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22 July 2012, Volume 16 Issue 30 Previous Issue    Next Issue

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Finite element modeling construction of human lumbosacral vertebrae based on CT data Zhu Li-xin, Wang Jian, Cao Yan-lin, Fan Wang-ju, Yu Guo-ji, Zhang Xi-bing, Ye Wen-ming 2012, 16 (30):  5511-5515.  doi: 10.3969/j.issn.2095-4344.2012.30.001 Abstract ( 220 )   PDF (472KB) ( 448 )   Save BACKGROUND: Now, the establishment of the finite element model is mainly based on the medical image modeling, which can directly reflect the real geometry of the lumbar spine. OBJECTIVE: To establish the three-dimensional finite element model of L1-S5 segment lumbosacral vertebrae based on the CT image data and image processing software. METHODS: A healthy male volunteer was selected; the data of spiral CT scan images of 0.625 mm thickness were imported into the Mimics10.01 software in Dicom format, then the lumbosacral vertebrae three-dimensional geometric mesh model was obtained after three-dimensional treatment. Finally, the three-dimensional finite element model of normal human lumbosacral vertebrae was established by Geomagic studio 12.0, HyperMesh 10.0 and Abaqus10.1 software. RESULTS AND CONCLUSION: Accurate human lumbosacral vertebrae three-dimensional finite element model was established successfully and validated. With the accurate CT scan data, it was efficient and effective to complete the construction of the finite element model of spine by software for image processing. Compared with a single segment mode, the multi-segment model could easily investigate the effect of clinical disease and surgical fixation on the health of spine, which makes up the shortcomings of currently single motion segment model. Related Articles | Metrics

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Finite element analysis of bridge combined fixation system and the locking plate-screw system on the application for femoral fractures Xiong Ying, Li Qun-hui, Liu Bai-lian, Zhao Feng, Wang Da-xing, Zhang Zhong-zi 2012, 16 (30):  5516-5519.  doi: 10.3969/j.issn.2095-4344.2012.30.002 Abstract ( 429 )   PDF (364KB) ( 530 )   Save BACKGROUND: The effect of the bridge combined fixation system for the fixation of bone fracture compared with locking plate system needs to be confirmed by experiment. OBJECTIVE: To compare the biomechanical properties of bridge combined fixation system and locking plate-screw system for the fixation of femoral fractures. METHODS: We used the finite element analysis method to analyze biomechanical characters of the femoral fractures fixed with the locking plate-screw system and bridge combined fixation system, such as the stress distribution and the strain characteristics of bone and fixation. RESULTS AND CONCLUSION: The stress on the locking plate screw when climbing stairs was increased for 48.6% compared with walking, the stress was 480 MPa and the maximum stress was on the middle of the locking plate-screw screws. The maximum stress on the middle of the bridge system when climbing was 34.1% larger than that when walking, the maximum stress was 373.9 MPa and occurred near the distal connection rod. The stress on the fracture area of bridge combined fixation system was smaller than that of locking plate system. In summary, as a new kind of bone fracture internal fixation, the biomechanical property of the bridge combined fixation system is significantly higher than that of the locking plate system with the advantages of better fixation stability and beneficial to bone growth. Related Articles | Metrics

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Three-dimensional gait analysis of the athletic relationship between knee and ankle based on back-propagation neural network Qu Xiao-na, Zhang Teng-yu, Wang Xi-tai 2012, 16 (30):  5520-5523.  doi: 10.3969/j.issn.2095-4344.2012.30.003 Abstract ( 296 )   PDF (404KB) ( 383 )   Save BACKGROUND: The study of the relationship between knee and ankle is poor although there have been a lot of researches on gait of people. OBJECTIVE: To analyze the relationship between knee and ankle based on back-propagation network. METHODS: The gaits of 30 healthy young people walking at fast, normal, and low speeds separately were detected by three-dimensional gait analysis system, and the gait data were investigated and analyzed. The data were predicted through the establishment of the back-propagation neural network and the knee-ankle coordination control method was explored. RESULTS AND CONCLUSION: Different people had different gaits, but the curve obtained by back-propagation neural network was similar with the experimental curve. The paper investigated and validated that it was viable and reasonable to forecast the kinematic relationship between the knee and ankle by back-propagation network system. The paper studied the coordination between the knee and ankle well, and provided the theory foundation for the design of the intelligent prostheses. Related Articles | Metrics

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Biomechanical and three-dimensional finite element analysis of children proximal femur anatomy-type plate Liao Ying, Han Zhi, Wang Xiao-xu, Huang Xuan-huai 2012, 16 (30):  5524-5528.  doi: 10.3969/j.issn.2095-4344.2012.30.004 Abstract ( 271 )   PDF (522KB) ( 335 )   Save BACKGROUND: Previous studies of three-dimensional finite element are more concentrated on orthopedic biomechanics in adults. OBJECTIVE: To investigate the biomechanical property of proximal femur anatomy-type plate for femoral subtrochanteric fractures by three-dimensional finite element analysis. METHODS: Totally 12 femurs were removed from 6 fresh children cadavers, and then divided into two groups after excluding bone disease by X-ray. Children proximal femur anatomy-type plate was used for experimental group, and reconstruction plate was used for control group. Biomechanical tests for the anti-axial compression, torsional stiffness and bending stiffness were performed. A healthy boy was selected to obtain image data of proximal femur by spiral CT scanning technology. The three-dimensional finite element model of children’s proximal femur was established based on plate data to carry out biomechanical analysis. RESULTS AND CONCLUSION: There was no significant difference of axial compression stiffness and torsional stiffness between the two groups (P > 0.05), but bending stiffness of two groups had significant difference (P < 0.05). The results indicated that the capacity of anti-compression and anti-torsion of the children proximal femur anatomy-type plate is equally to reconstruction plant, but the capacity of anti-bend of the children proximal femur anatomy-type plate is superior to the reconstruction plant. Three-dimensional finite element analysis of biomechanics indicated that the design of children proximal femur anatomy-type plate is consistent with biomechanics principle and can meet the need of proximal femur fixation in children with the good intension, rigidity and constancy. Children proximal femur anatomy-type plate has better biomechanical property for the femoral subtrochanteric fracture. Related Articles | Metrics

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Anterior cervical fusion and artificial disc replacement for the treatment of cervical spondylosis Ma Yuan, Liao Wen-sheng, Wang Li-min, Bao Heng, Wang Wei-dong, Tan Hong-yu, Zhang Wei, Jian Guang-xu 2012, 16 (30):  5529-5533.  doi: 10.3969/j.issn.2095-4344.2012.30.005 Abstract ( 316 )   PDF (465KB) ( 373 )   Save BACKGROUND: To data, there is no consistent conclusion on the effect of anterior cervical discectomy and fusion (ACDF) and artificial disc replacement in the treatment of cervical spondylosis. OBJECTIVE: To compare the effect of anterior cervical discectomy and artificial disc replacement in the treatment of cervical spondylosis. METHODS: 106 patients with cervical spondylosis were selected from Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University to perform the retrospective analysis. Nineteen patients received Bryan artificial disc replacement (replacement group), 87 patients received single-level ACDF (ACDF group). RESULTS AND CONCLUSION: All the patients were followed-up for 36-48 months. ①The neurological function of two groups was significantly restored during follow-up, and there was no significant difference of visual analogue scores and JOA scores between two groups during final follow-up (P > 0.05). ②All patients of the ACDF group achieved bone fusion at 6 months after operation without internal fixation loosening, dislocation or breakage. No complications such as prosthesis migration or loosening occurred in replacement group. As for the range of motion of cervical vertebrae and the replacement segment of cervical vertebrae, there was no statistical difference before and after operation (P > 0.05). No serious complications occurred. Single-level artificial disc replacement has fewer complications in the early stage, and the Bryan artificial disc replacement can achieve the satisfactory clinical outcome and preserve the range of motion of cervical vertebrae and the replacement segment of cervical vertebrae. Related Articles | Metrics

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Bipolar femoral head replacement for the treatment of femoral neck fractures in elder Parkinson's disease patients Zhuang Ze, Zeng Chun, Zeng Hua, Wang Kun 2012, 16 (30):  5534-5539.  doi: 10.3969/j.issn.2095-4344.2012.30.006 Abstract ( 470 )   PDF (489KB) ( 415 )   Save BACKGROUND: Due to the muscle imbalance outcomes, Parkinson’s patients are easy to fall and have a high risk of femoral neck fracture. OBJECTIVE: To explore the treatment outcomes of bipolar femoral head replacement for the femoral neck fractures in elder Parkinson’s patients METHODS: A retrospective analysis was carried out on the clinical data of the 14 Parkinson’s disease patients of femoral neck fractures, a total of 14 hips, who were treated with bipolar femoral head replacement. The patients were divided into three phases by Hoehn-Yahr classification, 3 cases in Ⅰ phase, 4 cases in Ⅱ phase, 5 cases in Ⅲ phase and 2 cases in Ⅳ phase. The average surgery age was 62 to 83 years old. The Harris score, Fugl-Meyer scale and Unified Parkinson’s Disease Rating Scale score were used as follow-up judgment. RESULTS AND CONCLUSION: The average follow-up time was 1 to 6 years. Harris score of 14 patients was postoperatively 85.4 better than preoperatively 22.3 (P < 0.05), Fugl-Meyer score was postoperatively 81.6 better than preoperatively 52.5 (P < 0.05). There was no significant difference of Unified Parkinson’s Disease Rating Scale score before and after operation, and the Parkinson’s disease controlled stable. No prosthesis loosening, dislocation or other complications. Early and mid-term follow-up showed under the effective medical control of the neurology drugs, bipolar femoral head replacement is a safe and effective treatment of femoral neck fracture for Hoehn-Yahr Ⅰ-Ⅳ Parkinson’s patient. There is relationship between the hip joint function and the control of the Parkinson’s disease after replacement. Related Articles | Metrics

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Appliation of multimodal pain control protocol in primary total knee arthroplasty Jiang Tao, Qu Yu-xing, Xu Jian-an 2012, 16 (30):  5540-5543.  doi: 10.3969/j.issn.2095-4344.2012.30.007 Abstract ( 297 )   PDF (354KB) ( 482 )   Save BACKGROUND: Acute pain during the peri-replacement period after total knee arthroplasty can impede the early rehabilitation exercises and increase the complications. Although the researchers have proposed a series of new ways and confirmed its effectiveness, the complications of drug abuse and nerve block cannot be avoided. Looking for a safe and effective analgesic program has become an important issue in joint replacement. OBJECTIVE: To evaluate the therapeutic effect and safety of multimodal pain control protocol by periarticular injection of composite narcotic drugs on postoperative pain and functional rehabilitation after total knee arthroplasty． METHODS: Between May 2009 and May 2010, 80 patients undergoing unilateral total knee arthroplasty were divided into two groups. The patients (n=38) in control group received the treatment of femoral nerve block or patient-controlled epidural analgesia; the patients (n=42) in the experimental group were treated with multimodal pain control protocol by periarticular injection of composite narcotic drugs. RESULTS AND CONCLUSION: At 6, 12 and 24 hours and 2 and 3 days after replacement, the visual analogue scale score of the experimental group was lower than that of the control group (P < 0.05). There was no significant difference of visual analogue scale score between two groups at 4 and 5 days after replacement (P > 0.05). Compared with control group, the short-term pain was reduced, time for active and passive flexion 90° was significantly shorter after replacement, and the walker assisted walking fields time was significantly decreased in the experimental group (P < 0.05). The patients in the two groups had the similar incidence of adverse reactions, and no wound infection or delayed healing appeared due to the rational use of drainage. Multimodal pain control protocol after total knee arthroplasty as a secure and effective analgesic program can significantly reduce the pain after replacement. Related Articles | Metrics

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Medium and long term effects of systematic back muscle exercise after percutaneous vertebroplasty for osteoporotic fracture Zhong Yi, Huang Yang-liang, Li Yi-qiang, Wang Chu-huai 2012, 16 (30):  5544-5548.  doi: 10.3969/j.issn.2095-4344.2012.30.008 Abstract ( 305 )   PDF (394KB) ( 450 )   Save BACKGROUND: Percutaneous vertebroplasty has been widely used to treat osteoporotic fractures as its pain relief effect is remarkable; however, the medium and long term effects still remain in uncertainty. It is reasonable to develop back muscle exercise on the purpose of improving clinical outcomes. OBJECTIVE: To analyze the medium and long term effects of postoperative back muscle exercises after percutaneous vertebroplasty for osteoporotic fracture. METHODS: Sixty osteoporotic fracture patients were randomly divided into experimental group and control group to receive the percutaneous vertebroplasty. General post-operation anti-osteoporotic therapy was offered to all the patients, whereas, the experimental group received additional systematic back muscle exercise. Five points support training was used as the first training program; if the exercise was carried on without difficulty; three points support training was taught. One point support training (swallow exercise) was carried out when three points support training was fulfilled satisfy. RESULTS AND CONCLUSION: Forty-two patients (20 in experimental group and 22 in control group) were successfully followed-up for two years. The Oswestry Disability Index of experimental group was significantly better than that of control group in 6 months, 1 and 2 years follow-up (P < 0.05). The Visual Analogue Scale of experimental group was significantly better than that of control group in one and two years follow-up (P < 0.05). It suggested that the benefit of the systematic back muscle exercise required at least 6 months to be observed; however, the favorable effect could be continued for a long time. Therefore, systematic back muscle exercise should be recommended as one of the treatment guideline for post percutaneous vertebroplasty patients. Related Articles | Metrics

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Comparison of biomechanical effect between self-made minimally invasive proximal femoral plate and common dynamic hip screw in stable intertrochanteric fractures Shi Ming, Li Tao, Han Dun-fu 2012, 16 (30):  5549-5553.  doi: 10.3969/j.issn.2095-4344.2012.30.009 Abstract ( 297 )   PDF (411KB) ( 395 )   Save BACKGROUND: A new implant has been developed to fix the stable intertrochanteric fractures. OBJECTIVE: To compare the biomechanical characteristics of self-made minimally invasive proximal femoral plate (SPFP) and dynamic hip screw (DHS) for stable intertrochanteric fractures of the femur. METHODS: The dry femur specimens were collected and the AO type A1.3 stable intertrochanteric fracture model was created successively and fixed with SPFP and DHS respectively. Then, six varistors were arranged along the internal and lateral cortex in the proximal femur. The compression, bending, shear and torsion were detected after fixation. RESULTS AND CONCLUSION: After the stable intertrochanteric fractures of the femur was fixed with SPFP, the internal and lateral strength were 13% higher than that after fixed with DHS, and the internal strength was 16% higher, the torsional strength was18% higher and the torsional stiffness was 31% higher than that after fixed with DHS. There was significant difference between SPFP and DHS fixation (P < 0.05). Compared the biomechanical characteristics of SPFP and DHS, SPFP had distinctive advantages over DHS in anti-tensile, anti-press, anti-rotation and varus ability. Related Articles | Metrics

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Gross distribution and biomechanical significance of bone trabecula of the cancellous around acetabulum Sun Jian-wei, Yin Wang-ping, Zhang Chun-cai, Ren Ke, Gao Zhen-cao, Zhu Xing-fei 2012, 16 (30):  5554-5557.  doi: 10.3969/j.issn. 2095-4344.2012.30. 010 Abstract ( 376 )   PDF (385KB) ( 328 )   Save BACKGROUND: Although a variety of mechanics study on the mechanical characteristics of the pelvis has been performed, but the exact stress distribution in the region remains unclear. ONJECTIVE: To observe the gross distribution of bone trabecula around acetabulum and compare with existing biomechanical research results. METHODS: Four dry pelvic specimens were cut in accordance with the plane which composed of acetabular edge and the plane of obturator in order to observe the distribution patterns of trabecular bone on the cross-section, and to observe the gross distribution of trabecula around acetabulum. RESULTS AND CONCLUSION: The trabeculae of hip bone were divided into three groups. ①Sacropubic bundle: It ran from the auricular surface, posterior superior iliac spine and posterior inferior iliac spine to pubic symphsis along the iliopectinal line, and part of the trabecula terminated in the posterior superior acetabular. ②Iliocotyloid bundle: It ran from the greater sciatic notch of the auricular surface to the superior posterior acetabular, and located in the shallow layer of the sacropubic bundle. ③Ilioischial bundle: From the region of the iliac crest to the ischial tuberosity, part of the trabecula terminated in the anterior superior acetabular. High-density trabecular net transversely located at the level of the sciatic notch, defined by a distinct saltire-shaped crossing over the acetabulum between the sacropubic and the ilioischial bundles. The human hip acetabulum was constituted by iliocotyloid bundle, sacropubic bundle and ilioischial bundle. High-density trabeculum net transversely located at the level of the sciatic notch, iliopubic eminence and the cross-section of sacropubic and the ilioischial bundles. This is consistent with the stress distribution and loading of the acetabular region in the current research. Related Articles | Metrics

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The biomechanical stability of cable dragged reduction and cantilever beam internal fixation by posterior atlantoaxial approach Huang Hai-feng, Liu Hao, Li Tao, Gong Quan, Luo Yu-kun, Wang Bei-yu 2012, 16 (30):  5558-5562.  doi: 10.3969/j.issn. 2095-4344.2012.30. 011 Abstract ( 296 )   PDF (435KB) ( 328 )   Save BACKGROUND: There are many methods of internal fixation for atlantoaxial dislocation caused by odontoid fractures, but all of them emphasize reset before fixation, so there is no a internal fixation both with satisfactory biomechanical stability and better intraoperative reset ability. OBJECTIVE: To evaluate the biomechanical properties of cable dragged reduction and cantilever beam internal fixation via posterior approach for upper cervical spine stability. METHODS: Occipitocervical spine specimens from twelve fresh human cadaveric were selected to establish fracture test model of odontoid Anderson type 2 which were mounted in a spine-testing machine to record the three-dimensional angular movement under 1.5 N•m load. The specimens were fixed by Brooks titanium cable, Magerl screws, the lateral mass screws in the atlas+axial pedicle screw and cable dragged reduction and cantilever beam. RESULTS AND CONCLUSION: Under 1.5 N•m load, the range of motion (ROM) during flexion and side bending of cable dragged reduction and cantilever beam internal fixation group were significantly smaller than those of other groups (P < 0.05). The ROM during in extension of cable dragged reduction and cantilever beam internal fixation group was significantly larger than that of Magerl screws fixation group (P < 0.05), but which was smaller than that of the Brooks titanium cable and pedicle screw fixation groups (P < 0.05). The ROM during rotation of cable dragged reduction and cantilever beam and Magerl screws fixation groups had no difference (P > 0.05), but which was smaller than that of the Brooks titanium cable and pedicle screw fixation groups (P < 0.05). The results indicated that stability of cable dragged reduction and cantilever beam internal fixation via posterior approach are better than the other groups, but which was only lower than Magerl screws fixation in the stability of the extension. Related Articles | Metrics

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Biomechanical properties and the effectiveness of posterior nail-rod for the treatment of sacroiliac joint dislocation He Li, Jia Jian, Liang Yan, Ge Zhen-xin, Ma Bao-tong 2012, 16 (30):  5563-5568.  doi: 10.3969/j.issn.2095-4344.2012.30.012 Abstract ( 380 )   PDF (495KB) ( 360 )   Save BACKGROUND: Sacroiliac screw has been widely used in the treatment of the sacroiliac joint dislocation, but it cannot achieve strong mechanical intensity due to its poor biomechanical properties. OBJECTIVE: To explore the mechanical intensity and clinical efficacy of posterior nail-rod for the treatment of sacroiliac joint dislocation. METHODS: ①Twelve cadaveric pelvis specimens, six males and six females, were selected to make the sacroiliac joint dislocation model and pubic symphysis separation model by cutting off the sacroiliac joint ligaments and pubic symphysis structure. Specimens were randomly divided into two groups: iliosacral screw fixation group and pelvis posterior single nail-rod fixation group, specimens in the two groups were fixed with iliosacral screw and pelvis posterior single nail-rod respectively. ②The clinical indications of ingle nail-rod system were set up, and the clinical data of 16 sacroiliac joint dislocation patients were collected, Mears image evaluation standard and pelvic fractures Majeed curative effect were used to assess data statistics and score. RESULTS AND CONCLUSION: In the same load, the displacement, axial stiffness, ultimate-load and yield-load of the posterior single nail-rod group were larger than those of iliosacral screw group (P < 0.05). All the 16 patients were followed-up for an average of 23.2 months (3-45 months). According to Mears image standard, there were 13 cases of anatomical replacement, and 3 cases in satisfaction. Pelvic fractures Majeed score was 60 to 100 points, 82 points in average; the good rate of C1 type fracture was 82%, and good rate of C2 type fracture was 80%. Compared with iliosacral screw fixation, the single nail-rod fixation for the treatment of sacroiliac joint dislocation has reliable strength stiffness and clinical curative effect. Related Articles | Metrics

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Effect of bone targeted affinity medicinal guiding in preventing and treating primary osteoporosis Wu Mi-shan, Wu Bo-wen, Ren Li-zhong, Wang Ru, Bai Xia, Han Hong-wei, Li Bin, Zhao Su-zhi 2012, 16 (30):  5569-5576.  doi: 10.3969/j.issn.2095-4344.2012.30.013 Abstract ( 297 )   PDF (583KB) ( 372 )   Save BACKGROUND: The theory of “kidney is in charge of the bones” is in line with the mechanism of bone metabolic regulation in modern medicine, the tonifying kidney prescriptions made according to the bone targeted affinity and medicinal guiding of cell signal transduction has effective action for osteoporosis, but further researches should focus on the action mechanism of the compatibility ratio of high dose and low dose guiding drugs at skeleton formation. It can clarify the two arguments about application of high dose and low dose guiding drugs by observing osteoporosis relevant specific indexes in clinic. OBJECTIVE: To investigate the correlation between target-oriented administration and drug own selectivity target-tropism special guiding carrier structure by comparing the treatment effects of the channel tropism functions of prescription for kidney tonifying of the compatibility ratio of high dose and low dose guiding drugs on primary osteoporosis of the channel and collaterals according to diagnosis. METHODS: The 180 patients with osteoporosis were randomly divided into six groups: high dose guiding drugs for kidney meridian group (HKG), low dose guiding drugs for kidney meridian group (LKG), high dose guiding drugs for liver meridian group (HLG), low dose guiding drugs for liver meridian group (LLG), high dose guiding drugs for spleen meridian group (HSG), low dose guiding drugs for spleen meridian group (LSG) with 30 cases in each group. Patients in HKG, HLG and HSG were given 20 g Achyranthes bidentata Bl versus 10 g Kang Gu Song Dan Qi instant granules every time respectively, three times daily for successive 6 months. Patients in LKG, LLG and LSG were given 20 g Achyranthes bidentata Bl versus 10 g Kang Gu Song Dan Qi instant granules every time, three times daily, six months as one course of treatment, and no other anti-osteoporosis treatment was performed during administration. The curative effect was evaluated by observing bone ache symptoms and changes in bone mineral density of lumbar vertebrae, serum calcium, alkaline phosphatase, bone gla protein, urinary hydroxyproline, urine calcium, urine creatinine, estradiol and testosterone. RESULTS AND CONCLUSION: High dose guiding drugs versus Kang Gu Song Dan Qi instant granules could treat primary osteoporosis of the channel and collaterals according to diagnosis. It could obviously increase the bone mineral density of lumbar vertebrae and the alleviating rate of ostealgia, and without any related adverse effect. Prescription for tonifying kidney of the compatibility ratio of high dose and low dose guiding drugs has effects on treating the primary osteoporosis, and the effect of the former is better than the latter. Related Articles | Metrics

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Effects of low frequency pulsed electromagnetic fields on the serum osteoprotegerin and nuclear factor-kappa beta ligand receptor activator in postmenopausal osteoporosis patients Chen Jian, Huang Hui, He Jian-quan, Huang Li-qun, Li Wu-liang 2012, 16 (30):  5577-5580.  doi: 10.3969/j.issn.2095-4344.2012.30.014 Abstract ( 340 )   PDF (388KB) ( 347 )   Save BACKGROUND: Pulse electromagnetic fields (PEMFs) can overcome the defects of the traditional treatment and have the treatment function to osteoporosis causing pain, bone mass and bone mineral density reducing. OBJECTIVE: To investigate the mechanism of low frequency PEMFs on the treatment of postmenopausal osteoporosis. METHODS: 150 postmenopausal women were selected to measure the lumbar bone mineral density by dual-energy X-ray absorptiometry based on the WHO standard. The results showed there were 50 cases of no osteoporosis and 100 cases of osteoporosis. The patients with osteoporosis were randomly divided into osteoporosis group and low frequency PEMFs group; the patients in these two groups were treated with oral calcium or oral calcium+14 days consecutive low frequency PEMFs. RESULTS AND CONCLUSION: Baseline materials in three groups were comparative. Women without osteoporosis showed higher levels of bone mineral density than women with osteoporosis (P < 0.01), and were not changed after treated with low frequency PEMFs (P > 0.05), but, the level of serum β-CrossLaps was significantly decreased (P < 0.05), the level of bone gamma-carboxyglutamic-acid-containing proteins was significantly increased (P < 0.01). Compared with osteoporosis group, the level of serum osteoprotegerin was significantly increased in no osteoporosis group and low frequency PEMFs group (P < 0.05) and the level of serum osteoprotegerin, nuclear factor-kappa beta was significantly decreased (P < 0.05). Low frequency PEMFs intervention for 14 days has a good preventive effect on osteoporosis. Related Articles | Metrics

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Effect of low-level laser on the healing of bone tissues around the implant in tibia of Beagle dogs Fan Qin, Xu Shi-tong, Liu Jian-guo, Lü Cong 2012, 16 (30):  5581-5585.  doi: 10.3969/j.issn.2095-4344.2012.30.015 Abstract ( 353 )   PDF (463KB) ( 469 )   Save BACKGROUND: There is no definitive conclusion for the effect of low-level laser irradiation on the healing and osseointegration of bone tissues around the implant. OBJECTIVE: To investigate the effect of low-level He-Ne laser irradiation on the healing of bone tissues around the implant. METHODS: Thirty-six implants were randomly divided into three groups and planted into both sides of tibia of six Beagle dogs. The dogs were received low-level He-Ne laser irradiation for 1 and 2 weeks, but the dogs in the control group did not receive laser irradiation. Two dogs were randomly euthanized at 4, 8 and 12 weeks respectively. RESULTS AND CONCLUSION: Methylene blue-acid fuchsin staining showed that the healing degrees of the bone tissue around the implant were higher by laser irradiation. Bone histomorphome showed that the bone-implant contact ratio was gradually increased in a time-depend manner; at the same time points, the bone-implant contact ratio was highest in the 2-week irradiation group, and followed by 1-week irradiation group. The results revealed that the locally low-level He-Ne laser irradiation could promote the healing of bone tissue around the implant and increase the degree of osseointegration. Related Articles | Metrics

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Effect of prostaglandin E2 on the acute pain of the patients with simple closed long bone fracture Ding Yang-yang, Ding Cheng-biao, Zhang Jian-xiang, Tang Jian, Peng Lei 2012, 16 (30):  5586-5590.  doi: 10.3969/j.issn.2095-4344.2012.30.016 Abstract ( 361 )   PDF (459KB) ( 398 )   Save BACKGROUND: The accumulation of prostaglandin E2 can cause the pain and increase the sensitivity of pain producing substance, such as the bradykinin, and decrease the pain threshold of the nerve root and cause the pain. OBJECTIVE: To observe the effect of prostaglandin E2 in the acute pain caused by acute fracture. METHODS: The patients with acute pain symptoms caused by simple acute closed long bone fracture received the analgesic treatment by intravenous injection of non-steroidal anti-inflammatory analgesics drug (intravenous flurbiprofen axetil injection). The pain visual analogous scale score was used to measure the pain scores before and after treatment, and the prostaglandins levels of the blood samples were measured. RESULTS AND CONCLUSION: The visual analog scale score and the level of prostaglandin E2 at 30 minutes before medication and 6 hours after medication were significantly higher than those at 2 hours after medication (P < 0.05). It confirmes that prostaglandin E2 plays an important role in the treatment of acute pain caused by simple acute closed long bone fracture, active use of analgesic drugs that inhibit the prostaglandin levels can effectively control the pain. Related Articles | Metrics

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Epidemiological distribution characteristics of distal radial fractures in 1 875 patients from the same institution in a year Huo Li-wei, Wang Guang-wei, Yu Wei-zhong, Huang Hong-xing, Huang Chong-bo 2012, 16 (30):  5591-5595.  doi: 10.3969/j.issn.2095-4344.2012.30.017 Abstract ( 280 )   PDF (383KB) ( 389 )   Save BACKGROUND: The epidemiological studies to the distal radial fractures can help us to understand the clinical characteristics in this region. OBJECTIVE: To study the epidemiological distribution characteristics of the distal radial fractures patients. METHODS: The study involved 1 875 patients (877 males and 998 females) with distal radial fractures who admitted to the Guangzhou Orthopaedic Trauma Hospital from August 2010 to July 2011. The characteristics, injury time and causes, fracture types and treatment approaches of the patients were collected and reviewed retrospectively. And the distribution of the epidemiological characteristics was described. RESULTS AND CONCLUSION: ①There was no significant difference in the distribution of the distal radial fractures in terms of age (P > 0.05). Patients with the age of 50-59 years accounted for 21.28%．②There was significant difference in the distribution of the distal radial fractures in terms of cause (P < 0.05). Slip was the leading cause of the distal radial fracture (53.7%). ③There was no significant difference in the distribution of the distal radial fractures types in terms of gender (P > 0.05). As for gender distribution, distal radial fractures usually occurred in the females (the male to female ratio was 0.89:1). ④Reset the fixed splinting techniques was the predominant management approaches, accounting for 88.96%. The distribution of the distal radial fractures of patients has unique characteristics in aspects of individual character, injury cause and treatment approach. Related Articles | Metrics

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Radiological evaluation of the anchor point of femoral neck axial line tail on the femoral lateral wall Yan Shi, Liu Zhen-hong, Feng Zhen, Zhao Jing-xin, Zhang Zhen-hua, Dong Yan-jun, Wu Li-xin, Li Cheng-ping 2012, 16 (30):  5596-5599.  doi: 10.3969/j.issn.2095-4344.2012.30.018 Abstract ( 289 )   PDF (976KB) ( 389 )   Save BACKGROUND: Determining the anchor point of femoral neck axial line tail on the femoral lateral wall is the most primary and critical steps for the placement of internal fixator during the treatment of femoral intertrochanteric fractures. OBJECTIVE: To radiological confirm the anchor point of femoral neck axial line tail on the femoral lateral wall. METHODS: The central line on the anterior surface of the femoral neck along femoral neck and the vertical central line on femoral proximal lateral wall were drawn on 80 adult femoral specimens. The intersection point of the above two central line was assumed as the anchor point of femoral neck axial line tail on the proximal femoral lateral wall. The thin steel wire was placed around the middle of femoral neck closely and a small steel ball was struck on the anchor point (A) and the on the point which located at 1.0 cm (B), 2.0 cm (C) and 3.0 cm (D) below the slope top point on the longitudinal center line on lateral surface of proximate femur, then the X-ray images were took along the femoral neck axis, and the location of the small steel ball imaging on the wire circle was observed. The distance between the center point of the small steel ball and the wire circle was measured, and the amount of the imaging point in the center. RESULTS AND CONCLUSION: The proportion of the small steel ball imaging that located on the point A, B, C and D on the center of the wire circle was 85%, 18.75%, 81.25% and 35%, and there was significant difference of the proportion between point B and D and point A (P < 0.05). The intersection point of the central line on the anterior surface of the femoral neck and the vertical central line on femoral proximal lateral wall can be regarded as the anchor point of femoral neck axis tail on femoral lateral wall . Related Articles | Metrics

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Accuracy of body mineral density of rats with different measurement methods by dual energy X ray absorptometry Wang Rui-chen, Li Yan, Dong Jun 2012, 16 (30):  5600-5603.  doi: 10.3969/j.issn.2095-4344.2012.30.019 Abstract ( 774 )   PDF (424KB) ( 432 )   Save BACKGROUND: Dual energy X-ray absorptiometry is regarded as the gold standard for osteoporosis diagnosing, but its system default measurement method has large errors on the measurement of small animal bone density. OBJECTIVE: To study the effect of different measurement methods of dual energy X ray absorptiometry on the accuracy of bone mineral density measurement. METHODS: Whole body scan of 6-7 months female SD rats was performed by dual energy X ray absorptiometry. Custom manual rectangular pattern, custom manual oval way and system default standard way were used respectively to measure the bone mineral density of rat body, head and spine. RESULTS AND CONCLUSION: There was no significant difference of the body, head and spine bone mineral density measured by custom manual elliptic way and system default standard way (P > 0.05), while the bone mineral density measured by custom manual rectangular pattern and the system default standard methods was significantly different (P < 0.01). The manual elliptic way and the system default standard way of dual-energy X ray absorptiometry have little effect on the measurement results, but the custom manual rectangular pattern has large error. Manually elliptic way can be considered as one of the analysis method after small animal bone mineral density measurement. Related Articles | Metrics

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Evaluation of the occult lesions and soft tissue injury after knee injury by 64-slice spiral CT Zhong Jun, Yang Fa-bao, Zhao Xue-hang, Zhang Li, Li Qin-xiang 2012, 16 (30):  5604-5608.  doi: 10.3969/j.issn.2095-4344.2012.30.020 Abstract ( 362 )   PDF (479KB) ( 379 )   Save BACKGROUND: The patients with knee trauma received the 64-slice spiral CT examination after the X-ray examination, and there still some differences on the choice of the post-processing technology in clinic according to the injury and reconstruction needs. OBJECTIVE: To investigate application value of 64-slice spiral CT and the post-processing technology in the knee injury. METHODS: The imaging data of the X-ray and 64-slice spiral CT of the 79 patients with knee injury were retrospectively analyzed, the post-processing technology, such as the multiple planar reformation, volume rendering and shaded surface display were adopted and combined with the image of the original bone and soft tissue window, and the images were dealt by two or more experienced X-ray and orthopaedic surgeons with double-blind analysis and compared with the clinical and operation results . RESULTS AND CONCLUSION: In all the 79 patients with knee injury, there were a total of 92 fractures. Ordinary X-ray diagnosis showed 68 cases of 82 fractures, except one false positive and five false negative, the detection rate was about 89%; after the 64-slice spiral CT and three-dimensional reconstruction, 79 cases of 92 fractures were diagnosed, the detection rate was 100%. Compared with the X-ray examination, the 64-slice spiral CT and the many kinds of reconstruct technique are important auxiliary examination methods of the knee injury, and they can further identify whether there are secretiveness fracture, micro fractures, dislocation and soft tissue injury around the knee joint. Related Articles | Metrics

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Imaging changes of acromioclavicular joint after removing hook plate and the necessity of hook plate removal Fan Rong, Wang Shi-bo, Luo Yu-chun 2012, 16 (30):  5609-5613.  doi: 10.3969/j.issn.2095-4344.2012.30.021 Abstract ( 321 )   PDF (497KB) ( 582 )   Save BACKGROUND: Now the studies on hook plate are mainly the curative effect and complications after internal fixation, but studies about symptoms and corresponding imaging changes after removing internal fixation are rarely. OBJECTIVE: To discuss the symptoms and imaging changes after removing hook plate and the necessity of removing hook plate. METHODS: Totally of 87 patients with the hook plate for the treatment of Neer Ⅱ type of distal clavicle fractures and Tossy Ⅲ type acromioclavicular joint dislocation were selected from Department of Orthopedics, the 101 Hospital of Chinese PLA between January 2009 and January 2011. There were 54 males and 33 females, aged 20-61years old with the average age of 39.8 years. All the patients were taken conventional X-ray after the hook plate removal. Shoulder joint function was tested by using Constant-Murley score system before and after the hook plate removal. RESULTS AND CONCLUSION: All the 87 patients were followed-up for 8 to 18 months. The hook plate was removed at about 12 weeks. Wound healing was well and without infection, fixation fracture and hook loosening. Constant-Murley score after the hook plate removal was significantly increased as compared with that before removing the plate (P < 0.001), except 8 cases were opposite which corresponding X-ray films were mainly represented bone absorption, acromioclavicular arthritis and acromion degeneration. The X-ray films explained why the score in the eight cases was opposite and this could be regarded as the diagnostic criteria to guide clinical treatment after removing fixation. It is recommended that the fixation should be timely removed after the shoulder ligaments (acromioclavicular ligament coracoclavicular ligament) healing. Related Articles | Metrics

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Angiography verification and clinical predictors of anatomical variations of radial artery in the southerner of China Li Lang, Zhong Ji-ming, Wu Xiang-hong, Tang Er-wen, Chen Wei, Xu Ge, Zeng Wei 2012, 16 (30):  5614-5619.  doi: 10.3969/j.issn.2095-4344.2012.30.022 Abstract ( 401 )   PDF (468KB) ( 416 )   Save BACKGROUND: There has rarely reported about the epidemiological study on vascular tortuosity and variation of radial artery in the southerner of China. OBJECTIVE: To investigate the incidence and clinical predictors of arterial anatomical variations of radial artery approach (RAA) in the southerner of China. METHODS: Totally 1 400 patients who underwent first-time transradial coronary procedures were included in this study. A detailed patient history was recorded. Radial arteriography was performed in all patients to detect the anatomic variations of this vessel. And then coronary angiography or percutaneous coronary intervention was undertaken. Multivariate Logistic regression analysis was performed to evaluate the predictive value of variables in arterial variations of RAA. RESULTS AND CONCLUSION: For people in southern China, the tortuosity of subclavian artery and radial artery was most common among vascular anatomic variations of the RAA. The overall rate of transradial procedural success rate was 96.1%. Procedural failure rate was more common in patients with anomalous RAA than in patients with normal RAA (15.1% vs 1.8%, P < 0.001). According to multivariate Logistic regression analysis, age, female gender, height, body mass index, hypertension, hyperlipidemia and smoking were independently associated with arterial anatomical variations of RAA. Related Articles | Metrics

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Research on information extraction technology of digital imaging and communications in medicine enhanced information objects Lü Xiao-qi, Hao Xiao-jing, Gu Yu 2012, 16 (30):  5620-5624.  doi: 10.3969/j.issn.2095-4344.2012.30.023 Abstract ( 407 )   PDF (482KB) ( 1292 )   Save BACKGROUND: With the development of medical imaging technology, earlier information object definition based on digital imaging and communications in medicine standard cannot highlight the new features of the image sequence. OBJECTIVE: To analyze the new technology, new structure and mechanisms of the enhanced information object and to find a way which can browse enhanced information object normally and gain relevant information. METHODS: The structure of enhanced information object was analyzed according to digital imaging and communications in medicine standard, based on the object-oriented programming, the image browsing was realized and the detailed information of image object was obtained. RESULTS AND CONCLUSION: This program could browse the enhanced information object smoothly and conveniently and get their label information. The existing medical image processing software can be improved and optimized by using this program. And the information can provide powerful technical support for three-simensional reconstruction and hang protocol and so on. Related Articles | Metrics

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A three-dimensional dose calculation method for electron beam irradiation based on CT images Weng Deng-hu, Xu Hai-rong 2012, 16 (30):  5625-5629.  doi: 10.3969/j.issn.2095-4344.2012.30.024 Abstract ( 407 )   PDF (458KB) ( 528 )   Save BACKGROUND: Electron beam irradiation can effectively cure superficial and eccentric tumors. Combined with CT images and three-dimensional dose algorithm, we can also realize the precise quantification of tumor dose using electron beam irradiation, which is more advantageous to tumor local controlling. OBJECTIVE: To study and implement a three-dimensional electron beam dose calculation method based on CT images. METHODS: The CT images of patients with nasal cavity and ethmoid sinus cancer were collected. Microsoft Visual C++ was used to parse CT images for related information, and then the human body emulational matrix was built for the dose model calculation, including oblique incidence correction and tissue inhomogeneity correction. The sagittal and coronal CT images in the three-dimensional display were reconstructed using VTK technique. The dose distribution curves displayed on cross-sectional, sagittal and coronal images were drawn by the dose distribution calculation methods. RESULTS AND CONCLUSION: According to the object-oriented analysis and design concept, we developed a high-visualized treatment planning software with interactive interface that is easy to operate. Besides, it could calculate accelerator output dose based on given target area dose. High doses line could be a very good conformal target area, and it could minimize the dose on the normal tissues and key organs, thereby protecting the tissues and organs. This planning software we developed realized the dose visualization in patients undergoing electron beam radiation therapy, and visually displayed the dose distribution, which is of significance for further improving the curative effects of radiation treatment and subsequent research of accurate radiotherapy. Related Articles | Metrics

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Design of mobile monitoring and orientation system based on 3G network Jin Hao-yu, Chen Hai-jun 2012, 16 (30):  5630-5633.  doi: 10.3969/j.issn.2095-4344.2012.30.025 Abstract ( 325 )   PDF (418KB) ( 582 )   Save BACKGROUND: To understand the disease situation timely has a great impact on the diagnosis and treatment. OBJECTIVE: To design a mobile monitoring and orientation system based on 3G network in order to solve the problem of data transmitting while patients are not in the hospital. METHODS: The patients’ real-time physical information gathered by pluggable monitor and location information was sent to the 3G mobile communication network through the locating transmission module, and then the mobile monitoring function was realized by receiving patients’ information through the server program compiled on the PC with true IP; the packet loss and error problems during transmission were solved through the development of wireless transmission protocols and software design. RESULTS AND CONCLUSION: The experiment result indicated that this system could transmit and display the patients’ real-time monitoring information and location information in long-distance, dynamically and without error. The system can work stable with low costs, and the study has great application value. Related Articles | Metrics

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Design of artificial hip joint prosthesis and analysis of interface stress An Ming-xun 2012, 16 (30):  5634-5638.  doi: 10.3969/j.issn.2095-4344.2012.30.026 Abstract ( 280 )   PDF (588KB) ( 705 )   Save BACKGROUND: A correct prosthesis with good compatibility to the host is the key for the success of total hip arthroplasty, and it relates to the biomechanical properties and service life of artificial joint after replacement. OBJECTIVE: To summarize the research progress about artificial hip joint prosthesis and to analyze the effect of artificial hip joint prosthesis design and interface stress on the compatibility of clinically used metal hip joint. METHODS: An electronic retrieve was performed in Wanfang database from January 2000 to December 2011 for articles regarding the hip prosthesis materials and artificial hip replacement, key words were "hip joint, prosthesis, replacement, biomechanics" in Chinese. The repetitive studies, reviews or Meta analysis articles were excluded. RESULTS AND CONCLUSION: Finally, 34 articles were involved into the evaluation. After total hip arthroplasty, biomechanical properties of artificial joint are closely related to its service life, prosthesis stress can be decomposed into normal stress and shear stress, the normal stress is beneficial for the prosthetic fixation and stress transfer, while the shear stress may lead to loosening of prosthesis. Common complications that influence the middle- and long-term effects after hip replacement include the changes of bone quality and bone mass surrounding the prosthesis, prosthetic loosening and dislocation, fracture around the prosthesis, material wearing and periprosthetic infection. Currently, there is no ideal prosthesis with a good biocompatibility and biomechanical compatibility, and further studies are required to conclusively determine the design, manufacture, wear resistance, interfacial stress and other biomechanical properties of artificial hip joint prosthesis, which all contribute to better adapt to the host. Related Articles | Metrics

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Effect and biomechanical analysis of steel plate implantation for traumatic fracture of long bone Chen Lu 2012, 16 (30):  5639-5643.  doi: 10.3969/j.issn. 2095-4344.2012.30. 027 Abstract ( 249 )   PDF (612KB) ( 351 )   Save BACKGROUND: The research and development of the medical metal materials should be started from the existing problems, using the new technologies and new processes to improve the performance of bio-metallic materials, in order to meet the bone physiological conditions. OBJECTIVE: To investigate the clinical effect of metal plate implantation for the treatment of traumatic fracture with emphasis on the biomechanical characteristics of bone metal plate. METHODS: A computer-based retrieval of PubMed database, VIP database and Wanfang database from January 2001 to January 2012 was performed for papers regarding the treatment of bone injury and metal materials fixation with the key words of “bone, medical, metal, materials” in English and “fracture, screw, fixation, mechanics” in Chinese in the titles and abstracts. Finally, 24 articles were involved in the final analysis according to the inclusion criteria. RESULTS AND CONCLUSION: With the development of the raw material industry progress and the renewal of orthopedic fixation devices, the orthopedic internal fixation plate and screws applied by vast majority of medical institutions have a good biocompatibility and stiffness. The domestic metal plate has the weak stress point at the junction of screw tail and screw rod, which may lead to the screw loosing, fracture at the junction of screw tail and screw rod, sliding-filament of the crew tail and slipping. It indicates that the plate quality, number of screws, forging process and clinical placement method may influence the biomechanics of internal fixation system. Related Articles | Metrics

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Development and application of pedicle screw fixation and computer navigation technology Jin Dong, Zhang Guo-zhong 2012, 16 (30):  5644-5647.  doi: 10.3969/j.issn.2095-4344.2012.30.028 Abstract ( 338 )   PDF (531KB) ( 472 )   Save BACKGROUND: Thoracolumbar pedicle screw fixation techniques play an important role in the development of spinal surgery, and spine computer navigation system can significantly improve the accuracy and safety of pedicle screws. OBJECTIVE: To study the clinical application of pedicle screw fixation. MESHODS: A computer-based retrieve was performed for the articles on the application of pedicle screw fixation and computer navigation technology in the fixation from January 1999 to December 2011 with the key words of “pedicle screw fixation, computer navigation technology, clinical application” in Chinese. Repetitive articles and Meta analysis articles were eliminated. Finally, 25 articles were included to discuss the research progress of pedicle screw fixation and relevant evaluation. RESULTS AND CONCLUSION: Computer-aided surgical technique is a new technology that can help surgeons to make the surgery safer and accurately through virtual the surgical environment based on the high-speed processing of large amounts of data information and control capabilities of computer. Recently, we have achieved great development on the study of thoracolumbar pedicle screws technology, especially the intraoperative monitoring tool, it has developed from traditional X-ray fluoroscopy or radiography monitoring and positioning to visualize monitoring by computer-aided technology. Computer navigation technology can simulate and measure the length and angle of the pin tract and the diameter of pedicle from the three-dimensional image data stored in the computer, which is benefit to select the pedicle screw with the best length and diameter, so that to make the pedicle screw surgery more precise, simple, fast and safe and then reduce the occurrence of postoperative complications. Related Articles | Metrics

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Comparative analysis on domestic and foreign research of magnetic resonance imaging in the diagnosis of rheumatoid arthritis Zhang Hui-bo, Liu Min, Wang Li, Jiang Tao, Zhai Ren-you 2012, 16 (30):  5648-5661.  doi: 10.3969/j.issn.2095-4344.2012.30.029 Abstract ( 320 )   PDF (759KB) ( 524 )   Save BACKGROUND: Rheumatoid arthritis diagnosis often depends on the clinical manifestations, laboratory tests and imaging examination. Magnetic resonance imaging technology has a good tissue resolution, and has higher sensitivity in the early diagnosis of rheumatoid arthritis. OBJECTIVE: To compare and analyze the domestic and foreign research of magnetic resonance imaging in the diagnosis of rheumatoid arthritis and to understand the trend of the research in this area. METHODS: A computer-based search was performed in CNKI database and SCI database from January 2002 to December 2011 for the articles related to the magnetic resonance imaging in the diagnosis of rheumatoid arthritis. The key words were “rheumatoid arthritis, image, magnetic resonance imaging” in Chinese and “MRI, rheumatoid arthritis, RA” in English. The analysis capabilities of the database and Excel charts function were used to analyze the data characteristics. RESULTS AND CONCLUSION: A total of 60 articles were obtained from CNKI database and 300 articles were obtained from SCI database, the number of the articles obtained from the SCI database was significantly higher than that obtained from CNKI database, the number of the articles from two databases showed an overall upward trend. For the articles related to the rheumatoid arthritis diagnosed by magnetic resonance imaging, most of them published in CNKI database were Magnetic Resonance Imaging, Medical Imaging Technology and Chinese Computed Imaging and most of the articles in SCI database were Annals of the Rheumatic Diseases, and the highest impact factor was 8.727. For the articles contained in CNKI database, 5 articles were published by People’s Hospital of Peking University, and in SCI database, 37 articles were published by University of Leeds, followed by Auckland University and the Hospital of University of Copenhagen. For the download frequency, Arthritis and Rheumatism got the highest reference times, so Arthritis and Rheumatism has become the classic journal of rheumatoid arthritis diagnosed by magnetic resonance imaging. To analyze from the national distribution of the articles, most of the articles in SCI database were published by England and United States, and a small amount of articles from China were published in SCI database. Related Articles | Metrics

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Peripheral fractures of prosthesis of femur after total hip arthroplasty Zheng Dong 2012, 16 (30):  5662-5669.  doi: 10.3969/j.issn.2095-4344.2012.30.030 Abstract ( 451 )   PDF (766KB) ( 483 )   Save BACKGROUND: Total hip arthroplasty is the most effective method for treatment of severe hip disease, and peripheral fractures of femur prosthesis is a serious complication after total hip arthroplasty. OBJECTIVE: To explore the trend of the literatures related to peripheral fractures of femur prosthesis after total hip arthroplasty. METHODS: A computer-based research was performed in CNKI database from January 2002 to December 2011 for the literatures related to the fracture around the femur prosthesis after total hip arthroplasty. The key words were “total hip arthroplasty, prosthesis, peripheral fractures”. The database analysis capabilities and Excel charts functions was used to analyze the data characteristics. RESULTS AND CONCLUSION: The peripheral fractures of femur prosthesis after total hip arthroplasty was mainly caused by the trauma, and the renovation treatment, aging of the patients, the type of prosthesis, the fixation of the prosthesis and the increasing of the amount of joint activities also related to the occurrence of the fracture. Vancouver typing methods were often used to evaluate the peripheral fractures of femur prosthesis after total hip arthroplasty. Vancouver typing included the site of fracture, the type of fracture, fixation of prosthesis, loosening of the prosthesis and bone loss of proximal femur and other factors, which has a good guiding value on the treatment of peripheral fractures of femur prosthesis. The shape memory embracing fixator, less invasive stabilization system, locking compression plate, allogenic cortical bone plates, carbon fiber plates, impaction bone grafting and revision and other fixation methods are often used for the treatment of peripheral fractures of femur prosthesis after total hip arthroplasty. Related Articles | Metrics

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The literature analysis of the intramedullary nailing implantation for the treatment of children’s femoral shaft fracture based on the Science Citation Index database Wu Su-ying 2012, 16 (30):  5670-5675.  doi: 10.3969/j.issn. 2095-4344.2012.30. 031 Abstract ( 226 )   PDF (566KB) ( 307 )   Save BACKGROUND: The femoral shaft fractures are common in orthopedic trauma department for children, which were treated by traction, cast immobilization, and rarely by surgery in the past. The treatment was simple, low cost, but children would suffer in bed for a long time, more complications. In recent years, an increasing number of orthopedic surgeons began to use a fixed method of surgery and a variety of devices. Elastic intramedullary nailing is an effective method of treatment for children with femoral shaft fractures, and provides a good choice with less trauma, quicker recovery, and shorter stay in bed, early weight the advantages of restoring function. OBJECTIVE: To explore the application of the intramedullary nail as well as the advantages of titanium elastic intramedullary nailing for the treatment of children’s femoral shaft fracture. METHODS: A retrieval was performed for the literature of the intramedullary nailing implantation for the treatment of children’s femoral shaft fracture, using key words of femoral shaft fracture, intramedullary nail, elastic stable intramedullary nailing, titanium elastic nail, child, internal fixation between 2001 and 2010 in SCI database. RESULTS AND CONCLUSION: The flexible intramedullary nailing for the treatment of children with backbone and metaphyseal fractures generally requires the minimum age of 3 to 4 years, a maximum of 13 to 15 years. The type of fracture to the femoral fractures and short form the middle normal oblique fractures for best, near the femoral big rotor or of the femoral condyle fracture use less as far as possible intramedullary nail was fixed. The flexible intramedullary nailing for the treatment of children’s femoral shaft fracture had fewer complications, and satisfactory clinical results. The literature of intramedullary nailing for the treatment of children’s femoral shaft fracture in the SCI database as well as at the national regional distribution, institutional distribution, the distribution of source journals showed an upward trend, and the research literature mainly to the United States and other academic stronger output of research institutions literature. Related Articles | Metrics

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Paraspinal muscle approach pedicle screw-rod system fixation for the treatment of thoracolumbar burst fractures: Compared with conventional approach Cai Fu-jin, Zhu Jian-ping, Luo Yu-chun, Yu Xiao-hua, Liu Xiao-hui, Li Hong, Chu Xu-dong, Hu Yi-ping 2012, 16 (30):  5676-5680.  doi: 10.3969/j.issn.2095-4344.2012.30.032 Abstract ( 251 )   PDF (510KB) ( 387 )   Save BACKGROUND: Paraspinal muscle approach for the treatment of thoracolumbar burst fracture makes it possible for pedicle screw-rod implantation and fixation through paraspinal muscle approach. OBJECTIVE: To compare the clinical effect of paraspinal muscle approach and conventional approach for the treatment of thoracolumbar burst fracture. METHODS: Fifty-three patients who suffered from thoracolumbar burst fractures without obvious nerve injury were included; all the patients were injured with kyphosis greater than 20° and/or anterior vertebral height collapse larger than 50%. The patients were treated with paraspinal muscle approach (n=28) and conventional approach (n=25) respectively. RESULTS AND CONCLUSION: The visual analog scale of the patients treated with paraspinal muscle approach was significantly decreased when compared with the patients treated with conventional approach (P < 0.05). There was no significant difference in the radiographic results (Cobb angle, height of anterior edge of the fractured vertebrae and midsagital diameter of the fractured spinal canal) between two groups (P > 0.05). Paraspinal muscle space approach fixation can reach the same effect with conventional approach for the treatment of thoracolumbar burst fractures, and can promote functional recovery. Related Articles | Metrics

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Biomechanical characteristics of posterior spine dual-plane osteotomy, debridement and fusion, pedicle screw fixation for spinal tuberculosis with severe kyphosis Chen Ming, Zhao Jin-min, Li Bing, Xiao Zeng-ming, Peng Xiao-zhong, Su Wei, Sha Ke, Wu Zhen-guo, Zhang Ying 2012, 16 (30):  5681-5685.  doi: 10.3969/j.issn.2095-4344.2012.30.033 Abstract ( 240 )   PDF (529KB) ( 410 )   Save BACKGROUND: It is effective in the application of posterior incision debridement, bone graft and fixation on the patients with spinal tuberculosis deformity angle more than 40°, spinal cord or cauda equina, nerve root compression and unstable. OBJECTIVE: To analyze clinical results and biomechanical characteristics of the posterior spine dual-plane osteotomy, debridement and fusion, pedicle screw fixation for the patients of spinal tuberculosis with severe kyphosis. METHODS: From January 2009 to January 2010, the clinical information of nine patients who accepted a bilateral posterior spinal osteotomy, debridement and fusion with pedicle screw fixation for the treatment of spinal tuberculosis with severe kyphosis was analyzed retrospectively. RESULTS AND CONCLUSION: All the patients were safe in the perioperative period, the term of followed up was 12 (8-16) months, without the cases recurrence of tuberculosis and were all bone fusion, Cobb angle of the last follow-up and visual analogue scale score compared with preoperative score improved significantly (P < 0.01), fusion time was 8.5 (5-14) months. The clinical outcomes illustrated that the correct anti-tuberculosis treatment with the posterior spine dual-plane osteotomy, debridement and fusion, pedicle screw fixation for the treatment of spinal tuberculosis with severe kyphosis has better clinical and biomechanical effectiveness. Related Articles | Metrics

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Clavicular hook plate implantation for the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation Zhang Jian-hua, Nie Yu, Zhou Yong-huan, Wang Guang-yong, Dun Xian-li, Li You-fang, Zhou Ting-yu, Zhong Bin 2012, 16 (30):  5686-5690.  doi: 10.3969/j.issn.2095-4344.2012.30.034 Abstract ( 320 )   PDF (292KB) ( 442 )   Save BACKGROUND: Surgical therapy has been frequently used to treat Rockwood type Ⅲ acromioclavicular joint dislocation to restore normal anatomy of stable structures around the acromioclavicular joint and heal free of tension. OBJECTIVE: To investigate the clinical effect of clavicular hook plate implantation on Rockwood type Ⅲ acromioclavicular joint dislocation. METHODS: A total of 56 patients with Rockwood type Ⅲ acromioclavicular joint dislocation were selected from Department of Orthopedics of Wufeng People’s Hospifal and Department of Orthopedics of Yiling Hospital between December 2005 and June 2008. All patients were treated with clavicular hook plate implantation. Indicators including visual analogue scale (VAS), the United States Shoulder and Elbow Surgeon Score (ASES), and Constant and Murley scoring system were tested pre-operatively, one year postoperatively, before internal fixation, and 3 months after internal fixation. Additionally, functional changes of the shoulder joint and complications were analyzed before and after clavicular hook plate implantation. RESULTS AND CONCLUSION: The surgery and follow-up were successfully achieved in 56 cases. The follow-up lasted for 15-30 months, with the mean time of 20 months. The internal fixation was taken out at about 1 year after implantation. Coracoclavicular ligament was repaired in 32 cases but not in 24 cases. Two patients with recurrence of acromioclavicular joint dislocation were excluded, and coracoclavicular ligament therapy was not performed. Shoulder pain, foreign body sensation, and internal fixation failure occurred in two cases. One year after operation, VAS was decreased compared with that before operation, but ASES and Constant and Murley score were significantly increased (P < 0.01). At 3 months after internal fixation, VAS was decreased compared with that at 1 year after operation, but ASES and Constant and Murley score were increased (P < 0.05). Results demonstrated that clavicular hook plate implantation for treating Rockwood type Ⅲ acromioclavicular joint dislocation is simple and minimally invasive, thus it is an ideal internal fixation. Related Articles | Metrics

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Therapeutic effect of dynamic hip screw versus proximal femoral nail anti-rotation blade for intertrochanteric fractures Chen Sheng-wen 2012, 16 (30):  5691-5695.  doi: 10.3969/j.issn.2095-4344.2012.30.035 Abstract ( 215 )   PDF (464KB) ( 392 )   Save BACKGROUND: Dynamic hip screw (DHS) is the gold standard for clinical fixation of intertrochanteric fractures, and achieves certain effect. But proximal femoral nail anti-rotation (PFNA) blade is a new modified proximal femoral fixation system, which is used to solve the deficiencies of previous fixation. OBJECTIVE: To compare the clinical effect of DHS and PFNA blade for intertrochanteric fractures. METHODS: Totally 76 patients with intertrochanteric fractures were selected including 36 cases treated with DHS and 40 cases with PFNA. All the patients received operative treatment with common operative route. RESULTS AND CONCLUSION: Incidence rate of medical complication and deformity rate of hip joint in the PFNA group were lower than those in the DSH group (P < 0.05). The excellent and good rate of the hip function recovery was 78% (28/36) in the DSH group, and which in the PFNA group was 82% (33/40). The results showed that both the two method of DHS and PFNA have good clinic curative effect for the treatment of intertrochanteric fractures, but the PFNA has the advantages of simple operation, less bleeding, and reliable fixation. Related Articles | Metrics

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Three different kinds of implant fixators for intertrochanteric fractures in old people Zou Ming, Bai Guang-fu, Zhang Yan, Li Kun, Luo Yu-chun 2012, 16 (30):  5696-5700.  doi: 10.3969/j.issn.2095-4344.2012.30.036 Abstract ( 351 )   PDF (438KB) ( 407 )   Save BACKGROUND: Traditional dynamic hip screw (DHS), proximal femur nail anti-rotation (PFNA) and anatomic proximal femoral locking plate (APFLP) are used in internal fixation of intertrochanteric fractures, but now which one is best method for the treatment of intertrochanteric fractures is still controversial. OBJECTIVE: To investigate the clinical efficacy of the DHS, PFNA and APFLP for the treatment of the intertrochanteric fractures in old people. METHODS: Totally 159 elderly patients with intertrochanteric fractures were retrospectively analyzed. Difference of the DHS, PFNA and APFLP for the treatment of the intertrochanteric fractures was compared. RESULTS AND CONCLUSION: ①Harris hip function score in the PFNA group was better than that in the APFLP group (P < 0.05) which was superior to DHS group (P < 0.05) at 1 week, 6 months and 1 year after surgery. ② X-ray of fracture healing in the PFNA group was better than that in the APFLP group (P < 0.05) which was superior to the DHS group (P < 0.05) at 3, 6, 12 months after surgery. It is indicated that the PFNA for the treatment of intertrochanteric fractures has many advantages in less damage, stronger fixation, simpler operation, higher fracture healing, shorter healing time, better functional recovery and so on. It is the ideal fixation for intertrochanteric fractures in old people. Related Articles | Metrics