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    26 August 2012, Volume 16 Issue 35 Previous Issue    Next Issue
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    Application of the new pedicle screw implanted stereotactic system
    Wang Fang-yong, Li Jian-jun
    2012, 16 (35):  6461-6465.  doi: 10.3969/j.issn.2095-4344.2012.35.001
    Abstract ( 328 )   PDF (468KB) ( 345 )   Save

    BACKGROUND: According to the characteristics of spinal anatomy and the measurement data based on the three-dimensional reconstructed image, the pedicle screw implanted stereotactic system has been designed and successfully applied for patent (patent No. ZL 201010123475.1).
    OBJECTIVE: To investigate the application of a pedicle screw implanted stereotactic system in spine specimen operation.
    METHODS: Six spine specimens were selected and divided into two groups: A and B. For group A, the implantation was under the guidance of ultra-red navigation. And for group B, the new stereotactic system was used for the operation. The CT scanning and the three-dimensional reconstruction were based on 2 mm CT scanning before operation. The parameters were calculated based on the reconstructed images. The grading of screws was based on the 2 mm criteria of Gertzbein and Robbins.
    RESULTS AND CONCLUSION: For group A, 48 screws were implanted, and the results showed 41 screws were graded as Ⅰ, 5 screws were graded as Ⅱ and 2 as Ⅳ. The good rate was 96% for group A. For group B, 48 screws were implanted, and the results showed 39 screws were graded as Ⅰ, 5 as Ⅱ and 4 as Ⅲ. The good rate was 92% for group B. There was no significant difference of pedicle screws accuracy between the two groups (P > 0.05). Preliminary result shows that the accuracy of the new stereotactic system is similar to that of ultra-red navigation method.

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    Anatomical measurement of three-dimensional reconstruction of adult talus and its significance for individualized treatment
    Zhang Yan-dong, Liu Yi-rong, Zhao Guo-zhi, Li Zhi-jun
    2012, 16 (35):  6466-6470.  doi: 10.3969/j.issn.2095-4344.2012.35.002
    Abstract ( 397 )   PDF (441KB) ( 565 )   Save

    BACKGROUND: Talus serves as an important part of the ankle joint, and its form directly affects the stability and morbidity of the ankle joint.
    OBJECTIVE: To establish digital three-dimensional computer model of the talus, and then to measure the relevant anatomical data to provide anatomical parameters for operative design of the ankle joint.
    METHODS: Sixty normal adult volunteers containing 30 males and 30 females were treated with CT scan. Scan slice thickness was 1.25 mm, scanning pitch was 1.25 mm, reconstruction slice thickness was 0.625 mm, reconstruction spacing was 0.625 mm, Fov 30×30 mm, matrix was 512×512 dpi, tube voltage was 150 kV and current was 260 mA. The original scan data were introduced into PC computer with the form of DICOM. Three-dimensional reconstruction software (Materrialise Mimics 13.01 test version produced in Belgium) was used for post-processing and measurement. Statistical analysis was preformed according to gender.
    RESULTS AND CONCLUSION: The digital and virtual reconstruction model of talus could be observed and measured from multi-plane. Measurements of the length of the talus, width of the talus, height of the talus, the anterior width of the trochlea of talus, the posterior width of the trochlea of talus, the height of trochlea of talus, the length of trochlea of talus, the length of medial malleolar facet and the length of lateral malleolar facet in the male were larger than those in the female. Anatomical data from measurement have an important impact on talus diseases, the design of surgical instruments and the formulation of individualized treatment programs.

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    Finite element analysis and clinical analysis on multi-pin internal fixation for the treatment of calcaneal fractures
    Sun Rong-xin, Jiang Kan, Bai Jing-ping
    2012, 16 (35):  6471-6477.  doi: 10.3969/j.issn.2095-4344.2012.35.003
    Abstract ( 266 )   PDF (571KB) ( 456 )   Save

    BACKGROUND: In the calcaneal fractures, proper treatment can significantly improve prognosis of the patients.
    OBJECTIVE: To analyze the effect of multi-pin fixation and plate fixation on calcaneal fractures, and to evaluate clinical efficacy of two kinds of internal fixation methods.
    METHODS: ①CT scan was performed on a normal male right calcaneus to establish a complete three-dimensional finite element model of calcaneus, and the model was used to simulate Sanders Ⅱ type fracture of calcaneus, and simulate the tendon loading condition after calcaneal fracture plate and multi-pin internal fixation. The stress distribution, the relative displacement of the fracture line and the maximum principal stress of internal fixation of three groups (plate functional location at 0°; multi-pin functional location at 0°; multi-pin planter flexion location at 30°) were comparatively analyzed. ②Retrospective study of 59 cases of Sanders Ⅱ type fracture, 36 cases of the foot treated with open reduction and multi-pin fixation, 23 cases of the foot treated with open reduction and plate fixation, then the soft tissue complications after fixation was evaluated.
    RESULTS AND CONCLUSION: ①The finite element analysis showed the biggest achilles tendon loading load was 160 N, the maximum principal stress values of the models in three groups were less than the yield strength of fixation 225 MPa. The relative displacement of calcaneal fracture line in three groups was less than the intra-articular calcaneal fractures indications standard (surgical separation of the fracture line or displacement ≥ 1 mm). Continuous loading 1- 1 000 N load condition, the achilles tendon loads of internal fixation failure in three groups were greater than 160 N. Stress distribution analysis showed multi-pin and plate fixation evenly distributed the stress. ②The clinical research results showed that good rate of Sanders Ⅱ fracture in multi-pin fixation group was more than 83%, the good rate in the plate fixation group was 78%, there was no significant difference of the efficacy after fixation between two groups (P > 0.05). The occurrence rate of postoperative soft tissue complications in multi-pin fixation group was lower than that in the plate fixation group (P < 0.05).

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    Three-dimensional finite element analysis of tendon reconstruction in ankle with deltoid ligament injury
    Xu Can, Zhang Ming-yan, Lei Guang-hua, Wen Ting, He Hong-bo, Zhang Can, Li Kang-hua
    2012, 16 (35):  6478-6483.  doi: 10.3969/j.issn.2095-4344.2012.35.004
    Abstract ( 357 )   PDF (617KB) ( 451 )   Save

    BACKGROUND: There are many methods to reconstruct the ankle with deltoid ligament injury, but there is no study to compare these methods.
    OBJECTIVE: To compare the effect of Wiltberger, Deland, Kitaoka and Hintermann on the repair of ankle with deltoid ligament injury by three-dimensional finite element analysis.
    METHODS: A three-dimensional finite element model of the ankle included six bony structures, cartilage and principal ligaments. In addition to the intact model, superficial deltoid-deficient, Wiltberger reconstruction, Deland reconstruction, Kitaoka reconstruction and Hintermann reconstruction models were simulated. Then, the biomechanics of the ankle joint was evaluated by loading the eversional or external torque through the range of ankle flexion.
    RESULTS AND CONCLUSION: No reconstruction method could completely restore the values for ankle flexibility and the stresses of the lateral ligaments to normality. The Kitaoka procedure was the most effective technique in eliminating external rotation displacement. The Deland procedure was the most effective technique in restoring the alar tilt stability. Among the four deltoid ligament reconstruction techniques, Kitaoka and Deland procedures have the advantage in restoring the stability of ankle rotation.

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    Finite element analysis on hyoid bone mechanics in obstructive sleep apnea hypopnea syndrome patient inserted with oral appliance
    Jiang Wei, Qu Ai-li, Wang Chun-xiu, Liu Dan, Su You-liang
    2012, 16 (35):  6484-6488.  doi: 10.3969/j.issn.2095-4344.2012.35.005
    Abstract ( 287 )   PDF (538KB) ( 415 )   Save

    BACKGROUND: The researches on the modeling establishment of mandibular, airway and hyoid bone by three-dimensional finite element are rare.
    OBJECTIVE: To establish the model of mandible, airway as well as hyoid bone and surrounding muscular tissues in order to change the upper airway structure by simulating the situation of oral appliance inserted in obstructive sleep apnea hypopnea syndrome patient. And to study the biomechanical performance of hyoid bone by load forward displacement on mandibular.
    METHODS: One male obstructive sleep apnea hypopnea syndrome patient was chosen. Spiral CT scanning technology was used to obtain CT images from the lower edge of the orbit to the thyroid cartilage. The different organizations were segmented out in Mimics10.01 software. Then the point cloud from Mimics10.01 software was processed in Imageware10 software. Finally, a three-dimensional finite element model was constructed in ANSYS10.0 software. Then, 2, 4, 6 and 8 mm forward displacements of mandibula were placed. The biomechanical performance of hyoid bone was observed.
    RESULTS AND CONCLUSION: The results show that the stress on the upper airway was mainly concentrated in the soft palate and oropharynx. The stress on the hyoid bone was focused on muscles which connect the lower jaw and airway. As the size of the mandibular advanced continuously the stress was increased. The hyoid bone mainly moved along forward and upward as the muscles pulled it. The way of three-dimensional finite element analysis can build a model with a high geometrical and mechanical similarity. It extends the methods to research obstructive sleep apnea hypopnea syndrome pathology.

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    Vectorial measurement on tibial sections for the shape design of anatomic prothesis in Chinese
    Han Gui-bin, Zhang Shou, Chen Jian-qiang, Xing Shi, Cui Ke-ze, Fan Zhong-cheng
    2012, 16 (35):  6489-6493.  doi: 10.3969/j.issn.2095-4344.2012.35.006
    Abstract ( 251 )   PDF (459KB) ( 395 )   Save

    BACKGROUND: At present, almost all the studies about anatomy of the section of proximal tibia focused on its quantitative relations between transverse diameter and several sagittal diameters but ignored their relative position.
    OBJECTIVE: To study the shape design of anatomic prothesis by measuring the vectorial data of tibial sections in Chinese.
    METHODS: Twenty-six cases/44 knees with knee osteoarthritis were selected from Haikou People’s Hospital. After harvesting the images of the tibial sections the same as in total knee arthroplasty by CT three-dimensional reconstruction technique, we set up coordinates in them and marked out segments from the center of the coordinates to the edges of the section images per 10°. On the basis of the data got by measuring the lengths of the segments, we guided the shape design of anatomic prosthesis.
    RESULTS AND CONCLUSION: The coordinates set up according to the design proposal in the images of tibial sections were feasible and repeatable. From 10°-350°, the length of every segment had dependence with the length of transverse diameter. If we preestablish a length of transverse diameter discretionarily, we can calculate all the lengths of 10°-350° segments through the average ratios of every segments. Marking all the points of those segments’ peripheral region and connecting them with continuous line, we can get the shape of tibial anatomic prosthesis. Measuring the tibial sections vectorially can get the data of the tibial sections and get the corresponding positional relationship, and is significant for the shape design of anatomic prothesis in Chinese.

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    Safety of the primary hip replacement without closed suction drainage
    Chen Ke, Lü Xiao-hua, Zeng Rong, Guo Wei-tao, Tan Hong-chang
    2012, 16 (35):  6494-6497.  doi: 10.3969/j.issn.2095-4344.2012.35.007
    Abstract ( 652 )   PDF (330KB) ( 529 )   Save

    BACKGROUND: There is controversy about whether put or not put the closed suction drainage after primary hip replacement.
    OBJECTIVE: To investigate the safety and effectivity of the primary hip replacement without closed suction drainage.
    METHODS: Ninety-two patients scheduled for primary hip replacement were assigned for the odd numbers group (with closed suction drainage and all of them were intravenous blood transfusion tube) and the even numbers group (without closed suction drainage). The effect of the primary hip replacement without closed suction drainage was evaluated through the comparison of the number of dressing changes, the swelling of thigh, pain scores, hospital stay, degree of hematocrit decreasing, number of blood transfusions and the rate of adverse reaction.
    RESULTS AND CONCLUSION: There was no significant difference of the swelling of thigh, pain scores, hospital stay, degree of hematocrit decreasing, number of blood transfusions and the rate of adverse reaction between two groups; the number of dressing changes in the even numbers group was significantly larger than that in the odd numbers group and the difference was significant. Primary hip replacement without closed suction drainage has more advantages than those with closed suction drainage.

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    Comparison of polyethylene wear between metal-on-polyethylene and ceramic-on-polyethylene bearing in total hip arthroplasty
    Lan Tian, Shi Zhan-jun, Chen Guo-fen, Lu Kun, Zhou Ya-peng
    2012, 16 (35):  6498-6502.  doi: 10.3969/j.issn.2095-4344.2012.35.008
    Abstract ( 346 )   PDF (417KB) ( 499 )   Save

    BACKGROUND: Total hip prosthesis with polyethylene liner has been widely applied in the total hip arthroplasty by the reason of stable quality and relatively low price. Nevertheless, polyethylene wear particles can induce periprosthetic osteolysis, and then lead to aseptic loosening, it is still the main reason influencing prosthesis survival rate.
    OBJECTIVE: To measure the polyethylene linear wear of metal-on-polyethylene and ceramic-on-polyethylene bearing by computer-aided method and to compare the difference of antiwear ability.
    METHODS: Forty-eight patients (58 hips) with Zweymuller uncemented total hip arthroplasty were selected from Nanfang Hospital of Southern Medical University from 1997 to 2005, and all the patients were followed-up. The migration in the femoral head center relative to the axis of acetabulum opening plane on digital consecutive radiographs were examined to determine direction and degree of polyethylene linear wear. The experiment was divided into two groups according to different weight-bearing interface combinations: metal-on-polyethylene group (36 hips) and ceramic-on-polyethylene group (22 hips), and then the liner wear rate of two groups was compared.
    RESULTS AND CONCLUSION: The average polyethylene linear wear rate of metal-on-polyethylene group after 6.3 years follow-up was (0.20±0.11) mm/year, the average polyethylene linear wear rate of ceramic-on-polyethylene group after 4.6 years follow-up was (0.11±0.03) mm/year. After controlling for potential confounding factors, such as age, follow-up time, bilateral femoral eccentricity and the linear wear direction, the covariance analysis showed that the linear wear rate of ceramic-on-polyethylene group was higher than that of metal-on-polyethylene group (P = 0.017). The study showed that ceramic-on-polyethylene bearing got lower wear rate in total hip arthroplasty, and it was beneficial to long-term result.

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    Meta analysis on the minimally invasive incision versus conventional incision for total hip arthroplast
    Chen Chang-liu, Shu Yong
    2012, 16 (35):  6503-6507.  doi: 10.3969/j.issn.2095-4344.2012.35.009
    Abstract ( 298 )   PDF (430KB) ( 556 )   Save

    BACKGROUND: Minimally invasive incision has a good short-term effect on total hip arthroplasty, but some scholars believe that minimally invasive incision has a poor intraoperative exposure than the traditional incision, and has the complications of poor placement of the prosthesis after replacement.
    OBJECTIVE: To assess the effect of minimally invasive incision versus conventional incision for total hip arthroplasty.
    METHODS: A computer-based online search of PubMed database and Ovid database was performed for the articles on minimally invasive incision for total hip arthroplasty published from 1975-2011, the randomized controlled trials of minimally invasive incision versus conventional incision for total hip arthroplasty were collected and the quality was individually evaluated by the Cochrane Collaboration standards. The Meta analysis was performed on the articles that met the inclusion criteria by RevMan 5.0 software.
    RESULTS AND CONCLUSION: A total of 14 related papers were included, Meta analysis indicated that minimally invasive incision for total hip arthroplasty could reduce the duration of operation, the amount of intraoperative blood loss, and the amount of total blood loss when compared with conventional incision, but the rate of complications had no difference. As for the aspect of hip function after total hip arthroplasty, the Harris score of minimally invasive incision was better than that of the conventional incision within one year. The hip function was better in the minimally invasive incision for less blood loss, duration of operation, hospital stay and less on-bed time.

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    Cementless lengthened-handled hip joint replacement for the treatment of unstable intertrochanteric fractures in elderly people
    Liu Chao, Peng Hao, Yin Dong, Xu Shun-en
    2012, 16 (35):  6508-6513.  doi: 10.3969/j.issn.2095-4344.2012.35.010
    Abstract ( 292 )   PDF (496KB) ( 414 )   Save

    BACKGROUND: The healing of unstable intertrochanteric fractures in elderly people is poor after internal fixation, and fixation with ordinary hip replacement is unstable, so a new therapeutic means is needed to solve this problem.
    OBJECTIVE: To study the curative effect of cementless lengthened-handled hip joint replacement on the treatment of unstable intertrochanteric fractures in elderly people.
    METHODS: From January 2004 to September 2011, 26 cases of unstable intertrochanteric fractures in the hospital were cured with cementless lengthened-handled hip joint replacement. The artificial hip joint was the lengthened-handled hip joint from Zimmer with a good biocompatibility.
    RESULTS AND CONCLUSION: All patients were followed-up for 2 to 5 years and 6 months. The results of this surgical method were satisfied, all patients could walk early without hip pain, and the joint function was good. Life quality of these patients was improved obviously. The Harris score of the hip joint of these 24 cases after two years follow-up revealed that 9 cases had excellent therapeutic result, 11 cases were fine, 3 cases were ordinary, and 1 case was bad. The excellent and good rate was 83%. One case appeared artificial joint dislocation sinking. This method of cementless lengthened-handled hip joint replacement for the treatment of unstable intertrochanteric fractures had got satisfied results. Patients treated with this surgery could walk early and conducive to the early recovery exercise. So it is a relatively safe and effective treatment method for treating unstable intertrochanteric fractures in elderly.

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    Double-action femoral head replacement for the treatment of unstable femoral intertrochanteric frautures in the elderly
    Zhang Jing-dong, Xiang Liang-bi, Zu Qi-ming, Liu Gui-tang, Bi Yan
    2012, 16 (35):  6514-6518.  doi: 10.3969/j.issn.2095-4344.2012.35.011
    Abstract ( 264 )   PDF (1KB) ( 425 )   Save

    BACKGROUND: Femoral intertrochanteric fracture is common fracture in the elderly patients, it was treated with closed and reduction proximal femoral nail/proximal femoral nail anti-rotation internal fixation now, but the treatment effect of the method is not satisfied.
    OBJECTIVE: To explore the effect of double-action femoral head replacement for the treatment of unstable femoral intertrochanteric fractures in elderly patients.
    METHODS: Thirty-nine patients with unstable femoral intertrochanteric fractures were cured by double-action femoral head replacement, all the patients were followed-up for more than 6 months. Harris score was used to evaluate the hip joint function, and the complications after replacement were observed.
    RESULTS AND CONCLUSION: Harris Scores after followed-up for 6 months showed that 17 cases were rated as excellent, 14 cases as good, 8 cases as fair. Three cases of cardiac insufficiency, one case of lung infection, two cases of dislocation (communication barriers, and could not cope with the rehabilitation training after replacement), two cases of deep vein thrombosis and five cases of urinary tract infection. All the patients were cured after symptomatic treatment. There were no serious complications, such as cardiac failure, stress ulcer, pulmonary embolism, periprosthetic infection or death. The treatment of unstable femoral intertrochanteric fractures with double-action femoral head replacement in elderly patients has the advantages of early ambulation weight and fewer complications after replacement.

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    Hip pain after total hip arthroplasty
    Li Guang-wei, Chen Lin-bin, Gao Yu-liang
    2012, 16 (35):  6519-3524.  doi: 10.3969/j.issn.2095-4344.2012.35.012
    Abstract ( 293 )   PDF (451KB) ( 434 )   Save

    BACKGROUND: Total hip arthroplasty is an effective measure for the treatment of various hip diseases. Due to the difficult implantation, pain and other complications after replacement, there is controversy in the diagnosis and treatment.
    OBJECTIVE: To analyze the causes of hip pain after total hip arthroplasty and investigate relative prevention and treatment measures.
    METHODS: The data of 21 patients (23 hips) with hip pain after total hip arthroplasty were collected, among them, 10 patients received conservative treatment, while the other 11 patients were given surgical treatment. The visual analogue scale score and Harris hip score were used to analyze the cause of hip pain after total hip arthroplasty.
    RESULTS AND CONCLUSION: All the 21 patients were followed-up for 1-9 years. Among the 3 patients with intra-articular pain in the infected group, 2 patients were given conservative treatment and 1 was given second stage revision, infection was cured by follow-up, and postoperative visual analogue scale score was decreased while the Harris score was significantly increased when compared with those before replacement, and the difference was statistically significant (P < 0.05). In the non-infected group, 8 patients were treated with conservative treatment and 10 patients received surgical treatment, the visual analogue scale scone and Harris score were improved when compared with those before replacement, and the difference was significant (P < 0.05).

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    Comparison among radial head resection, internal fixation and prosthesis replacement for the treatment of Mason type-Ⅲ radial head fracture
    Chen Jia-jia, Wang Li-ming, Zhao Lei, Jiang Chun-zhi, Gui Jian-chao, Wang Gang-rui
    2012, 16 (35):  6525-6529.  doi: 10.3969/j.issn.2095-4344.2012.35.013
    Abstract ( 372 )   PDF (418KB) ( 423 )   Save

    BACKGROUND: Looking at the current three surgical programs for Mason type-Ⅲ radial head fracture, each of them has advantages and disadvantages. There is still some controversy in the choice of surgical program.
    OBJECTIVE: To compare curative effect of radial head resection, internal fixation and radial head prosthesis replacement for the treatment of Mason type-Ⅲ radial head fracture, and to explore more reasonable and more effective treatment methods.
    METHODS: The clinical data of 33 patients with Mason type-Ⅲ radial head fracture were analyzed, according to different surgical techniques, and the patients were divided into resection group (n=11), internal fixation group (n=11) and replacement group (n=11). The results of the three groups were assessed by statistical analysis after follow-up.
    RESULTS AND CONCLUSION: All patients were followed-up for 12 to 53 months with an average of 20 months. The patients of three groups were all satisfied with the elbow joint function. There was no significant difference in the pain visual analogue scale score and flexion and extension activity of the elbow among three groups (P > 0.05), but there was significant difference in forearm rotation angle, carrying angle observed by X-ray, shift of radius and Broberg and Morrey elbow scores among three groups, and the indicators in replacement group were better than those in the internal fixation group, and the internal fixation group was better than the resection group. It indicates that the radial head prosthesis replacement for the treatment of Mason type-Ⅲ radial head fracture can get better elbow joint dysfunction compared with radial head resection and internal fixation.

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    Gait analysis on the ankle joint function of the patients following total ankle replacement
    Zhou Xin, Wei Min, Wang Wei
    2012, 16 (35):  6530-6534.  doi: 10.3969/j.issn.2095-4344.2012.35.014
    Abstract ( 305 )   PDF (375KB) ( 523 )   Save

    BACKGROUND: Recently, total ankle replacement has been widely used and the efficacy has also been recognized, but the efficacy is often assessed through various types of assessment criteria. However, there lacks the researches on the gait changes in the patients with total ankle replacement.
    OBJECTIVE: To evaluate the walking ability of the patients before and after total ankle replacement by using Kofoed scoring system and gait analysis system.
    METHODS: From September 2007 to June 2011, the patients received total ankle replacement were selected from Department of Orthopedics, Renji Hospital of Shanghai Jiao Tong University School of Medicine and were evaluated by using Kofoed scoring system and gait analysis system. Then compared with 15 normal control subjects and observed the changes of ankle joint function before and after total ankle replacement.
    RESLUTS AND CONCLUSION: After total ankle replacement, the Kofoed scoring score and most of the gait parameters were significantly improved (P < 0.05), such as the step length, gait velocity, the affected single leg supporting time and legs supporting time, as well as the activity of ipsilateral ankle joint, contralateral ankle joint, ipsilateral hip, ipsilateral knee and contralateral knee.

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    Proximal femoral nail antirotation for the treatment of elderly patients with unstable intertrochanteric fractures
    Xie Hai-ming, Jin Zheng-shuai, Li Yong, Yan Xue-fei, Yu Jian
    2012, 16 (35):  6535-6539.  doi: 10.3969/j.issn.2095-4344.2012.35.015
    Abstract ( 390 )   PDF (435KB) ( 487 )   Save

    BACKGROUND: Proximal femoral nail antirotation is a new designed intramedullary fixation system on the basis of the proximal femoral nails; it can improve the antirotation, angle stability and cut-resistant ability.
    OBJECTIVE: To evaluate the curative effect of proximal femoral nail antirotation on the treatment of unstable intertrochanteric fractures in elderly patients.
    METHODS: A retrospective analysis was preformed on the clinical data of 56 patients with unstable intertrochanteric fractures treated by proximal femoral nail antirotation. And details of surgery, quality of reduction, spiral blade position, postoperative complications and final results were evaluated.
    RESULTS AND CONCLUSION: Fifty-six cases were treated with closed reduction and internal fixation, and 46 cases were treated with proximal femoral nail antirotation smoothly. After implanted for 13 months, the imaging evaluation showed that the healing of the fracture was good in 44 cases and satisfactory in 12 cases. Spiral blade position of 42 cases located in the central femoral head, and 12 cases located in the back upper place of the femoral head, 2 cases located in the back lower place of the femoral head and mean neck-shaft angle was (128±4.8)°. All patients were healed in 3-6 months. The limb functions of 50 patients were restored to pre-injury activity level. No occurrence of femoral neck cut off and the blade did not cut into the acetabulum. Proximal femoral nail antirotation is a successful treatment for unstable intertrochanteric fractures in elderly patients.

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    Three kinds of metal implants for the treatment of fresh femoral neck fracture in elderly patients: 2-year follow-up
    Ding Xuan-xi, Xiao Wen-yao, She Wei
    2012, 16 (35):  6540-6544.  doi: 10.3969/j.issn.
    Abstract ( 644 )   PDF (414KB) ( 562 )   Save

    BACKGROUND: At present, the internal fixation and total hip arthroplasty are two main methods for the tneatment of femoral neck fracture in elderly patients. But, as for the surgical indications and the pros and cons, there is still a lot of controversy.
    OBJECTIVE: To analyze the curative effect and the significance of cannulated screw fixation, artificial femoral head replacement and total hip arthroplasty for the treatment of displaced femoral neck fracture in elderly patients.
    METHODS: 108 cases of 65 years old patients with femoral neck fracture were selected and treated with cannulated screw fixation, artificial femoral head replacement and total hip arthroplasty respectively. The differences of joint function, complications and secondary revision rate were compared.
    RESULTS AND CONCLUSION: In cannulated screw fixation group, the hospitalization time, bed time and the complications were higher than those in other two groups, and the 2-year follow-up function was the worst. The total hip arthroplasty had the short bed time, low complication and surgical revision rate and the best hip function after operation, while the longest operation time and bigger trauma required the patient had a higher general condition. The trauma of artificial femoral head replacement was smaller than that of the total hip arthroplasty, but the complication rate and the revision rate were higher and the function after total hip replacement was poor. Total hip arthroplasty for the treatment of displaced femoral neck fractures in elderly patients requires high activity and good general condition of the elderly patients which can lead to a good curative effect.

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    Posterior pedicle screw fixation combined with transpedicular self-bone grafting in the treatment of thoracolumbar burst fractures: Follow-up of the vertebral body height after 12 months
    Gu Xiao-bin, Zhu Guang-wei, Xiang Xiao-gang, Wang Lin
    2012, 16 (35):  6545-6549.  doi: 10.3969/j.issn.2095-4344.2012.35.017
    Abstract ( 259 )   PDF (472KB) ( 581 )   Save

    BACKGROUND: With the rapid development of biomechanics and fixation materials, pedicle screw fixation has become the main method for the treatment of thoracolumbar burst fractures.
    OBJECTIVE: To evaluate the clinical effect and influencing factors of posterior pedicle screw fixation comlined with transpedicular self-bone grafting in the treatment of thoracolumbar burst fractures.
    METHODS: Forty-seven thoracolumbar burst fracture patients treated by posterior pedicle screw fixation combined with transpedicular self-bone grafting were selected. American Spinal Injury Association and visual analogue score were measured preoperatively and postoperatively. Vertebral wall compressed ratios, Cobb angel and Oswestry disability index were measured preoperatively, postoperatively and 12 months after follow-up.
    RESULTS AND CONCLUSION: All the patients were followed-up. The pain and injured vertebral height were improved obviously. American Spinal Injury Association score of 55% patients was upgraded to 1 or 2 level. Postoperative anterior and posterior vertebral wall compressed ratios and Cobb angel were significantly decreased than preoperative (P < 0.05). After followed-up for 12 months, anterior and posterior vertebral wall compressed ratios and Cobb angel were slightly increased comparing with postoperation, but the difference was not significant (P > 0.05). Posterior fixation and transpedicular self-bone grafting can significantly restore vertebral height and maintain vertebral stability. The main factors affecting the Oswestry disability index score were the anterior vertebral compression rate of preoperatively and 12 months’ follow-up.

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    Posterior pedicle screw fixation combined with nanotechnology bone graft for the treatment of thoracolumbar fracture
    Huang Qi-kai, Li Ming, Hu Wen
    2012, 16 (35):  6550-6554.  doi: 10.3969/j.issn.2095-4344.2012.35.018
    Abstract ( 465 )   PDF (444KB) ( 593 )   Save

    BACKGROUND: Nanotechnology bone has the advantages of osteoinductive activity and excellent osteogenic property, and it can be shaping with less adverse reactions.
    OBJECTIVE: To observe the effect of posterior pedicle screw fixation combined with nanotechnology bone graft on the treatment of thoracolumbar fractures.
    METHODS: Forty-eight thoracolumbar fracture patients were treated with posterior pedicle screw fixation combined with nanotechnology bone graft within 3 days after in hospital, the Cobb angel, the anterior vertebral height and bone healing before and after treatment were analyzed and compared.
    RESULTS AND CONCLUSION: All patients were followed-up for over 9 months. At 7 days after nanotechnology bone implantation and the last follow-up, the Cobb angel and the anterior vertebral height were significantly improved compared with the pre-operation (P < 0.05), while there was no significant difference of the indexes (P > 0.05). All injured vertebral bone was healed well. For the treatment of thoracolumbar fractures, posterior pedicle screw fixation combined with nanotechnology bone graft has a good effect in maintaining the stability and the correction efficiency of reconstructed spine with high fusion rate and short healing time.

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    Application of EXAKT systems in the preparation of sections of soft and hard tissues containing metal implants
    Qi Jin, Huang Ping, Zhang Lian-fang, Feng Sheng-mei, Deng Lian-fu
    2012, 16 (35):  6555-6559.  doi: 10.3969/j.issn.2095-4344.2012.35.019
    Abstract ( 473 )   PDF (578KB) ( 516 )   Save

    BACKGROUND: It is difficult to cut thin sections of cortical bone and tissues installed with hard implant using Polycut microtome. Recently, such sections are commonly fabricated with EXAKT system.
    OBJECTIVE: To prepare thin sections of soft and hard tissues that contained metal implants by using EXAKT system.
    METHODS: The samples were obtained from the distal femur of rat, the fracture callus in mouse femur, the canine mandible with titanium alloy implant and the porcine coronary artery containing Co-Cr stent. The samples were fixed with polyformaldehyde and dehydrated with acetone, and then embedded with methylmethacrylate. The embedded samples were cut into 300 μm thick sections and then ground down to 5-10 μm. The thin sections were stained with hematoxylin-eosin or toluidine blue when necessary and observed under light microscope.
    RESULTS AND CONCLUSION: Toluidine blue staining showed that metaphyseal mineralized trabecular bone in the tissue sections of rat distal femur was light blue, and cortical bone was integrated with no fragmentation. The light blue host bone of the canine mandible with titanium alloy implant sections was closely integrated with the black metal implant and formed a solid interface. The callus sections of the tetracycline-labeled mouse femoral shaft fracture showed significant double fluorescence band under fluorescence microscope (ultraviolet light). Hematoxylin-eosin staining of the porcine coronary artery sections containing Co-Cr stent showed that the scaffold material remained in place without detachment or wavering phenomenon from the vessel wall, and the tissue was contained without shrinkage or collapse. The results suggest that proper use of EXAKT system is able to produce high-quality sections of soft and hard tissues, which can show the tissue structures and installed implant clearly.

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    Effects of hyaluronic acid on the osteopontin and CD44 expression in fibroblast-like synoviocytes of human with knee osteoarthritis in vitro
    Zhang Fang-jie, Luo Wei, Gao Shu-guang, Li Yu-sheng, Sun Jin-peng, Xiong Yi-lin, Lei Guang-hua
    2012, 16 (35):  6560-6564.  doi: 10.3969/j.issn.2095-4344.2012.35.020
    Abstract ( 363 )   PDF (478KB) ( 471 )   Save

    BACKGROUND: In the course of osteoarthritis, the changes of hyaluronic acid level can make a series changes of cytokines and enzyme expression levels. However, the relationship between the high expression of osteopontin and CD44 in the synovial tissue and the hyaluronic acid level change is not clear.
    OBJECTIVE: To change the contents of hyaluronic acid in the fibroblast-like synoviocytes, in order to investigate the effect of hyaluronic acid on the expression of osteopontin and CD44 of fibroblast-like synoviocytes in patients with osteoarthritis of the knee.
    METHODS: The study was performed on 10 specimens of synovium obtained from osteoarthritic patients. Then all the fibroblast-like synoviocytes 4-6 passaged cells were taken and divided into three groups: the control group without any treatment; hyaluronic acid group was treated with 100 mg/L hyaluronic acid for 24 hours; hyaluronidase group was treated with 300 mg/L hyaluronidase for 24 hours.
    RESULTS AND CONCLUSION: Compared with control group, the osteopontin mRNA expression in osteoarthritis fibroblast-like synoviocytes was increased in hyaluronic acid group (P < 0.05) and decreased in hyaluronidase group (P < 0.05), and the difference of osteopontin mRNA expression showed statistically significance in hyaluronic acid group and hyaluronidase group (P < 0.05). The difference of the CD44 mRNA expression in fibroblast-like synoviocytes was not significant among three groups (P > 0.05). Hyaluronic acid can up-regulate the osteopontin mRNA expression in osteoarthritis fibroblast-like synoviocytes and has no effect on the CD44 mRNA expression.

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    Relationship between the function and instability of the knee joint in patients with medial knee osteoarthritis
    Liu Feng, Zhang Jun, Wang Wen-xiu, Zhang Ming-qiang, Zhang Zhi-feng, Hou Hai-tao
    2012, 16 (35):  6565-6569.  doi: 10.3969/j.issn.2095-4344.2012.35.021
    Abstract ( 300 )   PDF (481KB) ( 409 )   Save

    BACKGROUND: The relationship between physical defects and the development of medial knee osteoarthritis is not clear.
    OBJECTIVE: To study the relationship between the physical function and the instability of knee joint in the patients with medial knee osteoarthritis.
    METHODS: 104 patients diagnosed with medial knee osteoarthritis were included, knee outcome survey-activities of daily living scale was used to measure knee joint instability, functional self-assessment was performed with the knee injury and osteoarthritis score, body functions based on physical assessment was evaluated by timing ladder test, and the radiographic evaluation was performed.
    RESULTS AND CONCLUSION: There was no significant difference of medial laxity, lateral laxity, diagonal, standardized maximal voluntary isometric contraction and stair climbing time between the patients with different degrees of knee instability (P > 0.05). While there was significant difference of pain, symptoms, activities of daily living, sports scores and the subsets of quality of life between the patients with different degrees of knee instability (P < 0.05). There was no direct correlation between the self-reported knee instability and the medial laxity, quadriceps femoris weakness and varus alignment in the patients with medial knee osteoarthritis.

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    Specific scale of hip-preserving treatment for osteonecrosis of the femoral head
    Zheng Zhi-hui, Wang Shao-wei, Li Wei-ju, Zeng Yi-rong
    2012, 16 (35):  6570-6577.  doi: 10.3969/j.issn.2095-4344.2012.35.022
    Abstract ( 290 )   PDF (526KB) ( 466 )   Save

    BACKGROUND: There are many criteria used to evaluate the curative effects of hip-preserving treatment for osteonecrosis of the femoral head, and there have been no consistent criteria, so the curative effects of hip-preserving treatment lack comparability to some extent.
    OBJECTIVE: To develop a specific scale used to evaluate the curative effect of hip-preserving treatment reference to WHO Quality of Life Scale model of development and scale development and application of the medical field guide.
    METHODS: Through the literature review and panel discussions, to design the theory model in reference to general scale under the guidance of related theory. Through the patient interview to form the entries pool, optimize the entries and get preliminary screening then form questionnaire. The field investigations were performed by pre-questionnaire, with the help of experts’ importance ratings, factor analysis, discrete trend method, regression, discriminant analysis and Cranach’s alpha coefficients to screen the entries, and finally form the eventually selected scale.
    RESULTS AND CONCLUSION: The eventually scale including four areas: physiological, psychological, social and health consciousness. The scale was divided into nine aspects: pain, limp, joint function, the positive and negative factors, social role, social relations and healthy self-evaluation and understanding of disease, plus an independent entry, a total of 32 entries. Once the eventually selected scale of the hip-preserving treatment of osteonecrosis of the femoral head completed its scientific assessment, it will be a specific scale to evaluate the curative effect of the hip-preserving treatment of osteonecrosis of the femoral head, and will provide a more comprehensive outcomes assessment to the patients who accept the hip-preserving treatment of osteonecrosis of the femoral head.

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    Adaptive algorithm of super-resolution image reconstruction
    Dai Shou-ping, Zhang Huai-guo, Xu Qi-fei, Wang Jian-hua, Wang Hou-jun, Li Xiao-dong
    2012, 16 (35):  6578-6582.  doi: 10.3969/j.issn.2095-4344.2012.35.023
    Abstract ( 349 )   PDF (399KB) ( 379 )   Save

    BACKGROUND: Super-resolution reconstruction has been extensively studied and used in many fields, such as video and remote sensing.
    OBJECTIVE: To reconstruct a high-resolution image from the low-resolution image sequence, an adaptive algorithm of super-resolution reconstruction is proposed.
    METHODS: We use a constant regularize parameter (λ=2/3) and adaptive step size as scheme Ⅰ. The scheme Ⅱ takes into account inaccurate estimates of the registration parameter, the point spread function and the additive Gaussian noise in the low resolution image sequence. We structure a novel adaptive regularization functional, and analyze experimentally the convexity of the nonlinear cost function. Based on the convex of the cost function, we get the adaptive step size by the mathematical theory, which improves the spatial resolution of the image and the rate of convergence.
    RESULTS AND CONCLUSION: Optical images are used to test the proposed method. The scheme Ⅱ performs better than scheme Ⅰ, in the sense of the enhanced peak signal to noise ratio. Compared to scheme Ⅱ, the computational cost of scheme Ⅰ is twice or more slower. The average computational cost of scheme Ⅱ is 68.25 seconds. The results show that the spatial resolution of the image and the rate of convergence are significantly improved. The experiment also proves that the stability of the algorithm is good with the progress of the iterative process.

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    Data acquisition and development of multifunctional anesthesia machine based on computer embedded systems
    Ling Xiao-long, Ge Bin, Li Hao, Zhu Ling-kang
    2012, 16 (35):  6583-6586.  doi: 10.3969/j.issn.2095-4344.2012.35.024
    Abstract ( 305 )   PDF (615KB) ( 435 )   Save

    BACKGROUND: During traditional clinical surgery, on the one hand anesthesia machine is used to monitor each parameter of the anesthesia and on the other hand to monitor vital signs information of patients, so there exists complicated line and equipment takes up workspace problems.
    OBJECTIVE: To improve the defect of space occupied by anesthesia machine and each monitoring equipment work alone.
    METHODS: A computer-based search of Wanfang database was performed by the first author for relevant articles in September 2011 with the key words of “anesthesia workstation, anesthesia care information management, embedded systems” in Chinese. Totally, 195 articles were retrieved, and finally 24 articles were included in result analysis.
    RESULTS AND CONCLUSION: As the continuous development of clinical anesthesia technology, multi-functional, high-security of inhalation anesthesia and improved anesthesia monitoring and patients management system are increasingly important in the modern medicine. During surgery, anesthesia machine not only need to monitor anesthesia data parameters, and always monitor vital signs information of the patient. But cultural clinical surgical procedures are currently monitoring mode by using anesthesia machines with ancillary equipments, so there is space usage problem. This article introduces the core of an embedded system, developed a kind of a new multi-functional anesthesia machine which combined anesthesia information management with body information monitoring function.

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    Value and significance of knee joint morphological measurement in total knee arthroplsty
    Cao Peng, Cui Yong
    2012, 16 (35):  6587-6590.  doi: 10.3969/j.issn.2095-4344.2012.35.025
    Abstract ( 396 )   PDF (518KB) ( 435 )   Save

    BACKGROUND: Observation and measurement of the size and design of the morphology of artificial knee joint are benefit to promote the stability and histocompatibility after knee prosthesis implantation.
    OBJECTIVE: To explore the effect of morphological measurement in total knee arthroplsty.
    METHODS: A computer-based search was performed with the key words of “artificial knee joint, prosthesis, measure, design, replacement” in English and Chinese for the literatures that related to the design and measurement of artificial knee joint prosthesis, as well as the literatures that related to the histocompatibility after knee joint prosthesis implantation published from January 1998 to December 2011.
    RESULTS AND CONCLUSION: The morphological measurement of the knee joint, namely the three-dimensional finite element model, the relevant parameters and prospects and the biomechanics research, was correlated with selection and design of knee prosthesis. The morphological measurement of the knee joint contained two-dimensional and three-dimensional measurement, and the three-dimensional measurement method was more accurate. There were good correlation between linear dimensions, height and linear dimension, and the application of measurement data has great significance in clinic. The typical knee joint three-dimensional anatomical model can provide a reliable method for the measurement of knee parameters in order to improve the success of the operation.

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    Application of X-ray image in normal bone tissue and bone disease diagnosis
    Li Feng, Sun Yan-li, Zheng Chang-hong, Tang Hong-tao, Xing Chun-sheng
    2012, 16 (35):  6591-6598.  doi: 10.3969/j.issn.2095-4344.2012.35.026
    Abstract ( 362 )   PDF (742KB) ( 390 )   Save

    BACKGROUND: X-ray imaging diagnosis is the commonly used method for the clinical treatment of bone and joint system which has become the important part of clinical imaging diagnosis.
    OBJECTIVE: To multi-level explore and analyze the research literature on the application of X-ray image in the normal bone tissue and bone disease diagnosis.
    METHODS: A computer-based search was performed in CNKI database from 2002 to 2011 for the literatures on the application of X-ray image in the normal bone tissue and bone disease diagnosis, the key words were “bone tissue, hip joint, knee joint, shoulder joint, elbow joint”. Bone and joint system was the body’s load-bearing systems and motion systems with complex and diversify structure, so the bone tissue X-ray imaging performance also showed the complexity and diversity, and bone tissue X-ray imaging diagnosis provided important complementary evidence for the clinical diagnosis and treatment.
    RESULTS AND CONCLUSION: Human organizational structure has different density and thickness. The absorbance volume of X-ray is different when penetrating the human body and the remaining amount is also different. The remaining X-ray can be displayed in the X-ray film with black and white contrast and level difference through the imaging of imaging medium or computer reconstruction process. X-ray imaging is not only used in the study of normal bone tissue, but also used in the diagnosis of bone disease.

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    Effect of pedicle screw internal fixation on the treatment of ankylosing spondylitis kyphosis deformity: Analysis on the cases and literatures
    Wang Xiao-ping, Lu Ming, Ma Hua-song, Qin Liu-hua, Ren Dong-yun, Chen Zhi-ming, Niu Jing, Zheng Rui, Zhang Jing
    2012, 16 (35):  6599-6606.  doi: 10.3969/j.issn.2095-4344.2012.35.027
    Abstract ( 294 )   PDF (824KB) ( 565 )   Save

    BACKGROUND: Patients with ankylosing spondylitis kyphosis deformity may be treated with single segment or two segment pedicle screw internal fixation according to the severity of deformity, and can obtain a good orthopedic effect.
    OBJECTIVE: To multi-level explore and analyze the clinical application results and literatures on the effect of pedicle screw internal fixation on the treatment of ankylosing spondylitis kyphosis deformity.
    METHODS: Sixteen clinical cases with ankylosing spondylitis kyphosis deformity treated with pedicle screw internal fixation were selected from the 306 Hospital of Chinese PLA for the analysis. A computer-based search was performed in CNKI database from 2002 to 2011 for the literatures on the effect of pedicle screw internal fixation on the treatment of ankylosing spondylitis kyphosis deformity. The key words were “pedicle screw, ankylosing spondylitis, kyphosis”. A total of 48 literatures were screened out and the data characteristics were in-depth analyzed.
    RESULTS AND CONCLUSION: Ankylosing spondylitis is a kind of chronic diseases and has the characteristics of violation of the central axis of the spine joint, and in the advanced period, it often associates with thoracic or thoracolumbar ankylosing spondylitis kyphosis deformity. The patient is often unable to head-up after thoracic spine flexion increasing, and more serious, the lower ribs will squeeze internal organs and lead to cardiopulmonary dysfunct, which may affect the daily life and the aesthetics. Spinal osteotomy combined with pedicle screw internal fixation orthopedic treatment can achieve good results.

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    Classification and design of artificial hip prosthesis
    Qin Xiao-dong, Fu Qiao
    2012, 16 (35):  6607-6614.  doi: 10.3969/j.issn.2095-4344.2012.35.028
    Abstract ( 2288 )   PDF (729KB) ( 923 )   Save

    BACKGROUND: Total hip replacement means a kind of prosthesis similar to human bone and joint made by the material with good biocompatibility; it can replace the joint or joint plane injured by disease or damage, ease joint pain, correct deformities prosthesis and improve the active function of the joint.
    OBJECTIVE: To multi-level explore and analyze the development trend of the research on the classification and design of artificial hip prosthesis.
    METHODS: A computer-bases search was performed in CNKI database from January 2002 to December 2011 for the literatures related to classification and design of artificial hip prosthesis, the key words were “total hip replacement, artificial hip prosthesis, prosthesis design, type of prosthesis”, and the analysis capabilities of the database and Excel chart function were used to analyze the data characteristics.
    RBSULTS AND CONCLUSION: A total of 135 literatures related to the classification and design of artificial hip prosthesis were screened out from CNKI database (2002/2011), and the number of the literature was on an increasing trend. Most of the literatures were the surgery literatures. As the Journal of Clinical Rehabilitative Tissue Engineering Research has the medical implant column, 33 literatures on the classification and design of artificial hip prosthesis were published. Shanghai Jiao Tong University is the key units for the research of the classification and design of artificial hip prosthesis. And professor Wang Cheng-tao is the main core author of this study. The key words show that the hip and femur biomechanical problem, as well as finite element analysis of artificial hip joint prosthesis, renovated and prosthesis aseptic loosening are the main problem for the classification and design of artificial hip prosthesis.

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    Proximal femoral nail anti-rotation in the treatment of elderly proximal femoral fractures based on hip function
    Liu Bai-feng, Li Chun-long, Han Xue-song
    2012, 16 (35):  6615-6622.  doi: 10.3969/j.issn.2095-4344.2012.35.029
    Abstract ( 294 )   PDF (777KB) ( 410 )   Save

    BACKGROUND: Almost 78.9% patients with proximal femoral fractures are aged over 65, and often accompanied by cardiovascular diseases, diabetes or lung disease. There is high risk of surgical treatment, and there is the phenomenon of osteoporosis and slow fracture healing, so a traumatic small, less bleeding and stable internal fixation method is required.
    OBJECTIVE: To multi-level explore and analyze the researches related to proximal femoral nail anti-rotation for the treatment of proximal femoral fractures.
    METHODS: A computer-based search was performed in CNKI database from January 2008 to December 2011 for the literatures related to proximal femoral nail anti-rotation for the treatment of proximal femoral fractures, the key words were “proximal femoral nail anti-rotation, proximal femoral, fractures, internal fixation”, and the analysis capabilities of the database and Excel chart function were used to analyze the data characteristics.
    RESULTS AND CONCLUSION: A total of 35 literatures related to proximal femoral nail anti-rotation for the treatment of proximal femoral fractures were screened out from CNKI database from 2008 to 2011. In 2011, 23 literatures were obtained in the database, and the number of the literature was on an increasing trend. Most of the literatures were published by Journal of Clinical Orthopaedics. The key words analysis showed that the proximal femoral nail anti-rotation mainly used for the treatment of elderly intertrochanteric fracture. The excellent and good rate of hip function score was more than 80% after the elderly intertrochanteric fracture treated by proximal femoral nail anti-rotation, and the method has the advantages of short operation time, well postoperative healing, less complication and can recover within short time. Proximal femoral nail anti-rotation is an ideal method for the treatment of elder proximal femoral fractures.

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    Effect of setting position of tibial prosthesis on the stability after total knee replacement
    Zhao Jin-ping, Xia Zhi-chang, Jia Zhi-cai
    2012, 16 (35):  6623-6627.  doi: 10.3969/j.issn.2095-4344.2012.35.030
    Abstract ( 356 )   PDF (568KB) ( 416 )   Save

    BACKGROUND: Choice of reference methods and techniques to determine the setting position or parameters of the tibial prosthesis in total knee arthroplasty is still rarely reported.
    OBJECTIVE: To analyze the effect of setting position of tibial prosthesis on its stability and compatibility in total knee replacement.
    METHODS: The articles that related to the tibial prosthesis or angle in the process of total knee replacement were selected through search. For the articles in the same field, those published recently or in the authorized journals were included.
    RESULTS AND CONCLUSION: After preliminary retrieval, 132 articles were screened out and 27 of them were involved in the retrospective analysis according to inclusion criteria. Due to individual differences of the geometry of the proximal tibia and surgical operation, the prosthesis and the proximal tibia section sometimes cannot show a good match. During total knee arthroplasty, the tibial surface angles, alignment and apposition have an important impact on the stability, flexion and extension functions of knee joint and life of the prosthesis; tibial prosthesis placement is directly related to the prosthesis loosening, subsidence and postoperative joint flu after total knee replacement. Therefore, selecting a suitable type of prosthesis for the patients and make a good match between the prosthesis and the proximal tibia section, the prosthesis implantation techniques are also needed to be improved in order to enhance the stability of the prosthesis.

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    Lower limbs angle parameter of elderly in different speeds
    Ding Min, Wu Qing-wen, Liu Feng-li, Guo Li-xia
    2012, 16 (35):  6628-6631.  doi: 10.3969/j.issn.2095-4344.2012.35.031
    Abstract ( 408 )   PDF (356KB) ( 440 )   Save

    BACKGROUND: At present, gait analysis is the main method to measure the joint angles of the patients when walking. However, these measurements in each rehabilitation period are time-consuming. Gait rehabilitation robot Lokomat can real-time record the joint angles and muscle parameters during exercise which is convenient.
    OBJECTIVE: To measure the lower limbs angle parameter of elderly in different speeds by gait rehabilitation robot Lokomat.
    METHODS: Thirty healthy elderly were selected as the research subjects, including 15 men and 15 women. The age was ranged from 60 to 64 years (62.40±1.58). The lower limbs angle parameters of the elderly were recorded under the conditions of 40% weight losing and 60% guidance force and in the speed of 1.6 km/h, 1.8 km/h and 2.0 km/h, respectively.
    RESULTS AND CONCLUSION: Results of dynamic parameters of the subjects showed that there was significant difference of the maximum left hip extension angle under the speed of 1.6 km/h, and there was significant difference of the bilateral hip flexion angle under the speed of 2.0 km/h between male and female groups (P < 0.05). Measurement results of knee and hip joint of elderly under different speeds showed that there was significant difference of the maximum bilateral knee joint extension angle under the speed of 1.6 km/h and 1.8 km/h, 1.6 km/h and 2.0 km/h, 1.8 km/h and 2.0 km/h (P < 0.05). The maximum hip flexion angle in men was greater than that in women under different speeds. Therapists should adjust the joint angle and the training mode of hip and knee joint based on the gender when giving the Lokomat gait rehabilitation training. With the increasing of the hip and knee flexion angle, the extension angle is decreased, and the therapists should adjust the range of motion according to different walking speeds, in order to enhance the co-ordination of leg movements in patients with robot exoskeleton mechanical leg and improve the training effect.

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    General spine system versus AF system fixation for the treatment of single-segment thoracolumbar fracture
    Fang Ti-gang, Fan Shi-feng, Bai Yun-fei
    2012, 16 (35):  6632-6635.  doi: 10.3969/j.issn.2095-4344.2012.35.032
    Abstract ( 313 )   PDF (397KB) ( 554 )   Save

    BACKGROUND: There are many pedicle screw systems, including AF system, general spine system and RF system fixation, but each of them has their disadvantages.
    OBJECTIVE: To compare the outcome of general spine system versus AF system fixation for the treatment of thoracolumbar fracture.
    METHODS: 110 patients with thoracolumbar fracture were divided into general spine system group (n=56) and AF system group (n=54) randomly. At 1 week, 3 months and 1 year follow-up after fixation, the anterior vertebral height, Cobb angle, Frankel grading of spinal cord injury and X-ray results after internal fixation were compared between two groups.
    RESULTS AND CONCLUSION: There was no significant difference of the percentage of vertebral height and Cobb angle between two groups at 1 week and 1 year follow-up after fixation. At 1 week after fixation, the percentage of anterior vertebral height and Cobb angle were better than those before fixation (P < 0.01), and there was no significant difference between two groups at 1 week and 1 year after fixation. According to the Frankel grading, there was no significant difference of the neurological function recovery between two groups after fixation. As for the postoperative complications, there was 1 case of one pedicle screw breakage in general spine system group, 2 cases of nail breaking and 3 cases of rod breaking in AF system group, and there was significant difference. Thoracolumbar fracture can be treated successfully with general spine system and AF system fixation. Compared to general spine fixation system, AF system has more nail breaking and rod breaking and cannot be used for multi-section fixation.

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    Survey on osteoporosis medical therapy in patients with osteoporotic hip fracture
    Wang Hong, Li Ming-sheng, Chen Hai-ling, Deng Li-li, Zhang Quan, Deng Wei, Li Wei
    2012, 16 (35):  6636-6640.  doi: 10.3969/j.issn.2095-4344.2012.35.033
    Abstract ( 308 )   PDF (481KB) ( 413 )   Save

    BACKGROUND: Osteoporosis of the hip is the main reason for the osteoporotic fracture.
    OBJECTIVE: To investigate whether osteoporosis was evaluated and treated appropriately in patients more than 50 years old with hip osteoporotic fracture.
    METHODS: The patients suffered from hip osteoporotic fracture and treated in Beijing Jishuitan Hospital during July 2009 to December 2010 were enrolled. Information were collected from electronic medical records and telephone follow-up, and 484 patients were investigated, the survey including bone mineral density examination, application status of anti-osteoporosis drug and awareness rate of osteoporosis.
    RESULTS AND CONCLUSION: Among 484 patients, bone mineral density examination was performed only in 13 patients (2.7%), 46 patients (9.5%) treated with anti-osteoporosis drugs before fracture, 93 patients (19.2%) received bone mineral density examination and 219 patients (45.2%) were treated with anti-osteoporosis drugs during hospitalization, 14 patients (2.9%) received bone mineral density examination and 96 patients (19.8%) were treated with anti-osteoporosis drugs during hospitalization during follow-up. The application rate of anti-osteoporosis drugs during follow-up was significantly higher than that before hospitalization (P = 0.000). The awareness rate for the patients and their families was 45.9%, and 54% of the patients obtained the information from medical staff. Most patients with hip osteoporotic fracture do not receive adequate anti-osteoporosis drugs or appropriate evaluation before fracture and during rehabilitation, so the awareness rate and the treatment rate of osteoporosis was low.

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    Correlation of Han adolescents’s hand-wrist bone maturation and cervical vertebrae maturation in Urumqi region
    Yang Chuan, Mi Cong-bo, Zu Qing, Xu Hong
    2012, 16 (35):  6641-6645.  doi: 10.3969/j.issn.2095-4344.2012.35.034
    Abstract ( 296 )   PDF (463KB) ( 401 )   Save

    BACKGROUND: Hand-wrist bone maturation as the gold standard for evaluating of bone age has been widely used in the clinical work, but the cervical vertebrae maturation as a new bone age evaluation, with its economic, simple and strong clinical operability has get widespread attention.
    OBJECTIVE: To investigate the correlation between adolescents’s hand-wrist bone maturation and cervical vertebrae maturation in Urumqi region, and to provide valid reference index for making diagnosis and treatment plan in orthodontics.
    METHODS: The lateral cephalograms and hand-wrist radiographs of the 96 cases (34 males, 62 females, 9-15 years of age) were taken before orthodontics treatment. The quality of X-ray image was good, and all the observation indicators were clearly visible without overlapping images. Cervical vertebrae maturation and hand-wrist bone maturation were evaluated.
    RESULTS AND CONCLUSION: The correlation coefficient between cervical vertebrae maturation and hand-wrist bone maturation was high (r=0.703, P < 0.01 for males and r=0.728, P < 0.01 for females respectively). The cervical vertebrae maturation and the hand-wrist bone maturation on lateral cephalogram were valid indicators on orthodontic practice to evaluate preciously patients’ state of development and growth. And the cephalogram can avoid additional X-ray radiation that patients received, reduce the economic burden of patients.

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    Comparison of pain endurance between professional athletes and common people after anterior cruciate ligament reconstruction under arthroscope
    Wang Jia-ning, Hu Yue-lin, Jiao Chen, Guo Qin-wei, Yang Yu-ping, Jiang Dong, Zhang Hai-long
    2012, 16 (35):  6646-6650.  doi: 10.3969/j.issn.2095-4344.2012.35.035
    Abstract ( 453 )   PDF (412KB) ( 431 )   Save

    BACKGROUND: Traditionally, professional athletes are considered more endurable in pain than common people.
    OBJECTIVE: To compare the pain endurance between professional athletes and common people after undertaking anterior cruciate ligament reconstruction.
    METHODS: Twenty patients (10 professional athletes and 10 common people) with anterior cruciate ligament rupture were selected from Peking University Third Hospital from June 2011 to December 2011. All the patients were treated with anterior cruciate ligament reconstruction under arthroscope by the same physician and the same positioning and fixation methods. The visual analogue scale scores for post-operative pain were recorded after the operated extremity obtained full muscle strength.
    RESULTS AND CONCLUSION: The pain of all the patients reached to the intolerable level at 7 hours after the operated extremity obtained full muscle strength, the shortest peak time was 2 hours and the median time was 4 hours. In professional athlete group, the median peak time was 3 hours and 5 hours in common people group, and there was significant difference between two groups (P < 0.05). Professional athletes held worse pain endurance than common people after anterior cruciate ligament reconstruction.

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