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24 December 2013, Volume 17 Issue 52 Previous Issue    Next Issue

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Two strengthening pedicle screw techniques and bone cement in lumbar internal fixation Jiang Ze-hua, Zhu Ru-sen, Yuan Jian-jun, Shao Gao-sheng, Zhang Xue-li 2013, 17 (52):  8941-8948.  doi: 10.3969/j.issn.2095-4344.2013.52.001 Abstract ( 269 )   PDF (2296KB) ( 636 )   Save BACKGROUND: Screw loosening and shedding may occur after osteoporosis associated with lumbar degenerative disease treated with pedicle screw fixation. Application of pedicle screw enhanced with cured materials can improve the therapeutic effect. OBJECTIVE: To compare the clinical effect of pedicle screws enhanced with poly(methyl methacrylate) and injectable calcium sulfate cement in the lumbar internal fixation of osteoporosis. METHODS: Sixty-one patients diagnosed with osteoporosis combined with lumbar spondylolisthesis, lumbar spinal instability, and severe lumbar spinal stenosis were collected. All patients were divided into two groups according to the treatment method: poly(methyl methacrylate) bone cement enhanced pedicle screw group and calcium sulfate bone cement enhanced pedicle screw group. RESULTS AND CONCLUSION: There were no significant differences in the operation time, blood loss, preoperative and postoperative visual analog scale score, Japanese Orthopedic Association scores and the Japanese Orthopedic Association score improvement rate between two groups (P > 0.05). The results showed that two patients had bone cement leakage in poly(methyl methacrylate) group which had no neurological symptoms caused by new symptoms during follow-up period. The bone mineral density was not improved gradually in poly(methyl methacrylate) group with follow-up time prolonging; however, in calcium sulfate group, the bone mineral density was increased significantly after treatment, and the change of bone mineral density was linearly related with Japanese Orthopaedic Association score improvement rate in calcium sulfate group. No screw loosening, pulling out or neurological dysfunction occurred in both groups. The results indicate that like poly(methyl methacrylate), balcium sulfate bone cement can increase the stability of pedicle screws. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Stress distribution after total hip arthroplasty with a neck-retaining femoral prosthesis Sun Yu-xi, Fu Zhi-hou 2013, 17 (52):  8949-8954.  doi: 10.3969/j.issn.2095-4344.2013.52.002 Abstract ( 155 )   PDF (788KB) ( 319 )   Save BACKGROUND: Collum Femoris Preserving prosthesis is developed by Pipino, an Italian surgeon, and LINK (Germany). Whether the femoral osteotomy plane recommended in the surgical manual is suitable for Chinese people and whether the osteotomy method can cause stress changes of the prosthesis and femur has not been yet reported. OBJECTIVE: Based on clinical reviews and three-dimensional finite element model, to analyze the clinical efficacy of total hip arthroplasty with Collum Femoris Preserving prosthesis and relevant stress distribution. METHODS: We retrospectively analyzed 36 patients undergoing total hip arthroplasty with neck-retaining femoral prosthesis and 36 patients receiving total hip arthroplasty with biotype prosthesis in terms of Harris scores, visual analog scale scores, preoperative and postoperative measurements of eccentricity changes, IDES-Engh radiological evaluation and the incidence of complications. Two different osteotomy plane finite element analysis models were created to analyze the eccentricity difference and changes in the stress distribution of prosthesis and femur when the osteotomy plane was set 1.5 cm above the intertrochanteric fossa or at the junction of femoral head and neck. RESULTS AND CONCLUSION: Neck-retaining total hip arthroplasty with the osteotomy plane set at the junction between the head and neck achieved good short-term outcomes, showing no difference from total hip arthroplasty with normal biological prosthesis. The finite element analysis showed that the eccentricity increased and the stress on the prosthesis and femur also increased when the osteotomy plane was set at the junction of femoral head and neck compared with that set 1.5 cm above the intertrochanteric fossa. But there was no difference in stress distribution between two osteotomy planes.   中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Ceramic-on-ceramic total hip arthroplasty in young and middle-aged patients of femoral neck fracture Hou Xi-jun, Li Lin, Wang Chun-hua, Li Yu-qiang 2013, 17 (52):  8955-8960.  doi: 10.3969/j.issn.2095-4344.2013.52.003 Abstract ( 345 )   PDF (629KB) ( 913 )   Save BACKGROUND: Ceramic-on-ceramic total hip arthroplasty can be applied to young patients requiring frequent activity and high quality of life. OBJECTIVE: To explore the short-term efficiency of ceramic-on-ceramic total hip arthroplasty in young and middle-aged patients of femoral neck fractures. METHODS: Fifty-one young and middle-aged patients under 50 years old with ceramic-on-ceramic total hip arthroplasty were selected to analyze the function of hip joints and the complication after operation. RESULTS AND CONCLUSION: All the patients were followed up for 6 months to 44 months. At the last follow-up, the average Harris score was 92.0±3.4 points with an excellent and good rate of 94.1%. No dislocation was observed and three cases exhibited mild limping. Imaging examination showed that, no prosthesis loosing, broken, sinking or radiolucent line around prosthesis was observed. Ceramic-on-ceramic total hip arthroplasty in young patients with femoral neck fractures can effectively decrease the osteolysis, prosthesis loosing and sinking caused by the debris of wearing, prolong the working life of the prosthesis, and improve the patient’s quality of life. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Total hip arthroplasty versus proximal femoral nail for intertrochanteric fractures Wang Ya-ping, Lu Tong 2013, 17 (52):  8961-8966.  doi: 10.3969/j.issn.2095-4344.2013.52.004 Abstract ( 320 )   PDF (801KB) ( 750 )   Save BACKGROUND: Internal fixation has become the first choice for the treatment of intertrochanteric fractures. However, the methods and materials for internal fixation are various. Which one has the best clinical efficacy? OBJECTIVE: To compare the effects of proximal femoral nail and total hip arthroplasty for the treatment of intertrochanteric fractures. METHODS: A total of 46 patients with intertrochanteric fractures were voluntarily divided into two groups: proximal femoral nail and total hip arthroplasty. Operation time, intraoperative blood loss, and Harris scores were compared between the two groups, and X-ray examination was used for assessment of clinical efficacy in the two groups. RESULTS AND CONCLUSION: Totally 46 patients were followed-up for 3 to 12 months. Fractures in all the patients were healed. As compared with the total hip arthroplasty group, in the proximal femoral nail group, approach incision was smaller, blood loss was higher, operation time and fracture healing time were longer, and Harris score was lower (P < 0.05). These findings indicate that the total hip arthroplasty is better than proximal femoral nail for intertrochanteric fractures, with less invasion and blood loss. However, the long-term effects need further studies. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Peri-operative treatment for total hip replacement in patients with hepatic cirrhosis Xu Jie, Huang Jing, Ma Ruo-fan, Li Deng, Cai Zhi-qing, Li Liang-ping 2013, 17 (52):  8967-8973.  doi: 10.3969/j.issn.2095-4344.2013.52.005 Abstract ( 277 )   PDF (952KB) ( 696 )   Save BACKGROUND: Hepatic cirrhosis may adversely affect the outcome of major orthopedic surgery, such as total hip arthroplasty. Peri-operative treatment is the challenge for all orthopedic surgeons. OBJECTIVE: To analyze the safety and feasibility of hip replacement surgeries in patients with hepatic cirrhosis. METHODS: Thirteen patients with hepatic cirrhosis that underwent hip replacement were retrospectively analyzed to evaluate the treatments and their efficacy before and after replacement. RESULTS AND CONCLUSION: All 13 surgeries were successfully performed. All cases were followed up for more than five months and were graded according to Child-Pugh Criteria for hepatic functional reserve preoperatively and postoperatively. Five cases of the seven preoperative grade A cases preserved grade A postoperatively during a two-week observation, while another two cases rose to grade B and needed hepatic conservation treatment before discharge. Two cases of the six preoperative grade B cases rose to grade C with developed jaundice and ascites. Of the two, one even suffered a complication of upper gastrointestinal hemorrhage 5 days after surgery. Somatostatin and proton pump inhibitors were administered to stop bleeding. All cases gained a satisfying recovery. Harris hip score at follow-up showed favorable hip function. Hip replacement is safe and feasible for patients with hepatic cirrhosis when full evaluation of hepatic function and appropriate perioperative management are ensured.   中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Mechanics analysis on knee joint after virtual replacement Matthew Jian-qiao Peng, Zhang Zhan-lei, Zhong Shi-zhen, He Er-xing 2013, 17 (52):  8974-8980.  doi: 10.3969/j.issn.2095-4344.2013.52.006 Abstract ( 326 )   PDF (990KB) ( 622 )   Save BACKGROUND: Simulative dynamics provides advantages of repeatable and non-invasive to a model. Additionally, structural model of individualism improves the reliability of Finite Elemental Analysis. It is an optimal attempt to analyze mechanics of knee joint after virtual replacement surgery. OBJECTIVE: To achieve dynamic information of contact stress upon knee joint surface by finite element analysis surgery for total knee arthroplasty postoperatively, and to provide objective data for further “surgery plan”. METHODS: After scanning affected knee joint by CT/MR and scanning knee prosthesis by laser instrument, a model composed of prosthesis, knee joint as well as its ligament was rebuilt computationally; dynamic lines were measured. After prosthesis installation & osteotomy performed by facility of Simulation in Mimics according to knee joint replacement standard, this model was imported into ANSYS so as for Meshing, Material assignment, load applied. Stress distribution was analyzed by Finite Element Method. RESULTS AND CONCLUSION: The best finite element model of postoperative TKA 3D knee joint was obtained; dynamic data were tested to be approximately agreeable to those previous studies of direct measurement upon prosthesis. The experiment of analyzing structural deformation, stress distribution & internal energy change benefits to search the best position for prosthesis installation, osteotomy and surgical result prediction. Thus, these are indispensable data in surgery plan.   中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Air wave pressure therapy in prevention of deep vein thrombosis of the lower extremity after total knee arthroplasty Tang Jin, Yang Tao, Xiong Xiao-jiang, Chen Lin, Cheng Zhi-yong, Zhan Fang-biao, Liao Yi-ming 2013, 17 (52):  8981-8986.  doi: 10.3969/j.issn.2095-4344.2013.52.007 Abstract ( 245 )   PDF (804KB) ( 625 )   Save BACKGROUND: Numerous studies have shown that air wave pressure therapy plays an important role in prevention of deep venous thrombosis of lower limb after a major operation on the hip. OBJECTIVE: To explore the efficacy of air wave pressure therapy on deep vein thrombosis of the lower extremity in patients with total knee arthroplasty. METHODS: A total of 80 patients with total knee arthroplasty were randomly divided into experimental group and control group. Patients in the control group were treated only with conventional method to help the patient massage the lower extremity by the nurse and combined with active functional exercise; patients in the experimental group were treated with air wave pressure therapy at 2 days postoperatively, and were also treated with conventional method to help the patient massage the lower extremity by the nurse and combined with active functional exercise. Swelling index, coagulation index and the number of patients with deep venous thrombosis of the lower extremity were recorded in both groups. RESULTS AND CONCLUSION: At 2 weeks after treatment, swelling index, coagulation index and the number of patients with deep venous thrombosis of the lower extremity were significantly reduced in the experimental group, and its effects were significantly better than those in the control group (P < 0.05). Early use of air wave pressure therapy after total knee arthroplasty can alleviate limb swelling effectively and have obvious advantages in improving coagulation index and blood coagulation condition and in preventing deep vein thrombosis of the lower extremity after total knee arthroplasty. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Semi-shoulder arthroplasty for complicated proximal humerus fractures Liu Chang-lu, Liu Xiao-min, Huang Jian, Nie Hui-juan, Ma Gang, Ding Liang-jia 2013, 17 (52):  8987-8992.  doi: 10.3969/j.issn.2095-4344.2013.52.008 Abstract ( 222 )   PDF (705KB) ( 534 )   Save BACKGROUND: Semi-shoulder or total shoulder arthroplasty for complicated proximal humerus fractures is better in the rapid elimination of pain and restoration of joint function. OBJECTIVE: To analyze the surgical techniques and clinical effects of semi-shoulder arthroplasty on the treatment of complicated proximal humerus fractures. METHODS: The surgical efficacy of 12 cases of complicated proximal humerus fractures who had all received semi-shoulder arthroplasty was analyzed. According to Neer classification, there were two cases of three-part fractures and 10 cases of four-part fractures. X-ray observation and Neer scoring criteria were also used to conduct a clinical evaluation of shoulder joint function after operation. RESULTS AND CONCLUSION: All the patients were followed up for 18 months in average (6 to 48 months). Based on Neer scoring, excellent was in 10 cases, good in one case, fair in one case. The excellent rate was 92%. During the follow-up period, prosthesis location was good and there were no complications, such as periarticular fractures, nerve injury, infection, dislocation or looseness. Attention should be paid for the effective restoration of shoulder cuff and the correct reconstruction of the large and small nodules in semi-shoulder arthroplasty. Besides, it also should be combined with the early and standard functional exercises. The clinical effect of semi-shoulder arthroplasty is satisfactory and it is an effective way to treat complicated proximal humerus fractures. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Bone cement vertebroplasty for symptomatic thoracic vertebral hemangioma Yan Xiong-wei, Zhang Hong-yan 2013, 17 (52):  8993-8998.  doi: 10.3969/j.issn.2095-4344.2013.52.009 Abstract ( 544 )   PDF (778KB) ( 1355 )   Save BACKGROUND: Since percutaneous injection of bone cement vertebroplasty has been successfully used in treatment of spine fracture, percutaneous vertebroplasty is trying to be utilized in the treatment of vertebral hemangiomas. OBJECTIVE: To evaluate the safety and effectiveness of percutaneous injection of bone cement vertebroplasty in the treatment of symptomatic vertebral hemangiomas. METHODS: Totally nine patients with symptomatic thoracic vertebral hemangioma patients, including two males and seven females, had back pain. Of them, two cases suffered from nerve root irritation. Percutaneous vertebroplasty with bone cement was used alone. Postoperative clinical and radiographic follow-up was conducted. RESULTS AND CONCLUSION: The success rate was 100%, and no pulmonary embolism or nerve injury appeared. Postoperative imaging showed no leakage of spinal canal or foramen. At 24 hours after treatment, the symptoms had eased; nine cases were followed up for 3 to 36 months, showing that the original symptoms and signs disappeared or almost disappeared, no recurrence of vascular tumors. Results indicated that the percutaneous injection of bone cement vertebroplasty for the treatment of symptomatic vertebral hemangiomas is a safe and effective treatment; it can not only relieve symptoms, but also can increase the stability of the vertebral body, and prevent compression fracture and recurrence. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Long-segment pedicle screw fixation and individual osteotomy in the treatment of ankylosing spondylitis with kyphosis Wang Xiao-ping, Lu Ming, Ma Hua-song, Zhou Jian-wei, Yuan Wei, Chen Yang, Niu Jing, Ren Dong-yun, Qin Liu-hua, Zheng Rui, Zhang Jing 2013, 17 (52):  8999-9004.  doi: 10.3969/j.issn.2095-4344.2013.52.010 Abstract ( 197 )   PDF (746KB) ( 410 )   Save BACKGROUND: Orthopedic osteotomy at the apex of kyphosis is best for treatment of ankylosing spondylitis from a biomechanical aspect, but there is a high risk for intraoperative spinal cord injury. OBJECTIVE: To explore the clinical efficacy of vertebral plate osteotomy + vertebra osteotomy +long-segment pedicle screw fixation in the treatment of ankylosing spondylitis with kyphotic deformity. METHODS: Thirty-six patients with ankylosing spondylitis were subjected to pedicle subtraction osteotomy and Smith-Peterson osteotomy, and then followed up for 3 months to 2 years. RESULTS AND CONCLUSION: After implantation, sagittal imbalance did not occur in 36 patients, and the improvement rate of sagittal imbalance was 64%. The improvement rates of thoracolumbar kyphosis and chin-brow vertical angle were 60% and 98%, respectively. The pain relief rate was 64%, and the Oswestry Disability Index was 95%. There were no pulled nails, broken nails and broken robs after implantation. These findings indicate that the combination of selective osteotomy technique and long-segment internal fixation can achieve stable fixation effects, prevent sagittal imbalance, and avoid the occurrence of pulling nails, breaking nails and breaking robs caused by osteoporosis. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Mid-third clavicle fracture combined with acromioclavicular joint dislocation treated with double Endobutton plate plus clavicle plate Chen Yu, Song Xuan, Yu Si-ming 2013, 17 (52):  9005-9010.  doi: 10.3969/j.issn.2095-4344.2013.52.011 Abstract ( 277 )   PDF (682KB) ( 485 )   Save BACKGROUND: Combination of mid-third clavicle fracture with acromioclavicular joint dislocation is a rare injury. The internal fixation treatment of this injury remains controversial. OBJECTIVE: To investigate the treatment of a rare injury of mid-third clavicle fracture combined with acromioclavicular joint dislocation. METHODS: Three patients with mid-third clavicle fracture with acromioclavicular joint dislocation from 2005 to 2011 were analyzed retrospectively. The three patients were treated with clavicle anatomic locking plate+wire subcoracoid cerclage, clavicle anatomic locking plate+clavicular hook plate and clavicle anatomic locking plate+dual Endobutton plate coracoclavicular ligament reconstruction, respectively. The treatment effects of these three methods were compared, including the operation time, blood loss, and the shoulder function evaluation. RESULTS AND CONCLUSION: One case was misdiagnosed as simple mid-third clavicle fracture. All the three patients were followed-up for more than 12 months, and the clavicle fracture healed in all three cases. The internal fixators were moved out at 12, 9 and 11 months, the Endobutton plate was still in the body, and no redislocation happened in all cases. The pain, daily function, activity and muscle strength were compressively assessed before and after internal fixator removal. The scores of the three patients were 64, 71 and 92 before surgery, and 68, 79 and 95 after surgery. Patient treated with double Endobutton and locking plate had the best recovery. Double Endobutton plus clavicle plate are good choice as internal fixation in the treatment of mid-third clavicle fracture combined with acromioclavicular joint dislocation. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Two kinds of locking plate for treatment of proximal humerus fractures in the elderly Chen Li, Zhao Di-qing, Yang Guang-zhong, Chen Gang 2013, 17 (52):  9011-9016.  doi: 10.3969/j.issn.2095-4344.2013.52.012 Abstract ( 412 )   PDF (750KB) ( 451 )   Save BACKGROUND: Proximal humeral internal locking system (PHILOS) and locking proximal humerus plate (LPHP) are both new types of internal fixation plates, and have satisfactory effects in the treatment of proximal humerus fractures. However, which is better? OBJECTIVE: To compare the short-term efficacy of PHILOS and LPHP in the treatment of elderly patients with proximal humeral fractures. METHODS: The follow-up data of 61 elderly patients with proximal humeral fractures were retrospectively analyzed. The patients were divided into PHILOS group (n=34) and LPHP group (n=27). According to the Neer system, there were two parts of fractures in seven cases, three parts of fractures in 11 cases, four parts of fractures in nine cases in LPHP group; there were two parts of fractures in nine cases, three parts of fractures in 14 cases, four parts of fractures in 11 cases in PHILOS group. The operation time, blood loss, and drainage volume were recorded. The time of fracture healing, functional recovery, and complications were observed. Statistical analysis was performed.     RESULTS AND CONCLUSION: All 61 patients were followed up for 12-36 months (mean 20.6 months). There was no statistical difference in operation time, blood loss, drainage volume, time of fracture healing, functional recovery and complications between the two groups (P > 0.05). Both LPHP and PHILOS groups could obtain good effects in treatment of senile proximal humeral fractures. The excellent and good rate was respectively 81.5% and 82.4% in two groups. They have advantages of reliable fixation, few complications, and high satisfaction rate. Currently these locking plates have a high clinical value and can be considered as useful implants for ORIF of displaced and unstable proximal humeral fractures. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Hollow screw and suture fixation for treatment of tibial intercondylar eminence fractures under arthroscopy Chen Wei-dong 2013, 17 (52):  9017-9022.  doi: 10.3969/j.issn.2095-4344.2013.52.013 Abstract ( 353 )   PDF (690KB) ( 620 )   Save BACKGROUND: Intercondylar eminence fractures of the tibia are often treated by arthroscopic surgery, but the fixation methods are controversial. OBJECTIVE: To compare curative effect of hollow screw and suture fixation in treatment of tibial intercondylar eminence fractures under arthroscopy. METHODS: A total of 46 patients with tibial intercondylar eminence fractures were recruited from the Third People’s Hospital of Yancheng, China from June 2010 to January 2013. According to the patient’s willing and physician’s suggestions, the involved patients were divided into hollow screw group (n=25) and suture fixation group (n=21), undergoing hollow screw and suture fixation under arthroscopy, respectively. RESULTS AND CONCLUSION: According to Ikeuchi grade, the excellent and good rate after fixation showed no significant differences between the two groups (P > 0.05), but the functional training time in hollow screw group was significantly shorter than that in suture fixation group (P < 0.05). Hollow screw treatment under the arthroscopy is better than suture fixation in treatment of intercondylar eminence fractures of the tibia. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Minimally invasive percutaneous fixation based on ISO-C3D computerized navigational system for fracture of the acetabulum Ma Yu-peng, Zhou Dong-sheng, Li Lian-xin, Mu Wei-dong, He Ji-liang, Li Qing-hu 2013, 17 (52):  9023-9028.  doi: 10.3969/j.issn.2095-4344.2013.52.014 Abstract ( 311 )   PDF (681KB) ( 553 )   Save BACKGROUND: Percutaneous hollow screw under X-Ray fluoroscopy has been shown to treat fracture of acetabulum of the pelvis, but the time of internal fixation was long, and the amount of radiation exposure to the patients and physicians was large. OBJECTIVE: To test the application of the ISO-C3D computerized navigational system for fracture of acetabulum. METHODS: Thirty-one patients with fracture of the acetabulum were treated with percutaneous hollow screw under a fluoroscopy-based ISO-C3D computerized navigational system. The interval from injury to operation was 4 to 13 days. All patients were followed up for one year. RESULTS AND CONCLUSION: The average bleeding volume during operation was only 18 mL, except that the bleeding volume of only one patient, who suffered from the sacroiliacjoint injury and received open reduction and internal fixation, was up to 300 mL. The total number of screws used in the operation was 42, among which 24 were screws for acetabular anterior column fracture and 18 for posterior column fracture. All screws were implanted once precisely. The average time of internal fixation was 59 minutes, and the mean time for fluoroscopy was 39 seconds. The 31 patients were pain-free one week after the operation and no complication (infection, vascular nerve injury or implant breakage) was noted post-operatively. When the follow-up ended, radiography revealed fracture union with satisfactory screw fixation (no screw breakage or loosening). According to Matta functional scoring, results were excellent in 23 cases, good in 8 cases, with an excellent and good rate of 100%. According to Majeed functional scoring, the results were excellent in 22 cases, good in 6 cases and average in 3 cases, with an excellent and good rate of 90%. These results indicated that ISO-C3D computerized navigational system can supply stable internal fixation without an increase of complication. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Multiple stepwise regression analysis on postoperative knee joint function limitation in complex femoral condyles fractures Li Song-jun, Wang Zhao-jie, Tan Wei-yuan, Kuang Li-peng, Chen Jun-ping 2013, 17 (52):  9029-9034.  doi: 10.3969/j.issn.2095-4344.2013.52.015 Abstract ( 260 )   PDF (682KB) ( 488 )   Save BACKGROUND: Knee joint function limitation often occurs after internal fixation of complex femoral condyle fractures, but the mechanism and its influencing factors are also unclear. OBJECTIVE: To screen and analyze the relevant factors of knee joint function limitation after internal fixation of complex femoral condyle fractures. METHODS: We retrospectively summarized postoperative follow-up data of 6 and 12 months from 121 patients with complex femoral condyle fractures. Knee joint function recovery was evaluated according to Merchan criteria. A multiple stepwise regression analysis was carried out in terms of gender, age, causes, concomitant injuries, skin and soft tissue injury, fracture type, fixed method, operation time, postoperative plaster fixed situation, healing of postoperative incision, bone healing and postoperative functional exercises, to summarize the relevant influencing factors for knee joint function limitation. RESULTS AND CONCLUSION: Whether the knee joint function after internal fixation was limited acted as the dependent variable Y, and factors with statistical significance of the single factor analysis served as the independent variable X. We used the multiple stepwise regression analysis for multiple factors analysis. Results showed that the gender of patients (X1), with or without concomitant injuries (X3), soft tissue damage (X4) and operation time (X6), a total of four factors, could not be introduced into the model, suggesting that these four factors had no significant correlation with postoperative knee joint function limitation. Another eight factors could be introduced into the factor analysis model, showing that the cause of injury (X2), fracture type (X5), the choice of internal fixation (X7), with or without bone graft (X8), with or without postoperative plaster cast (X9), postoperative knee joint functional exercise or not (X10) and postoperative wound healing (X11), the degree of postoperative bone healing (X12) are closely related to postoperative knee joint function limitation in complex femoral condyles fractures. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Displacement of steel plate for humeral fractures under the load of 100 N and 500 N measured using digital speckle method Yang Li-ping, Tian Ming, Zhou Yi-ping, Ye Hong, Li Bi-jun, Chen Ying-jie 2013, 17 (52):  9035-9040.  doi: 10.3969/j.issn.2095-4344.2013.52.016 Abstract ( 104 )   PDF (856KB) ( 409 )   Save BACKGROUND: There is no unified measure of bone tissue mechanical property test at present. The study concerning traditional sensor for fracture displacement had some problems such as low precision, and high consumption cost. OBJECTIVE: To measure the displacement of plate and screw after internal fixation for fracture of humerus using digital speckle method. METHODS: A total of eight humeral specimens were taken. The steel plate fixation model in the humerus 1/2 was made. The specimens were fixed using eight-hole steel plate, and four screws were fixed on each end of fracture line. Five conditions of experimental model were designed for comparative analysis. Condition a: compression plate fixation group (not saw off, to simulate fracture healing). Condition b: on the basis of sawing off in condition a, one screw was removed on the proximal end. Condition c: on the basis of condition b, one screw was removed on the distal end. Condition d: on the basis of condition c, one screw was removed on the distal end. Condition e: on the basis of d, one screw was removed on the distal end. The screws were numbered No. 1-8 from top to bottom. That is, the screws on upper fracture line were numbered No. 1-4, and those on the lower fracture line were numbered No. 5-8. The specimens were installed on electronic universal testing machine, and loaded 100 N and 500 N. The displacement was calculated using the related software. RESULTS AND CONCLUSION: Significant differences in total displacement were detected under different loads (F=49.155, P < 0.001). With increased load, the total displacement of the fourth and fifth screws gradually increased under five kinds of conditions. These indicated that the two screws on the two ends of the fracture line endured more stresses (stress concentration), and easily broke. It would be better to choose the screw with the screw diameter of 1-2.5 mm bigger than the present one in order to increase its stability to avoid the breakage of screws. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Interbody fusion cage and autograft fusion for lumbar spondylolisthesis: A meta-analysis Mardan•Mamat, Sheng Wei-bin, Alim•Abdurexit, Guo Hai-long, Deng Qiang, Liang Wei-dong, Mamatkirmulla•Tursunjan 2013, 17 (52):  9041-9048.  doi: 10.3969/j.issn.2095-4344.2013.52.017 Abstract ( 332 )   PDF (970KB) ( 526 )   Save BACKGROUND: The surgical treatment for lumbar spondylolisthesis has developed from posterior lumbar interbody fusion to bone graft fusion and internal fixation, which is widely applied in clinics. OBJECTIVE: To systemically evaluate the clinical therapeutic efficacy of lumbar interbody fusion between cage and autograft alone for treating lumbar spondylolisthesis, and to provide evidence-based measures for clinical treatment. METHODS: An online search of China Biological Medicine disk, PubMed, PQDT, Cochrane Library, Springerlink,MEDLINE, and EMBASE databases was performed from March 1990 to December 2012. In addition, we hand-based searched Chinese Journal of Spine and Spinal Cord, Chinese Journal of Orthopaedics, Orthopedic Journal of China, and Chinese Journal of Reparative and Reconstructive Surgery for clinical studies about the comparison of lumbar interbody fusion between cage and alone-autograft for treating lumbar spondylolisthesis. The selected trails were screened out according to the criterion of inclusion and exclusion, and quality was evaluated. RevMan 5.1.5 software (Cachrane Library) was used for Meta analysis. The following indexes were used to compare the results: intraoperative blood loss, operative time, height of vertebral space, fusion rate, excellent and good rate, complication rate and operation fee. RESULTS AND CONCLUSION: One prospective study and eight case-controlled retrospective studies were included, involving 585 patients. The results of Meta-analysis indicated that compared with autograft fusion, cage fusion showed no differences in operative time [MD=7.19, 95 %CI (-34.39, 48.77), P=0.73], intraoperative blood loss [MD=21.34, 95%CI (-139.56, 182.24), P=0.79], excellent and good rate [OR=1.53, 95%CI (0.93, 2.53), P=0.09], and complication rate [OR=0.94, 95%CI (0.51, 1.75), P=0.85]. The fusion rate was higher in cage fusion compared with autogaft fusion [OR=1.87, 95%CI (1.08, 3.25), P=0.03]. Cage fusion better maintained loss of the height of vertebral space [MD=0.03, 95%CI (0.01, 0.04)] and a higher operation fee [MD=0.92, 95%CI (0.30, 1.82), P=0.004] than autograft fusion. Both cage and autograft fusion are effective for treating lumbar spondylolisthesis. Compared with autograft fusion, cage fusion has the higher fusion rate and higher operation fee, and significantly maintains the height of vertebral space. There was no difference in operative time, blood loss, excellent and good rate, and complication rate. Because of the lack of prospective articles and small sample size, large-sized randomized controlled studies are urgently needed to provide evidence. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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System evaluation of methotrexate therapy and triple therapy for rheumatoid arthritis Zhang Lei, Nuerai•Shawutali, Aynaz•Badelhan, Yang Kang-hua, Wulanbai•Tangkejie, Huang Yong, Jiasharete•Jielile 2013, 17 (52):  9049-9054.  doi: 10.3969/j.issn.2095-4344.2013.52.018 Abstract ( 589 )   PDF (725KB) ( 583 )   Save BACKGROUND: At present, it is controversial to choose methotrexate therapy alone or triple therapy in the treatment of rheumatoid arthritis. OBJECTIVE: To systemically evaluate the efficacy and safety of methotrexate therapy and methopterin + hydroxychloroquine + sulfasalazine triple therapy in the treatment of rheumatoid arthritis. METHODS: Computer retrieval was performed on the Cochrane library, PubMed, EMBASE NRR (http://www.updatesoftware.com/National), CCT (http://www.controlled-trails.com) and the Chinese biomedical literature database. Manual retrieval was performed on Chinese major orthopedic journals. Randomized controlled trials of methotrexate therapy alone and methopterin + hydroxychloroquine + sulfasalazine triple therapy treatment for rheumatoid arthritis were collected. Methodological quality of the included studies was evaluated. The statistical software Revman 5.0 provided by the Cochrane collaboration was used. RESULTS AND CONCLUSION:   A total of four literatures in a randomized controlled trial, a total of 297 cases were included; the methodological quality was all class B. Meta-analysis results showed that blood sedimentation improvements were larger in methotrexate therapy alone than in the triple therapy [mean difference = 7.01, 95% confidence interval (CI) (2.82, 11.19), P = 0.001). Improvements of joints were better in triple therapy than that in single therapy [OR=0.62, 95%CI (0.41, 0.95), P = 0.03). There was no significant difference in adverse events.   Meta analysis could not be done in ACR, because literature did not provide detailed data. Compared with the triple therapy treatment, methotrexate therapy alone obviously reduced the sedimentation of rheumatoid arthritis in adults, but in terms of joint function improvement, triple therapy was superior to methotrexate therapy alone. Moreover, on the adverse event, there was no significant difference between the two groups. Because this system evaluation included a less number of cases, it still needs strict large-sample randomized controlled studies to increase the strength of the evidence. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Bone inductive potential of electron beam melting rapid prototyping technology in the repair of orthopedic implants Wang Cai-mei, Zhang Wei-ping, Wang Gang, Yan Hui, Yang Xiao-jie, Li Zhi-jiang 2013, 17 (52):  9055-9061.  doi: 10.3969/j.issn.2095-4344.2013.52.019 Abstract ( 488 )   PDF (867KB) ( 1089 )   Save BACKGROUND: Electron beam melting rapid prototyping technology, has the characteristic of shaping precisely and complexly, is a new type of rapid prototyping technology using metal powder. Now, it has shown unique advantages in the fields of aerospace, automotive and medical implant equipments. OBJECTIVE: To explore the properties of the product, the customization ability of orthopedic implants through electron beam melting rapid prototyping, especially the ability of inducing bone ingrowth. METHODS: We retrieved PubMed Database, China Journal Full-text Database, and China National Knowledge Infrastructure, as well as Dongfang Daily, World Science, and Chinese Journal of Orthopaedics by hand, and assembly documents in Chinese and English. Retrieval time was up to September 2013. Inclusion criteria: ① articles concerning electron beam melting rapid prototyping technology; ② articles addressing surgical implants. A total of 50 articles were included. RESULTS AND CONCLUSION: Electron beam melting state Ti6Al4V orthopedic implant has a good comprehensive performance, since the three-dimensional porous structure via electron beam melting rapid prototyping, which has a characteristic of customization, can induce bone ingrowth. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Porous tantalum rod in treating early-stage avascular necrosis of the femoral head: Application and issues Liu Jing-feng, Feng Jian-min 2013, 17 (52):  9062-9068.  doi: 10.3969/j.issn.2095-4344.2013.52.020 Abstract ( 255 )   PDF (674KB) ( 604 )   Save BACKGROUND: Each clinical treatment option for avascular necrosis of the femoral head has its own advantages and disadvantages, but early diagnosis and early treatment are firmly rooted in most of orthopedic doctors, and the purpose of treatment is focused on how to preserve the femoral head and how to maintain the hip function. OBJECTIVE: To summarize the current opinions and studies concerning the treatment of avascular necrosis of the femoral head, including core decompression and porous tantalum rod implantation, and to elucidate the clinical results and cost-effectiveness of the use of porous tantalum rod. METHODS: The PubMed database was searched by the first author for the articles on the aspect of pathogenesis, risk factors, disease staging and treatment options of avascular necrosis of the femoral head from January 1985 to August 2013 with the key words of “avascular necrosis”, “osteonecrosis of the femoral head” and“tantalum rod” in titles or abstracts. Literatures exhibiting poor correlation with the research purpose and duplicate literature were excluded, and finally, 42 articles were included in result analysis. RESULTS AND CONCLUSION: The key point of treating avascular necrosis of the femoral head depends on early diagnosis and early intervention. Core decompression plus porous tantalum rod implantation is a minimally invasive technique in treating early-stage avascular necrosis of the femoral head, in which the subchondral fracture and the femoral head collapse do not occur. If core decompression and porous tantalum rod implantation is used properly, this option does delay or prevent the progress of avascular necrosis of the femoral head. But, if avascular necrosis of the femoral head is in late stage, which means that subchondral fracture and the femoral head collapse occur, the clinical results of this option are poor. Although porous tantalum rod implantation in the treatment of early-stage avascular necrosis of the femoral head demonstrates good exciting short-term results, the clinical value of its long-term results and cost-effectiveness should be elucidated in multicentre, double-blinded, randomized, controlled trials in the future.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Cervical expansive unilateral open-door laminoplasty: implant, bone graft and complications Dai Jie, Maierdan•Maimaiti 2013, 17 (52):  9069-9076.  doi: 10.3969/j.issn.2095-4344.2013.52.021 Abstract ( 215 )   PDF (731KB) ( 577 )   Save BACKGROUND: Cervical expansive unilateral open-door laminoplasty has obtained definite curative effects in treatment of cervical spondylosis in the clinic. OBJECTIVE: To summarize the effects of cervical expansive unilateral open-door laminoplasty for cervical spondylosis from the evolution of surgeries, the advantages and disadvantages of each surgery and postoperative complications.  METHODS: Unilateral open-door, expansive laminoplasty, indications, and postoperative complications were key words. Computer was used to search VIP journal full-text database and PubMed database, and 65 articles were used for further analysis. RESULTS AND CONCLUSION: Cervical expansive unilateral open-door laminoplasty for multi-segmental cervical spondylotic myelopathy, ossification of posterior longitudinal ligament and spinal cord injury without radiographic spinal fracture and dislocation combined with spinal stenosis had obtained affirmative outcomes. Clinicians should carefully select operation mode and be conscious to prevent postoperative complications. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Total knee replacement and arthroscopic treatment for pigmented villonodular synovitis of the knee joint Lei Peng-fei, Xie Jie, Wen Ting, Zhong Da, Wang Long, Yang Xu-cheng, Hu Yi-he 2013, 17 (52):  9077-9082.  doi: 10.3969/j.issn.2095-4344.2013.52.022 Abstract ( 324 )   PDF (797KB) ( 873 )   Save BACKGROUND: Surgical treatment for pigmented villonodular synovitis can maximize the excision of synovial lesions and recovery of joint function. OBJECTIVE: To investigate the knee joint function and relapse rate following treatment of pigmented villonodular synovitis with total knee replacement and arthroscopic synovectomy. METHODS: We retrospectively analyzed 34 cases of knee pigmented villonodular synovitis admitted for surgical treatment in the Department of Orthopedics, Xiangya Hospital of Central South University, China from December 2006 to December 2011. In these cases, 24 patients received arthroscopic synovectomy and 10 patients were subjected to total knee replacement. Adjuvant radiotherapy was conducted according to postoperative patient’sconditions. Lysholm scoring was employed in the arthroscopic synovectomy group, and American Knee Society scoring was used in the total knee replacement group. Knee function in two groups was compared before and after treatment. Follow-up observation was performed to compare knee function recovery and relapse rate between two groups. RESULTS AND CONCLUSION: Thirty-four patients were effectively followed up for 12-66 months, mean 41.3 months. Statistical analysis showed that in the arthroscopic synovectomy group, the postoperative Lysholm score was (86.3± 10.3) points, significantly higher than the preoperative score which was (55.5±13.2) points (t=3.81, P=0.016, P < 0.05). In the total knee arthroplasty group, the American Knee Society score was increased from (40.7±2.2) points preoperatively to (90.2±1.1) points postoperatively (t=6.27, P < 0.01). In the arthroscopic synovectomy group, the American Knee Society score was increased from (34.2±3.9) points preoperatively to (80.8±1.9) points postoperatively (t=16.58, P < 0.01). Arthroscopic synovectomy combined with adjuvant radiotherapy can achieve better outcomes in pigmented villonodular synovitis patients, while the total knee replacement for advanced with advanced knee diffuse pigmented villonodular synovitis is better to restore knee function and the recurrence rate is low. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Manual reduction for external fixation of distal radius fractures Chen Ling-yun, Hu Yong-bin, Lu Wei-min, Yu Neng-bao, Fu Qiang 2013, 17 (52):  9083-9088.  doi: 10.3969/j.issn.2095-4344.2013.52.023 Abstract ( 346 )   PDF (670KB) ( 781 )   Save BACKGROUND: Manual reduction for external fixation of distal radius fractures can achieve good outcomes. OBJECTIVE: To carry out the bibliometric analysis on manual reduction for external fixation of distal radius fractures. METHODS: Literatures concerning reduction for external fixation of distal radius fractures were retrieved in CNKI database from 2003 to 2012. The keywords were “external fixation; distal radius fractures”. Duplicate and irrelevant articles were eliminated, and a total of 408 articles were retrieved. A bibliometric analysis of these 408 articles was performed in terms of publishing time and number, subject categories, source journals, research institutions, times cited and download frequency. RESULTS AND CONCLUSION: Literatures concerning manual reduction for external fixation of distal radius fractures exhibit an upward trend in number. In 2012, there were 85 relevant articles. In the past 10 years, 18 relevant articles have been published in Chinese Journal of Traditional Medical Traumatology & Orthopedics, which is the most. There are not many relevant studies in various research units, only 1-7 articles published per unit, and five articles are funded. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Patella fracture repair: Cannulated screw tension band versus steel wire fixation Zhao Hang, Xiao Hai-jun 2013, 17 (52):  9089-9094.  doi: 10.3969/j.issn.2095-4344.2013.52.024 Abstract ( 719 )   PDF (782KB) ( 789 )   Save BACKGROUND: Cannulated screw tension band combined with wire fixation is most commonly used for treatment of patella fractures. OBJECTIVE: To evaluate the clinical outcomes of combination of cannulated screw tension band and wire fixation in the treatment of patella fractures. METHODS: A literature search method was employed to retrieve relevant articles addressing cannulated screw tension band and wire fixation of patella fractures. In-depth analysis of literatures meeting the study criteria was carried out. Patients with patella fractures who received cannulated screw tension band and wire fixation were followed up to evaluate the postoperative fracture healing, complications and functional recovery of the knee joint at the injury side. Then, the clinical efficacy of cannulated screw tension band combined with wire fixation was analyzed. RESULTS AND CONCLUSION: After treatment with cannulated screw tension band and wire fixation, patients with patella fractures exhibited good fracture healing and low probability of complications, including screw or wire loosening, broken, and shedding. Functional recovery of the affected knee was up to 90%. Clinical case analysis showed that cannulated screw tension band combined with wire fixation achieved good outcomes in the treatment of patella fracture, with over 90% functional recovery of the affected knee, which is consistent with the reported results. It indicates that the cannulated screw tension band combined with wire fixation is one of the ideal and reliable methods in use for internal fixation of patella fractures. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Prognosis of hip fractures in elderly patients: Effects of albumin, lymphocyte and hemoglobin Wang Zhen-heng, Fang Yong-chao, Kan Xiang-xiang, Guo Ting, Zhao Jian-ning 2013, 17 (52):  9095-9100.  doi: 10.3969/j.issn.2095-4344.2013.52.025 Abstract ( 183 )   PDF (613KB) ( 453 )   Save BACKGROUND: Studies have shown that malnutrition was associated with death of elder people after fracture of hip, but there were no above-mentioned reports in China. OBJECTIVE: To retrospectively analyze the relationship of blood albumin, total lymphocyte count and hemoglobin levels to prognosis when elder patients with fracture of hip were on admission. METHODS: 130 elderly patients with hip fractures aged ≥ 70 years were included underwent either total hip arthroplasty or bipolar arthroplasty. Admission serum albumin, total lymphocytecount and hemoglobin levels were recorded. The patients were followed up for 1 year or till the death. Survival data were available in 92 patients. Rates of survival were calculated by the Kaplan-Meier method and the Log-Rank test. Cox proportional hazard regression model received prognostic multivariate analysis. RESULTS AND CONCLUSION: Of the 92 patients, albumin < 35 g/L in 20 cases (22%), total lymphocyte count < 1.5×106/L in 67 cases (73%), and hemoglobin < 120 g/L in 56 cases (61%). Kaplan-Meier method showed that the survival rate of patients with normal albumin (≥ 35 g/L) was significantly higher than those with reduced albumin (< 35 g/L) (P < 0.01). No significant difference was detected in the survival rate of patients with normal total lymphocyte count (≥ 1.5×106/L) and reduced total lymphocyte count (< 1.5×106/L) (P > 0.05). The survival rate of patients with normal hemoglobin (≥ 120 g/L) was significantly higher than those with decreased hemoglobin (< 120 g/L) (P < 0.05). Cox multivariate analysis displayed that albumin decrease is an independent prognostic factor for death of patients with hip fracture. Results indicated that the prognosis of elder patients with hip fracture was strongly associated with their nutritional conditions. Albumin and hemoglobin levels at admission can be considered as important indexes for judging patient’s prognosis. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics