screw loosening following anterior cervical plate fixation. METHODS: Among 41 cases of cervical spondylosis and cervical injuries undergoing anterior cervical fixation plate, there were 3 cases of screw loosening. The causes and control methods were analyzed and proposed to reduce the anterior plate incidence of screw loosening. RESULTS AND CONCLUSION: Three cases of screw loosening presented with varying degree of dysphasia. After diagnosed, second operation was performed within 2 weeks to adjust the position of re-fixed titanium screw, and the long-term observation showed patients with good symptom relief. The surgical indications and the choice of the rational application of internal fixation devices as well as the correct postoperative management is the key to prevent screw loosening. Related Articles | Metrics

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Three-dimensional reconstruction of finite element model of the cervical motion segment according to Chinese Digital Human CT data Yuan Yuan-xing, Wan Lei, Yin Qing-shui, Zhong Shi-zhen 2011, 15 (26):  4915-4918.  doi: 10.3969/j.issn.1673-8225.2011.26.041 Abstract ( 132 )   PDF (413KB) ( 475 )   Save BACKGROUND: Our team has built finite element dynamic bone models of different parts, but how to ensure the model’s precision and effectiveness, there still needs further study. OBJECTIVE: To provide accurate biomechanics model of Digital Human. METHODS: The CT data of Virtual Chinese Human --the male No.1 (VCH-M1) were imported into the MIMICS13.1 software authorized by the Materialise Company, and then the outcome document was entered into the ABAQUS6.7 software to perform finite element analysis. The result was observed and then the effectiveness of the models was tested.  RESULTS AND CONCLUSION: The “.lis” document was chosen in the finite element analysis software ABAQUS6.7. Three dimension models of cervicalt were acquired. The model has 10 465 panel points and 52 752 units. It is verified that this model is effective. Results confirmed that the biomechanics model of Digital Human can be calculated for meeting the revolutionary requirement of the future digital medical science. Related Articles | Metrics

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Three-dimensional mechanics characteristics of the Ludloff osteotomy in repair of hallux valgus Mao Wei, Yan Hui 2011, 15 (26):  4919-4922.  doi: 10.3969/j.issn.1673-8225.2011.26.042 Abstract ( 101 )   PDF (332KB) ( 439 )   Save BACKGROUND: Now, three-dimensional studies related to the Ludloff osteotomy are little, and the conclusions are different. We still cannot fully understand the characteristic of osteotomy. OBJECTIVE: To study the characters of three-dimensional mechanics of the Ludloff osteotomy in repair of hallux valgus. METHODS: A wooden cylinder of 86.56 mm long and 30.65 mm diameter was selected for simulation test of the Ludloff osteotomy in repair of hallux valgus. Data were measured and recorded. RESULTS AND CONCLUSION: As the extent of the correction increased, the length of the cylinder became shorter and shorter, and the distal end of the cylinder became pronated constantly. Ludloff osteotomy makes the first metatarsal head constant internal rotation so that it is benefit for improving the biomechanics of the metatarsophalangeal joints. A section of 15-20 degrees deviating to plantar should be suggested for patients with serious metatarsalgia. Ludloff osteotomy should be taken cautiously for those patients whose Ⅰ/ⅡIMA is more than 30 degrees. Related Articles | Metrics

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Preventive effect of comprehensive rehabilitation nursing on early complications of total hip arthroplasty Du Xing-li, Fang Han-ping, Fang Zhong, Li Feng 2011, 15 (26):  4923-4926.  doi: 10.3969/j.issn.1673-8225.2011.26.043 Abstract ( 114 )   PDF (287KB) ( 705 )   Save BACKGROUND: Although the early postoperative functional rehabilitation can effectively guarantee the results of operations, incidence rate of complications following total hip replacement is still high. OBJECTIVE: To evaluate preventive effect of comprehensive rehabilitation care of early complications of total hip arthroplasty. METHODS: Totally 90 total hip arthroplasty patients were randomly divided into control group and study groups equally. Both groups were given conventional treatment and care, of which the study group underwent comprehensive postoperative rehabilitation care. The control group received general procedure of rehabilitation care. RESULTS AND CONCLUSION: There was no difference in postoperative Harris score at 1, 2, 12 and 20 weeks after surgery between study group and control group (P > 0.05). Compared with control group, the incidence of joint dislocation, infection, deep vein thrombosis of study group post-surgery 2 and 12 weeks, and the heterotopic ossification at 12 weeks after surgery were significantly lower (P < 0.01). These suggest that comprehensive rehabilitation care significantly reduces early complications of total hip replacement surgery, and effectively promotes the functional recovery of hip joint. Related Articles | Metrics

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Calcitonin promotes implant osteointegration in osteoporosis condition Chen Bai-ling, Xie Deng-hui, Lü Wei-jia, Li Fo-bao, Liao Wei-ming, Li Yi-qiang 2011, 15 (26):  4927-4930.  doi: 10.3969/j.issn.1673-8225.2011.26.044 Abstract ( 82 )   PDF (381KB) ( 400 )   Save BACKGROUND: Calcitonin can increase bone quantity and quality so as to reduce bone fracture occurrence. OBJECTIVE: To evaluate the effects of calcitonin on implant’s osteointegration and further on promoting the biological fixation of implants in osteoporotic condition. METHODS: Sprague-Dawley rats were randomly divided into three groups: sham surgery + hydroxyapatite (HA), ovariectomy (OVX) + HA, and OVX + calcitonin + HA groups. Postmenopausal osteoporosis models were established in the OVX + HA and OVX + calcitonin + HA groups. The porous HA prostheses were inserted into the tibial platform in each group after model induction, and rats in the OVX + calcitonin + HA group were given calcitonin for 12 weeks by subcutaneous injection. RESULTS AND CONCLUSION: Lumbar vertebral bone mineral density (BMD) decreased in OVX + HA group, and the lumbar BMD increased in the OVX + calcitonin + HA group after administration of calcitonin. Comparing with that in OVX + HA group, osseointegration rate in OVX + calcitonin + HA group was increased by 22.0% (P < 0.05). Results verified that in osteoporotic condition, subcutaneous administration of calcitonin could increase bone mass surrounding the implants and promote osteointegration. Related Articles | Metrics

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Load-strain-displacement of three patterns of dual-plate fixation for intercondylar fracture of the humerus Cai Hao, Ni Xiao-hui, Dong E-liang, Sheng Guo-qing, Qin Yu-xing, Wang You-hua 2011, 15 (26):  4931-4935.  doi: 10.3969/j.issn.1673-8225.2011.26.045 Abstract ( 94 )   PDF (351KB) ( 411 )   Save BACKGROUND: Dual-plate has been regarded as an ideal clinical therapy for intercondylar fracture of the humerus. However, the placement pattern remains controversial. OBJECTIVE: To compare biomechanical characteristics of three placement patterns of dual-plate internal fixation for intercondylar fracture of the humerus. METHODS: A total of 18 anticorrosive cadaveric adult humerus specimens were used to prepare “T” style intercondylar fracture of the humerus. Two strain gauges were stuck at each side of the fracture line. The fracture was treated by dorsal-plate, perpendicular-plate, and parallel-plate fixation. Biomechanical tests were performed on these specimens, including strain, displacement, and rigidity. RESULTS AND CONCLUSION: Data of the stress and displacement showed that there was no significant difference in displacement among three different internal fixation methods under stress bellow 500 N. The displacement of parallel-plate group was less than dorsal-plate and perpendicular-plate groups under stress of 500 N (P < 0.05). The strain was significantly less in parallel-plate group compared with dorsal-plate and perpendicular-plate groups (P < 0.05). The strain of internal and external condyle was greater than intercondylar strain, and the strain of external condyle was the largest. There were no significant differences in rigidity among three groups under stress less than 300 N. The axial compressive rigidity was largest in parallel-plate group under stress of 300-500 N compared with the other groups (P < 0.05). Under the same load condition, parallel-plate yielded the best results, and there was no obvious difference between dorsal-plate and perpendicular-plate.  Related Articles | Metrics

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Advance of finite element methods in spinal biomechanical research He Jian-ying, Dong Xie-ping 2011, 15 (26):  4936-4940.  doi: 10.3969/j.issn.1673-8225.2011.26.046 Abstract ( 163 )   PDF (284KB) ( 432 )   Save BACKGROUND: The finite element method can replace traditional biomechanical experiment for processing digital simulation and repeating experimental analysis. It has been used extensively and deeply in studying spinal biomechanics. OBJECTIVE: To emphasize the application of finite element method to spinal anatomy, spinal disease, spinal-related surgery, and establishment of spinal finite element models. METHODS: An online search of PubMed database and CNKI was performed using key words of “spine, finite element” for articles published between January 2000 and August 2010. A total of 44 manuscripts that were related to finite element of spine, published in authorized journal and considered to be a representative, were selected. RESULTS AND CONCLUSION: Finite element method is characterized by low cost and good repeatability. It not only has effect on deepening theory research, but also provides reliable basis for increasing understanding of occurrence, development of disease, and individualized treatment plan preparation. Finite element method has been an important part of digital medicine. Using finite element method further deepened people’s realization of spinal biomechanics behavior. Related Articles | Metrics