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27 August 2011, Volume 15 Issue 35 Previous Issue    Next Issue

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Surgical anatomy of extended anterolateral acromial approach for internal fixation of proximal humeral fracturesm Zhou Guo-xin, Hou Zhi-qi, Tan Ping-xian, Ye Gan-hu, Yao Huo-sheng, Huang Zhi-song 2011, 15 (35):  6461-6465.  doi: 10.3969/j.issn.1673-8225.2011.35.001 Abstract ( 295 )   PDF (1536KB) ( 574 )   Save BACKGROUND: There are many surgical approaches for the shoulder joint. Two of which are widely used for proximal humeral fractures in clinic: the deltopectoral approach and the anterolateral acromia approach. However, the existing surgical approaches have some limitations. OBJECTIVE: To observe the courses of the axillary nerve and relative structures of humerus and deltoid from lateral arm, and to provide the anatomical information of a new surgical approach for proximal humeral fracture. METHODS: Twelve adult cadaveric upper limbs (male 7, female 5) were dissected to define the course of the anterior branch of axillary nerve in the anterior and middle compartments of deltoid muscle, measure the relative distance of them, compare the characteristics of the axillary nerve as it crosses the raphe between the middle and anterior heads of the deltoid.Simulation of surgical operation was implemented on a corpse after the initial data collection had been conducted. RESULTS AND CONCLUSION: The anterior branch of axillary nerve passed through the upper 1/3 of the deltoid muscle, the crossing of the anterior branch of axillary nerve and the line from the lateral tip of acromion to deltoidtuberosity was (6.0±1.3) cm below the level of acromon. A single motor branch was found to distribute the anterior head of the deltoid. An avascular raphe was located between the anterior and middle heads of the deltoid. The raphe could be identified as a white band of connective tissue between the two muscular heads. No branches to the anterior head of the deltoid cross the raphe was found. The cross stitch length in this group were greater than 1 cm, the tension of the axillary nerve was low after the plate was implanted. Through the raphe between the two muscular heads of deltoid, a surgical approach could be created for the exposure of proximal humerus, with easily extending distally after protecting the main motor branch of the axillary. This surgical approach is safe for fracture reduction directly, with subsequent plate fixation. Related Articles | Metrics

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Local application of ibandronate enhances early fixation of implants X-ray, histomorphology and biomechanical pull-out tests  Lu Qiu-dong, Hu Wen-hai, Li Cheng-li, Hu Tong-yu 2011, 15 (35):  6466-6470.  doi: 10.3969/j.issn.1673-8225.2011.35.002 Abstract ( 289 )   PDF (426KB) ( 392 )   Save BACKGROUND: The aseptic loosening of prosthesis has become one of the most obvious matters after operation of prosthesis replacement.   OBJECTIVE: To verify the effect of ibandronate on early fixation of implants by local application. METHODS: Forty-four Zelanian rabbits were used in the experiment. A standard animal model of the rabbits’ both tibia was embedded with metal screw into the proximal end. Ibandronate at 1 mg/L was sprinkled locally in the left tibia of every rabbit (experimental group), while saline solution was given in the right tibia (control group). RESULTS AND CONCLUSION: ①X-ray showed that, the light-gap around the screw of the experimental group was remarkably narrower than that in control group in weeks 2, 4, 8 after model establishment; there were more new bones observed around the screw of experimental groups in weeks 4, 8 compared with control group. ②Histomorphology showed that in week 2, the width of the fiber membrane in control group was more thicker than in experimental group (P< 0.001); In weeks 4 and 8, the new bone mass (%) of experimental group was obviously higher than that of control group (P < 0.001). ③Biomechanical pull-out test showed that, the maximal shear strength (Pm) of experimental group was significantly higher than that of control group in weeks 4 and 8 (P < 0.001). These findings indicate that, local application of ibandronate solution can obviously promote new bone formation at the earlier period, improve early fixation of implants and decrease the incidence of aseptic loosening of prosthesis.  Related Articles | Metrics

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Human proximal femoral morphological parameters error analysis based on reverse engineering Meng Xiang-jie, Ge Shi-rong 2011, 15 (35):  6471-6474.  doi: 10.3969/j.issn.1673-8225.2011.35.003 Abstract ( 329 )   PDF (1318KB) ( 338 )   Save BACKGROUND: Accurately describing the proximal femur morphology is very critical to the design and implantation of prosthesis. OBJECTIVE: Based on reverse engineering, this paper tried to analyze the error generated when the proximal femoral morphological parameters describe the morphology of the proximal femur (Proximal femoral morphological parameters Error), classify the areas generating proximal femoral morphological parameters error, and give suggestions for improvement. METHODS: Mimics and Imageware were used to measure the morphological parameters of a 25-year-old female’s healthy hip to establish a model based on the parameters reversely. The commands “Curve-Cloud Difference” and “Surface to Cloud Difference” were used to analyze the proximal femoral morphological parameters error. RESULTS AND CONCLUSION: The overall proximal femoral morphological parameters error of this female femoral was (1.29±0.99) mm. Among the error, the out surface of the femoral shaft’s matching error accounted for 70.43%, medullary cavity accounted for 21.46%, and the femoral head only accounted for 8.11%. The proximal femoral morphological parameters error existed in the following areas: the femoral head was not standard sphere; the intersecting curves between the five planes near the small rotor and the cortical bone surface was not simply circle or ellipse with same axis directions; the measurement of the small rotor’s geometrical characteristics was also neglected. Improvements are as follows: researchers should measure both the length of the axes and the angle between the axes and the anteroposterior plane; researchers should also take more attention in measuring the geometrical characteristics of the rotor. Related Articles | Metrics

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Effect of bound stress due to Cerclage band on callus formation and fracture healing in animal models Li Li-jun, Ni Dong-kui, Zheng Dao-ming, Pang Xiao-jian 2011, 15 (35):  6475-6478.  doi: 10.3969/j.issn.1673-8225.2011.35.004 Abstract ( 286 )   PDF (1164KB) ( 388 )   Save BACKGROUND: Some people believe that Cerclage band can influence the blood supply at fracture site leading to delayed healing and nonunion of fractures. OBJECTIVE: To observe the effects of Cerclage band with three different bound stresses on the callus formation and fracture healing in fracture animal models. METHODS: Femoral shaft fracture animal models of non-weight-bearing were established and divided into three groups. The cerclage band with three different bound stresses (200, 150, 100 N) was added at the fracture site, separately. Callus formation and fracture healing were observed at 2, 4, 6 weeks postoperatively. RESULTS AND CONCLUSION: In the 200 N group, the callus formation at the fracture site was limited, no bone healed and the long-term stability of the fracture end was impacted. In the 100 N group, there was no influence on fracture healing, but deformity healing was easly found. In the 150 N group, the fractures fixed and healed well. In circumstances of maintaining the appropriate bound stress, the cerclage bands added at the fracture site can effectively maintain the stability and can avoid fracture displacement or deformity healing, so as to protect the normal fracture healing, and the blood supply of periosteum in the fracture site cannot be affected. The healing progress can be accelerated. Related Articles | Metrics

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Digital three-dimensional model reconstruction in pathological fractures of pediatric odontoid process based on CT images Zhou Xia, Zhao Hua-fu, Zhou Ye, Wan Lei, Zhang Hong-bin, Wang Jie 2011, 15 (35):  6479-6482.  doi: 10.3969/j.issn.1673-8225.2011.35.005 Abstract ( 297 )   PDF (1365KB) ( 377 )   Save BACKGROUND: Children’s bone structure of the pedicle anatomy is often complicated and variable, the three-dimensional model of odontoid process fracture via three-dimensional reconstruction can be used to guide the surgery and improve the success rate of surgery. OBJECTIVE: To study an accurate digital model of pathologic odontoid process fracture in pediatrics and its clinical applications. METHODS: One child with pathologic odontoid process fracture, 2 years old, was chosen, and his slice scanning CT images were read by Simpleware software for three-dimensional reconstruction. Based on reverse engineering and rapid prototyping technique, the individual skeleton model was obtained. Subsequently treated by resin, the model was guided to the surgery. RESULTS AND CONCLUSION: The three-dimensional model of pediatric atlantoaxial including odontoid process was successfully established. With the model, the region could be directly observed, and the position and angel of screw fixation could be measured accurately, which played a good role on the operation design. The three-dimensional model intuitively and accurately reflected the structure of patient’s atlantoaxial and odontoid fracture, which improved the safety and accuracy of atlantoaxial pedicle screw fixation. Related Articles | Metrics

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Three-parameter calculation model of the femoral neck cancellous bone compression creep equation Wang Yang, Liu Da-yu, Li Xin-ying, Ma Hong-shun 2011, 15 (35):  6483-6486.  doi: 10.3969/j.issn.1673-8225.2011.35.006 Abstract ( 281 )   PDF (702KB) ( 331 )   Save BACKGROUND: Both the studies of artificial joints and femoral and neck fracture fixation need to know the femoral neck cancellous bone creep mechanical properties. OBJECTIVE: To quantitatively investigate the time-dependent variation of femoral neck creep. METHODS: Creep experiments were conducted on eight femoral neck cancellous bone specimen using an electronic all-powerful machine. The experiments were performed at 36.5 ℃ as the body temperature, and the stress speed was 0.11 MPa/s. The experiment duration was 7 200 s. On hundred experiment data were collected and processed based on a three-parameter model. RESULTS AND CONCLUSION: The femoral neck cancellous bone creep changed quickly within initially 600 s, and then went up slowly. The creep amount was 0.84%. The creep curves changed in an index manner, and the three-parameter model was very good to fit the creep curves and equations of the femoral neck cancellous bone. Related Articles | Metrics

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Establishing a model of lower cervical spine based on the picture archiving and communication system database and its clinical significance Hou Rui, Jia Wei-dou, Liu Xuan-yi, Wang Yan, Zhang Hua-dong, Zhang Li-min 2011, 15 (35):  6487-6492.  doi: 10.3969/j.issn.1673-8225.2011.35.007 Abstract ( 309 )   PDF (618KB) ( 388 )   Save BACKGROUND: Lower cervical pedicle screw has greater biomechanical strength, higher level of three-dimensional stability and fusion rate of bone graft. However, because the cervical anatomical structure is complicated and has great individual difference, it often leads to screw placement difficulty and surgical risk. OBJECTIVE: Using the picture archiving and communication systems (PACS) combined with 64-slice Helice CT film and X-ray preoperative accurate measurement of cervical rear anatomy structure, to guide the implantation of the cervical pedicle. METHODS: A retrospective review in 51 patients with lower cervical disease was operated suing the PACS measurement localization method with cervical vertebral pedicle internal fixation. Meanwhile, two different cervical vertebral pedicle screw internal fixation of surgery patients were collected for statistics analysis during the same period: (1) Anatomy set of screws method in 26 cases, (2)Pipeline dredge method in 17 cases. All research data above were assessed based on Andrew Scoring System. The practical application and clinical effect were compared using statistical method. RESULTS AND CONCLUSION: The accurate rate for screw location by using PACS measurement localization method was higher than that in the other two groups (P < 0.05). The patients in the PACS measurement localization group had no spinal cord injury, vertebral artery damage, nerve injury, etc. Using the PACS combined with 64-slice Helice CT film and X-ray preoperative accurate measurement of cervical rear anatomy structure before operation can be able to guide the security of implantation of cervical pedicle screws in the operation. Its clinical effect is obviously better than the traditional methods as anatomy set of screws method and pipeline dredge method. Related Articles | Metrics

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Cranioplasty for frontotemporal area skull defects with digital non-model-multi-spot shaped titanium mesh Zhong Jie, Kai Sa-er, Long Fei, Xu Jun-wei 2011, 15 (35):  6493-6495.  doi: 10.3969/j.issn.1673-8225.2011.35.008 Abstract ( 351 )   PDF (581KB) ( 370 )   Save BACKGROUND: Traditional hand-shaping cranioplasty for frontotemporal area skull defects cannot obtain a good result. OBJECTIVE: To evaluate the clinical application of titanium mesh for cranioplasty of frontotemporal area skull defect with digital non-model-multi-spot shaping technique. METHODS: Thirty-six patients suffering from frontotemporal area skull defects were treated by digital non-model-multi-spot shaping technique from February 2006 to June 2010. A retrospective analysis of clinical data on these patients was performed． RESULTS AND CONCLUSION: Postoperative three-dimensional reconstruction of the skull showed physiological original shape recovery. The postoperative satisfaction rate of patients reached 100%without major complications. The time for the cranioplasty lasted 0.5-1.5 hours, 0.8 hour on average. All the patients were follow-up for 1-5 years. Displacement, deformation, no mouth, pain when chewing did not occur. Cranioplasty of frontotemporal area skull defect with digital-non-model-multi-spot shaped titanium mesh enjoys short operative time and few postoperative complications. Related Articles | Metrics

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Artificial femoral head replacement for treatment of osteoporosis-induced unstable intertrochanteric fractures: A finite element stress analysis Zhang Shao-wei, Peng Li-hua, Zhao Guang-rong, Chen Shi-rong 2011, 15 (35):  6496-6499.  doi: 10.3969/j.issn.1673-8225.2011.35.009 Abstract ( 341 )   PDF (482KB) ( 517 )   Save BACKGROUND: Usual mechanics experiment approach cannot be applied directly to human body and the inter-comparability of models is low. Therefore finite element numerical simulation to mechanical behavior of human body has become an effective method for better understanding of the human body. OBJECTIVE: Based on computer simulation of unstable intertrochanteric fractures of femoral head replacement, to perform a stress analysis of the femur and prosthesis after replacement and to evaluate the initial stability of the prosthesis. METHODS: Both lower extremities of the volunteers underwent thin CT scan to obtain data related to the femur. The image data were input into Mimics11.1 image processing software for image processing; then, the data were input into UG4.0 software for modeling. The Boolean calculation was performed between the prosthesis and the femur. There were two groups: normal joint replacement group and artificial joint replacement group. Material assignment, definition of contact, force load, and stress analysis were observed in the two groups. RESULTS AND CONCLUSION: Artificial hip joint replacement changes the force trends; the stability of prosthesis for intertrochanteric fractures after joint replacement is good, and the artificial joint maintain stable under normal load. Related Articles | Metrics

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Short-term clinical effects of modified Watson-Jones total hip arthroplasty versus modified Gibson approach Wei Qing-jun, Zhao Jin-min, Lu Rong-bin, Li Xiao-feng, Lu Ding-gui 2011, 15 (35):  6500-6503.  doi: 10.3969/j.issn.1673-8225.2011.35.010 Abstract ( 385 )   PDF (547KB) ( 402 )   Save BACKGROUND: Recently, modified Watson-Jones total hip arthroplasty (THA) has been widely used in the world. OBJECTIVE: To compare short-term clinical effects between minimally invasive modified Watson-Jones THA and modified Gibson THA. METHODS: Twenty-two patients accepted modified Watson-Jones method and 30 patients underwent modified Gibson approach. RESULTS AND CONCLUSION: The follow-up time was 18 months in 49 cases, 1 case lost to follow-up in modified Watson-Jones group and 2 cases in modified Gibson group. The significant differences between two groups were observed in decreases of indicators such as length of incision, volume of blood loss perioperative period, volume of blood transfusion, days at hospital postoperatively and time of operation (P < 0.05). Volume of postoperative blood loss, position of prosthesis, and hip functional evaluation system (Harris) were not significantly different between two groups. Complications including infection, dislocation, neurovascular injury, deep vein embolism were not observed in all cases. The general results of modified Watson-Jones group are better than modified Gibson group according to the short term follow-up data. Minimal invasive method leads to decreases of complications, loss of blood and time at hospital, good results in hip function, and early exercise is available. Related Articles | Metrics

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Minimally invasive surgery unicompartmental knee arthroplasty assisted by computer navigation system Liu Xiao-dong, Tu Yi-hui, Cai Min-wei, Xue Hua-ming, Ma Tong, Yang An-li 2011, 15 (35):  6504-6508.  doi: 10.3969/j.issn.1673-8225.2011.35.011 Abstract ( 285 )   PDF (625KB) ( 481 )   Save BACKGROUND: Computer navigation system in total hip replacement can strictly locate prosthetic position. OBJECTIVE: To explore the feasibility and preliminary effect of minimally invasive surgery unicompartmental knee arthroplasty (MIS-UKA) assisted by computer navigation system. METHODS: Between May 2009 and May 2010, 28 consecutive patients (28 knees) with unicompartmental knee osteoarthritis were treated with MIS-UKA assisted by computer navigation system. RESULTS AND CONCLUSION: All cases were followed up for average 18 months (12-24 months). The mean length of incision was 6.8 cm, the mean surgical time was 91.6 minutes, the mean blood loss during operation was 45.8 mL and the mean drainage was 38.5 mL. At the last follow up, all cases achieved significant relief of pain, improvement of HSS score and range of motion, and correction of varus deformity. None had complications of infection, fat embolism, deep vein thrombosis, malposition of prosthesis, dislocation and loosing. Computer navigation system-assisted MIS-UKA gives a better correction of alignment of the leg and orientation of the components. Computer navigation system can effectively improve the outcome of MIS-UKA. Related Articles | Metrics

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Controlled active motion and continuous passive motion are beneficial to function rehabilitation after total knee arthroplasty Liu Wei, Wu Yu-li, Cong Rui-jun, Fu Pei-liang, Li Xiao-hua, Wu Hai-shan 2011, 15 (35):  6509-6513.  doi: 10.3969/j.issn.1673-8225.2011.35.012 Abstract ( 301 )   PDF (538KB) ( 1106 )   Save BACKGROUND: Early rehabilitation training can improve the knee function to maximal extent after total knee arthroplasty (TKA). OBJECTIVE: To acknowledge the difference between controlled active motion and continuous passive motion effects on function rehabilitation after TKA. METHODS: 226 patients who underwent unilateral TKA were divided randomly into controlled active motion group and continuous passive motion group. Patient’s general condition, range of motion (ROM), visual analogue scale (VAS) score, knee society score (KSS) function score were recorded at 1.5, 3, 6 months postoperatively. RESULTS AND CONCLUSION: At 3 months postoperatively, the KSS score in the controlled active motion group was superior to that in the continuous passive motion group; at 6 months postoperatively, there was no significant difference in the KSS score between the two groups. At 1.5 and 3 months after TKA, the ROM in the controlled active motion group was better than that in the continuous passive motion group; while, at 6 months, no significant difference was shown between the two groups. Controlled active motion can promote the function rehabilitation after TKA. Related Articles | Metrics

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Effects of epidural analgesia and intravenous analgesia on early postoperative cognitive dysfunction after limb orthopedics surgery in the elderly Wang Shi-ying, Kong Ling, Bi Guang-yan, Wei Guang-wu 2011, 15 (35):  6514-6517.  doi: 10.3969/j.issn.1673-8225.2011.35.013 Abstract ( 384 )   PDF (623KB) ( 587 )   Save BACKGROUND: Postoperative cognitive dysfunction (POCD) is being recognized as a complication contributing to perioperative morbidity and mortality of the elderly. We hypothesized that the use of postoperative epidural analgesia would be associated with less incidence of POCD when compared with postoperative intravenous analgesia after limb orthopedics surgery in the elderly. OBJECTIVE: To compare the effects of epidural analgesia and intravenous analgesia on early postoperative cognitive dysfunction after limb orthopedics surgery in the elderly. METHODS: Sixty aged patients undergoing elective limb orthopedics surgery were randomly allocated to receive either epidural anesthesia with postoperative intravenous analgesia or epidural anesthesia with postoperative epidural analgesia. RESULTS AND CONCLUSION: POCD occurred in 14/30 patients (47%) in the intravenous analgesia group and in 9/30 patients (30%) in the epidural analgesia group. There was a significant difference between the two groups (P < 0.01). Logistic regression analysis showed that short duration of education and total hip arthroplasty were independent risk factors for the occurrence of early POCD. The results indicated that POCD occurred in 38% of the elderly patients undergoing limb orthopedics surgery and the epidural analgesia group had less negative effect on early POCD. Short duration of education and operation of total hip arthroplasty were risk factors for early POCD. Related Articles | Metrics

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Minimally invasive percutaneous plate osteosynthesis for distal metaphyseal fracture of tibia: Meta plate versus locking plate Ma Tong, Cai Ming-wei, Liu Xiao-dong, Tu Yi-hui 2011, 15 (35):  6518-6521.  doi: 10.3969/j.issn.1673-8225.2011.35.014 Abstract ( 368 )   PDF (506KB) ( 593 )   Save BACKGROUND: Minimally invasive percutaneous plate osteosynthesis has become widely used for the treatment of distal metaphyseal fracture of the tibia. Different plates have their own unique advantages. OBJECTIVE: To evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis with Meta plate versus locking plate in the treatment of distal metaphyseal fracture of the tibia. METHODS: Twenty-three cases of distal tibia fractures were treated with MIPPO technique, including 16 cases undergoing Meta plate fixation and 7 undergoing locking plate fixation. The incision and complications were observed. The results were evaluated by AOFAS scores. RESULTS AND CONCLUSION: All patients were followed up for average 13.8 months, ranging from 12 to 19 months. The average healing period was 14.1 weeks. Using the AOFAS ankle-hindfoot scale, the average score was 93 points. One patient had loss of alignment, and one underwent superficial infection. Minimally invasive plate osteosynthesis with Meta plate or locking plate is safe and effective for distal metaphyseal fracture of the tibia. Related Articles | Metrics

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Self-locking expandable intramedullary nail versus locking plate in the treatment of closed tibial shaft fractures Ma Xue-hai, Zheng Jin, Zheng Sheng-nai, Tang Cheng, Xu Yan 2011, 15 (35):  6522-6526.  doi: 10.3969/j.issn.1673-8225.2011.35.015 Abstract ( 317 )   PDF (768KB) ( 463 )   Save BACKGROUND: Because the operation technique of self-locking expandable intramedullary nail is relatively simple, it has some advantages in the treatment of simple closed tibial fracture. OBJECTIVE: To investigate and discuss the feasibility and clinical outcome of self-locking expandable intramedullary nail versus locking plate in the treatment of closed tibial shaft fracture. METHODS: In self-locking expandable intramedullary nail group, 15 cases were operated. In locking plate group, 16 cases were operated. Time of operation, the intra-operative blood loss, the rate of complications, time of leave bed, time of bone union, the KSS score of the knee were recorded. RESULTS AND CONCLUSION: The time of operation and intra-operative blood loss in self-locking expandable intramedullary nail group were lower than those in locking plate group (P < 0.05), while the time of leave bed was shorter in the self-locking expandable intramedullary nail group (P < 0.05). There were no statistical differences in the perioperative or postoperative complications, the time of bone union, and the KSS score of the knee in the two group. It may be an appropriate technique for using self-locking expandable intramedullary nail to treat closed tibial shaft fracture. Related Articles | Metrics

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Different interbody implants for long segment ossification of cervical posterior longitudinal ligament Tan Ming, Zhao Ming-jie, Jiao Gen-long, Li Zhi-zhong, Sun Guo-dong 2011, 15 (35):  6527-6531.  doi: 10.3969/j.issn.1673-8225.2011.35.016 Abstract ( 290 )   PDF (572KB) ( 580 )   Save BACKGROUND: Treatments for ossification of cervical posterior longitudinal ligament (OPLL) are controversial, and there is no there is no standard treatment program. OBJECTIVE: To discuss and analyze the different surgical treatments effect on long-segment OPLL. METHODS: Thirty-five long-segment OPLL accompanied with severe cervical spondylotic myelopathy were followed up, including 10 cases undergoing anterior cervical corpectomy, removal or partial removal of ossification foci, interbody implant fusion as group A, 16 receiving posterior open-door laminoplasty, decompression, bone graft and internal fixation as group B, and 9 undergoing posterior open-door laminoplasty without internal fixation as group C. RESULTS AND CONCLUSION: All cases were followed up for 6-24 months. Twelve months after treatment, the mean amelioration rate was 79.59% in group A, 83.01% in group B, 60.35% in group C. There was 1 case with dural tear in group A, and 3 cases without obvious symptom changes in group C. These findings indicate that the therapy of open-door laminoplasty, decompression, bone graft and internal fixation is good, safe and effective for long-segment OPLL. Related Articles | Metrics

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Biomechanical stability of the lower cervical spine inter-fixation by anterior approach combined with posterior articular screws Kang Jian-ping, Feng Da-xiong, Wang Qing, Zhong De-jun, Li Jun, Ye Fei, Wang Song 2011, 15 (35):  6532-6535.  doi: 10.3969/j.issn.1673-8225.2011.35.017 Abstract ( 322 )   PDF (632KB) ( 390 )   Save BACKGROUND: A simple anterior corpectomy or discectomy, or simple posterior open canal to expand a single trip cannot fully complete three-column spinal cord decompression and spinal stabilization in patients with degenerative cervical stenosis. OBJECTIVE: To study the biomechanical stability of the lower cervical spine inter-fixation by anterior approach combined with posterior srticular screws.  METHODS: Ten cervical spine specimens were gained from cadavers. Every specimen was managed via two methods sequentially: The first method was by posterior C3-C7 open-door laminoplasty combined with posterior articular screw fixation and by anterior C5 subtotal corpectomy with bone granule graft in the titanium mesh and ORION fixation (test group); The second method was by posterior C3-C7 open-door laminoplasty and by anterior C5 subtotal corpectomy with bone granule graft in the titanium mesh and ORION fixation (control group). RESULTS AND CONCLUSION: Compared with the control group, displacement angles of flexion, extension, left/right lateroflexion left/right rotation in the test group were lower (P < 0.001). The findings indicated that: ①The lower spine gained the excellent biomechanical stability in flexion, extension, lateroflexion and rotation via the treatment of anterior fixation combined posterior articular screw fixation. ②The treatment of anterior fixation combined with posterior articular screw fixation provided significant biomechanical stability to the lower cervical spine in flexion position. Related Articles | Metrics

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Posterior screw-rod system fixation combined with anterolateral decompression and bone graft for severe thoracolumbar burst fracture in 12 cases Liu Jun, Xiang Liang-bi, Wang Qi, Chen Yu, Yu Hai-long, Cao Yan 2011, 15 (35):  6536-6539.  doi: 10.3969/j.issn.1673-8225.2011.35.018 Abstract ( 305 )   PDF (592KB) ( 422 )   Save BACKGROUND: The procedures of anterolateral decompression, bone graft with mesh and internal fixation with screws and rods can achieve through the same incision in the treatment of thoracolumbar burst fractures. OBJECTIVE: To evaluate the clinical effects of anterolateral decompression, bone graft with mesh and internal fixation with screws and rods in the treatment of thoracolumbar burst fractures. METHODS: Twelve thoracolumbar burst fracture patients with neurologic deficit were treated with anterolateral decompression, bone graft with mesh and internal fixation with screws and rods. RESULTS AND CONCLUSION: The mean follow-up time was 16 months. Sufficient decompression, excellent fusion of bone graft and recovered vertebral body height were achieved in all cases. The Cobb’s angle was rectified from preoperative 22° to 6° postoperatively. And Frankel grade scores were significantly improved in 9 cases (grade 1 in 6 cases, grade 2 in 3 cases, and no changes in 3 cases). The procedures of anterolateral decompression, bone graft with mesh and internal fixation with screws and rods are effective, which can achieve anatomical reduction, complete decompression and restabilization through the same incision. But the operation indications should be restrictedly controlled because of the more trauma and blood loss. Related Articles | Metrics

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Unilateral versus bilateral instrumented posterolateral lumbar fusion in degenerative spondylolisthesis: A randomized controlled trial Chu Ge, Kahaer•Aikenmu, He Zu-sheng 2011, 15 (35):  6540-6545.  doi: 10.3969/j.issn.1673-8225.2011.35.019 Abstract ( 387 )   PDF (624KB) ( 522 )   Save BACKGROUND: Segment fusion supplemented by pedicle screw fixation for lumbar degenerative diseases can increase the fusion rate. OBJECTIVE: To determine the effectiveness of unilateral pedicle instrumentation in clinical outcome and rate of union in comparison with the classic bilateral system. METHODS: Eighty-two patients were randomized into two groups: Group 1 (n=42) had had bilateral instrumentation, and Group 2 (n=40) had only had unilateral instrumentation. RESULTS AND CONCLUSION: Statistically, there was no significant difference between the two groups in relation to demographics, blood loss, need of transfusion, hospital stay, complications, clinical results, rate of union, and effect on adjacent discs. The operating time needed for Group 2 was significantly shorter than that for Group 1 (P < 0.001). In Group 1, 3 of 186 screws violated the pedicle cortex requiring reoperation because root irritation versus no complication on a total of 90 screws in Group 2. Unilateral instrumentation used for the treatment of degenerative lumbar spondylolisthesis is as effective as bilateral instrumentation when performed in addition to 1- or 2-level posterolateral fusion. The cost of this method is lower, saves time, and reduces possible risk inserting screws in only one side. Related Articles | Metrics

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Normal hips and the hips covered with protective brace：A finite-element comparative analysis He Jian-ying, Dong Xie-ping 2011, 15 (35):  6546-6550.  doi: 10.3969/j.issn.1673-8225.2011.35.020 Abstract ( 328 )   PDF (522KB) ( 367 )   Save BACKGROUND: Finite element method has become an important means for biomechanical study against sideways falls because of its unlimited sample size, small experimental error and good repeatability. OBJECTIVE: To establish three-dimensional normal pelvis and brace-covered pelvis models and then to analyze the stress, strain and displacement distribution during sideways fall and to verify the effectiveness of hip brace. METHODS: Digital human Abaqus 6.51 software was used to build three-dimensional normal pelvis and brace-covered pelvis models. The rigid constraint surface was fixed. The whole pelvic model was loaded with 2 m/s loading. The stress, strain and displacement variation with time and contours were detected prior to and after wearing the hip brace. RESULTS AND CONCLUSION: Compared with the normal model, the contact force between the pelvis and the ground, the maximal compression strain of the cancellous bone when the maximal contact force between the pelvis and the ground generated, the maximal strain of the greater trochanter and femoral neck, the maximal von-Mises stress of the greater trochanter and femoral neck, and the mean stress of the greater trochanter and femoral neck were significantly reduced in the brace-covered pelvis model during sideways falls. These findings indicate that the hip brace can play a protective role in the greater trochanter, and effectively reduce the incidence of intertrochanteric fractures during sideways fall. Related Articles | Metrics

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Perfusion function of rat proximal femur bone marrow and its stability determined using dynamic contrast-enhanced MRI Zhang Ya-feng, Cheng Qiong, Zhu Yong, Liu Fan 2011, 15 (35):  6551-6554.  doi: 10.3969/j.issn.1673-8225.2011.35.021 Abstract ( 310 )   PDF (490KB) ( 291 )   Save BACKGROUND: Due to improvement of MRI surface coil and new-type contrasts, it is possible to use dynamic contrast-enhanced MRI to measure bone marrow blood perfusion function in rats. OBJECTIVE: To explore the methodology using dynamic contrast-enhanced MRI to measure the perfusion function of rat proximal femur bone marrow and explore its reliability. METHODS: Contrast agents were injected from tail vein into Wistar rats. Dynamic contrast-enhanced MRI was measured using 1.5T whole body MRI scanner. One week later, the measurement was repeated. Then, time-signal intensity curve was explored. Maximum enhancement (ME) and enhancement slope (ES) were calculated. RESULTS AND CONCLUSION: ME of test 1 and test 2 were (140.42±17.17)% and (136.57±13.87)%, respectively. ES of test 1 and test 2 were (3.81±0.17)%/s and (3.71±0.20)%/sec, respectively. There was no statistically significant difference in ME and ES between the two tests. The methodology explored in this study which used dynamic contrast enhanced MRI to measure the perfusion function of rat proximal femur bone marrow were reliable and repeatable. Related Articles | Metrics

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Ex vivo femoral bone mineral measurements in sheep using dual energy X-ray absorptiometry Dong Jun, Yan Hu, Tan Yuan-chao, Zhang Qiu-ling, Lu Yu-lai 2011, 15 (35):  6555-6558.  doi: 10.3969/j.issn.1673-8225.2011.35.022 Abstract ( 304 )   PDF (573KB) ( 449 )   Save BACKGROUND: At present, sheep has gradually become a promising model in osteoporosis research. OBJECTIVE: To measure the sheep femoral fracture fragments and all bone mineral density by the dual energy X-ray absorptiometry (DXA), and to discusses the precision and accuracy of the DXA in the process of measurements. METHODS: The Own Lunar lumbar model was scanned with DXA 10 times every day in order to determine the precision of the machine and then continuous scanned for 25 days. Shewhart control chart was established according to the measured data. Five femoral bones were selected from three sheep and scanned repeatedly seven times. The DXA animal analysis software was used to analyze the bone density of the sheep femoral fracture fragments and all bone mineral density to calculate its accuracy. Besides, eight femoral bones from four sheep were selected, fixed at the femoral fracture site by two kinds of steel plates for analysis of bone mineral density and observation of bone mineral content changes. RESULTS AND CONCLUSION: The precision of the machine was -1.0% and the accuracy of the sheep femoral fracture fragments and all bone density was 0.005-0.537 g/cm2. The short-term precisions of the femoral and fracture fragments bone mineral density were separately 0.8% and 1.5%, and the short-term precisions of the femoral and fracture fragments bone mineral content were 0.9% and 7.5%. There was no significant meaning in the bone density of sheep femoral fixed by different plates and bone mineral content difference. The results confirm that the DXA can accurately measure the bone density of the femur in vitro, but there are some errors in analyzing the bone mineral density of fracture fragments. Related Articles | Metrics

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Three-dimensional reconstruction of cardiac ultrasonic image based on VTK and ITK Toolkit  Huang Yun-zhi, Liu Qi 2011, 15 (35):  6559-6562.  doi: 10.3969/j.issn.1673-8225.2011.35.023 Abstract ( 563 )   PDF (573KB) ( 707 )   Save BACKGROUND: Three-dimensional model of medical images can provide direct visual reference for medical workers. Accurate three-dimensional structure of cardiac has an increasingly prominent on the clinical diagnosis. OBJECTIVE: To accomplish the three-dimensional structure reconstruction of continuous multi-frame ultrasound images from the B scan. METHODS: With the help of the toolkits including Visualization Toolkit (VTK) and Segmentation & Registration Toolkit (ITK), the method of Ray Casting was adopted to realize the three-dimensional construction of cardiac ultrasonic image using the given DICOM continuous multi-frame of medical ultrasound images, under the platform of VC++. In the designed system, user could interact with the three-dimensional images through clicking the mouse and figure the image from any view. RESULTS AND CONCLUSION: The results show that composite volume rendering is more feasible in the reconstruction. Related Articles | Metrics

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Lumbar facet orientation in patients with lumbar disc herniation Yan Guang-hui, Xu Bao-shan, Xia Qun, Tan Qing-shi, Wang Wen-ge, Yang Hai-ping 2011, 15 (35):  6563-6566.  doi: 10.3969/j.issn.1673-8225.2011.35.024 Abstract ( 403 )   PDF (557KB) ( 643 )   Save BACKGROUND: The relationship between lumbar facet orientation and lumbar disc herniation (LDH) is the one of the research focus in the spine. But that does not reach consensus. OBJECTIVE: To investigate the relationship of lumbar facet orientation to LDH. METHODS: A total of 169 backleg pain patients were examined with CT, which were in three groups. L4/5 LDH was 35 subjects in group A, L5/S1 LDH was 67 subjects in group B and the other 67 subjects (control group) were normal in CT examination in group C. All measurements were performed using bone window CT images. The plane was selected aligned parallel to the vertebral up endplate. The lumbar facet was separated in anteriomedialis-angle and posteriolateralis-angle based on the most depressed of the lumbar facet. The three angles between left and right in one group and in the three groups were compared respectively. RESULTS AND CONCLUSION: ①For groups A and B, the left angle was bigger than the right in the lumbar facet angle (P < 0.05); while the control group had no difference between both sides (P > 0.05); and there was no difference between the both sides for three groups in anteriomedialis-angle and posteriolateralis-angle (P > 0.05). ②Difference in lumbar facet angle, anteriomedialis-angle and posteriolateralis-angle was not found in the three groups (P > 0.05). ③The lumbar facet angle and posteriolateralis-angle were gradually increased from L3/4 ,L4/5 and L5/S1 in all subjects (P > 0.05); while the L4/5 was the biggest, the L3/4 was the smallest for the anteriomedialis-angle (P > 0.05). There are some associations between lumbar intervertebral disc herniation and lumbar facet angle asymmetry. The lumbar facet angle and posteriolateralis-angle is more and more coronal from L3/4, L4/5 and L5/S1 in all subjects and the anteriomedialis-angle is more coronal in L4/5, which may cause lumbar spinal stenosis. Related Articles | Metrics

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Static magnetic field reduces the toxic effect of metal ions on osteoblasts Zhou Tong-hua, Dai Min, Cheng Xi-gao, Zhan Ping, Xiong Hao, Zhou Wen-nan, Yan Xiao-qing 2011, 15 (35):  6567-6570.  doi: 10.3969/j.issn.1673-8225.2011.35.025 Abstract ( 301 )   PDF (603KB) ( 406 )   Save BACKGROUND: Static magnetic field can promote the proliferation, differentiation and functional activity of osteoblasts. OBJECTIVE: To investigate the toxic effect of metal ions Co2+, Cr3+ on osteoblasts under the static magnetic field. METHODS: CoCl2 powder and CrCl3 powder were dissolved in the asepsis injecting water. Mouse calvarial osteoblasts (MC3T3-E1) were cultured with Co2+ and Cr3+ ions in different magnetic field of 1, 10, 100 mT. Cells only cultured with Co2+ and Cr3+ ions were taken as control group. RESULTS AND CONCLUSION: Under the static magnetic field, osteoblasts showed more mature morphological features; the toxic effect of metal ions Co2+ and Cr3+ on osteoblasts reduced significantly; G2M (dividing phase) distribution ratio increased and G0G1 (dormancy stage) distribution ratio decreased; the A value tested by alkaline phosphatase activity in the three experiment groups up-regulated obviously. The static magnetic field in certain intensity could antagonize the toxic effect of metal ions Co2+ and Cr3+ on osteoblasts. Related Articles | Metrics

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Constructing a rabbit model of necrosis of the femoral head by the combination of dexamethasone and lipopolysaccharide Tian Li, Liang Xiao-peng, Tian Xiao-ye, Yu Xin-chen, Tian Jing 2011, 15 (35):  6571-6574.  doi: 10.3969/j.issn.1673-8225.2011.35.026 Abstract ( 337 )   PDF (562KB) ( 435 )   Save BACKGROUND: An ideal animal model of necrosis of the femoral head is beneficial to the studies on the cause of disease, pathogenesis and treatment. OBJECTIVE: To research the experimental result of necrosis of rabbit femoral head induced by the combination of dexamethasone and lipopolysaccharide. METHODS: Thirty male New Zealand rabbits were divided into experimental group (20 rabbits) and control group (10 rabbits) randomly. Two injections of 10 μg/kg body lipopolysaccharide and three injections of 25 mg/kg dexamethasone were performed in the experimental group. Physiologic saline was injected in the control group. RESULTS AND CONCLUSION: The CT scanning showed non-uniform of bone density of the femoral head in the experimental group. The indexes of Micro-CT bone metrological parameters were significantly lower in the experimental group than in the control group (P < 0.05). Bone cell lacunae, increased fat cells and thrombokinesis were observed in histopathological examination. The osteonecrosis rate of survived rabbits as well as the rate of empty bone lacunae was significantly lower in the experimental group than the control group. It is indicated that the combination of dexamethasone and lipopolysaccharide can induce an osteonecrosis model. Related Articles | Metrics

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M-shaped plate fixation for posterior pelvic ring injury: A stability study Wang Wei-feng, Zhou Dong-sheng, Tan Guo-qing, Fu Bai-sheng, He Ji-liang, Liu Yu-long 2011, 15 (35):  6575-6578.  doi: 10.3969/j.issn.1673-8225.2011.35.027 Abstract ( 314 )   PDF (591KB) ( 400 )   Save BACKGROUND: Accurate reduction and stable fixation after posterior pelvic ring injury are closely related to postoperative functional status. OBJECTIVE: To investigate the clinical experience that M-shaped plate fixation for injuries at the posterior ring of the pelvis. METHODS: The clinical data of 32 cases with posterior pelvic ring injury undergoing M-shaped plate were analyzed retrospectively. There were 22 males and 10 females, at age range of 18-51 years (mean 34.5 years). Fracture reduction was evaluated by Matta criterion and function was evaluated by Majeed functional scoring. RESULTS AND CONCLUSION: The average intraoperative time was 1.5 hours (ranging from 1 to 2 hours), and the average intraoperative blood was 190 mL (ranging from 80 to 300 mL). There was no iatrogenic nerve injury and all the incisions healed during the primary procedure. All the patients were available at follow-up, with a mean period of 22 months (ranging from 8 to 36 months). According to Matta criterion for fracture reduction, the results were excellent in 24 patients, good in 6 and fair in 2, with excellence rate of 93.8%. According to the Majeed functional scoring, the results were excellent in 20 patients, good in 8 and fair in 4, with excellence rate of 87.5%. M-shaped plate fixation for posterior pelvic ring injury has the advantages of broad indications, simplicity of operator, short intraoperative time, small trauma, less bleeding, fewer complications, and significant clinical efficacy, which is worth spreading. Related Articles | Metrics

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Osteoprotegerin expression changes in the periodontal tissue following titanium-alloy miniscrew as anchorage for the maxillary incisors intrusion Lu Jia-jing, Qi Tao, Ge Zhen-lin 2011, 15 (35):  6579-6583.  doi: 10.3969/j.issn.1673-8225.2011.35.028 Abstract ( 399 )   PDF (783KB) ( 359 )   Save BACKGROUND: Osteoprotegerin (OPG) inhibits osteoclast (OC) formation and differentiation and increases bone density. It is a key factor for inhibiting bone resorption. However, the precise mechanism of OPG remains unclear following mini-implant anchorage for the maxillary incisors intrusion. OBJECTIVE: To observe the expression of OPG in the periodontal tissue following the mini-implant anchorage for the maxillary incisors intrusion. METHODS: Nine dogs were selected and randomly divided into 5 groups: Ⅰ group was control group, including 1 dog with no force given; Ⅱ, Ⅲ, Ⅳ, Ⅴ groups contained 2 dogs respectively. Mini-implants were inserted into the labial alveolar bone between the roots of maxillary the second and the third incisors on both sides; 100 g force was imposed on the first and the second incisors on both sides. At the end of 1, 2, 4, 12 weeks (activation for 4 weeks, then retention for 8 weeks after force removal), the animals were sacrificed, the first and second incisor teeth on the one side were randomly selected and these teeth with gums, alveolar bone tissue were completely cut. Then expression of OPG in periodontal ligament (PDL) was inspected by using immunohistochemistry. RESULTS AND CONCLUSION: Expression of OPG in the alveolar bone and periodontal ligament tissues increased at 1 week after force given, reached maximum at 2 weeks after activation, and then dropped to normal level at 4 weeks after activation. After 12 weeks (activation for 4 weeks, then retention for 8 weeks after force removal), it increased insignificantly, which did not differ from that at 4 weeks after activation and the control group. OPG participated in the reconstruction of periodontal tissues and dynamically changed along with time following mini-implant anchorage for the maxillary incisors intrusion. Related Articles | Metrics

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Optical localizer of surgical navigation system based on binocular stereo vision Wu Xue-mei, Liu Qi 2011, 15 (35):  6584-6587.  doi: 10.3969/j.issn.1673-8225.2011.35.029 Abstract ( 437 )   PDF (616KB) ( 730 )   Save BACKGROUND: Localizer of surgical navigation system based on binocular stereo vision can supply real-time displays of the relative location and orientation between surgical instruments and the lesion location for doctors. It can improve surgical precision and reduce the time of surgery, makes it possible for that conventional surgery can not achieve. OBJECTIVE: To localize the points of markers for navigation on the surgical needle-holder by binocular stereo vision. METHODS: First, extract characteristics of the central objectives of markers for navigation on the surgical needle-holder by gravity method with threshold; Second, Considering that the surgical navigation system requires high-precision location and well stability, with the camera’s calibrating results by Zhang’s camera calibration method, get the three-dimensional coordinates of markers for navigation on the surgical needle-holder by least square method, and then relative location between puncture needle and the lesion site will be given. RESULTS AND CONCLUSION: Stereo Optical Localizer System can fulfill real-time positioning of markers for navigation on the surgical needle-holder under the current experiment condition and the surgical precision is high enough for the need of surgical navigation. Related Articles | Metrics

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Design of color matching system for porcelain teeth based on computer digital image processing and pattern recognition technology Liu Ji-hong, Tao Yi-tian 2011, 15 (35):  6588-6591.  doi: 10.3969/j.issn.1673-8225.2011.35.030 Abstract ( 408 )   PDF (626KB) ( 449 )   Save BACKGROUND: In order to make the porcelain tooth and the patient’s own tooth more alike, dentist needs tooth guide’s help. Dentist puts tooth guide near patient’s tooth, and finds the most similar color with naked eye. This method is easily affected by the light surrounding. Or different dentists may give different judgment of one patient. OBJECTIVE: To design an image acquisition system for color matching to find the nearest color of the tooth in the tooth guide, and to improve the recognition rate as much as possible. METHODS: Capture and collect tooth photos in the tooth guide. Extract the color feature of the tooth with image processing techniques. Recognize the color type which the tooth belongs to in the tooth guide in different methods. RESULTS AND CONCLUSION: Nearest method and K-nearest neighbor method can do the recognition, but the recognition rates are not good enough due to the small data amount. The nine-slice method can raise the recognition rate, and get an available result. Related Articles | Metrics

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Application of BP artificial neural network in the electronic medical record system Wang Xin-ping, Sun Xin, Sun Yao 2011, 15 (35):  6592-6595.  doi: 10.3969/j.issn.1673-8225.2011.35.031 Abstract ( 375 )   PDF (609KB) ( 469 )   Save BACKGROUND: There are a large number of information in the electronic medical records which can assist medical diagnosis and decision-making; OBJECTIVE: To perform data mining in electronic medical records based on BP neural network. METHODS: BP artificial neural network theory and algorithms are analyzed, and there are six steps to build a BP artificial neural network model, including the training data set identification, data preparation, network model, data mining, and evaluating and predicting the results obtained from the BP network. The related applications of the BP artificial neural network in the electronic medical records were analyzed. RESULTS AND CONCLUSION: BP artificial neural network can be used to analyze and predict the electronic medical records to find the risk factors. BP artificial neural network data analysis has practical application value in the electronic medical records system. Related Articles | Metrics

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Research on minimally invasive robotic surgery Xu Zhao-hong, Song Cheng-li, Yan Shi-ju 2011, 15 (35):  6598-6601.  doi: 10.3969/j.issn.1673-8225.2011.35.033 Abstract ( 519 )   PDF (771KB) ( 957 )   Save BACKGROUND: With the rapid development of robotics technology, minimally invasive robotic surgery (MIRS) has been investigated in various surgical procedures due to its high accuracy, fine manipulation capability, good repeatability, high reliability, lack of fatigue, tele-operation. OBJECTIVE: To analyze the status of MIRS, and to study the key technology of MIRS. METHODS: According to the characteristics and clinical application of MIRS, from in vitro and  robotic surgery, some key technologies are discussed in detail. RESULTS AND CONCLUSION: Haptic (mainly force) feedback plays a significant role in MIRS. The proposed key technologies could be used to tele-robotic system and clinical application. Related Articles | Metrics

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Cell transplantation and tissue engineering reconstruction of nucleus pulposus in the treatment of intervertebral disc degeneration  Chen Qing-he, Ye Jun-jian 2011, 15 (35):  6602-6606.  doi: 10.3969/j.issn.1673-8225.2011.35.034 Abstract ( 360 )   PDF (666KB) ( 478 )   Save BACKGROUND: It is the best ideal therapy for degenerative disc diseases to implant cells or cell scaffold complex into the degenerated disc so as to improve the regeneration of the intervertebral disc. OBJECTIVE: To evaluate the clinical effect and prospect of in vivo transplantation of nucleus pulposus cells for degenerative disc diseases. METHODS: The first author retrieved PubMed, CNKI, and Wanfang databases for articles about tissue engineering nucleus pulposus, tissue engineering materials and bone marrow mesenchymal stem cells for treatment of degenerative disc diseases published from 1990 to 2010. RESULTS AND CONCLUSION: The common scaffolds include collagen scaffold, agarose scaffold, alginate scaffold, polyglycolic acid scaffold, chitosan scaffold and composite scaffold. By gene screening technique, the seed cells were selected from autologous disc cells or mesenchymal stem cells. Then, the cells and/or cell scaffold complex transplantation was for synthesis of regenerated extracellular matrix. It provides a new therapeutic strategy for functional recovery of degenerated disc through the reversal and restoration of intervertebral disc cells. Related Articles | Metrics

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Current situation and progress of bone histomorphometry studies in clinical bone diseases Li Jian-chi, Huang Bi-liu, Xu Zi-qiang 2011, 15 (35):  6607-6610.  doi: 10.3969/j.issn.1673-8225.2011.35.035 Abstract ( 362 )   PDF (593KB) ( 696 )   Save BACKGROUND: Bone histomorphometry is a quantitative histological examination of an undecalcified bone biopsy performed to obtain quantitative information on bone remodeling and structure. It has been widely used in the development of mechanisms in metabolic bone disease, anti-osteoporosis drugs and other research in recent years. OBJECTIVE: To review bone histomorphometry from it was aware of clinical research to clinical applications and prospects, to clarify its application and research status in clinical bone diseases. METHODS: A computer of CNKI database (2000-2010) and PubMed database (1965-2010) was performed by the first author using “bone histomorphometry, metabolic bone diseases, bone biopsy, bone remodeling, humans” in Chinese and English as the key words, to retrieve relevant literatures about the research of bone histomorphometry in clinical bone disease, Finally, 30 literatures were included for analysis. RESULTS AND CONCLUSION: The results show that the bone histomorphometry is of indispensable value and significance in clinical use and effective assessment. Bone histomorphometry has an important role in bone structure, bone metabolism, bone biology pathology, bone and bone-reactive protein and other drugs in several directions, multidisciplinary research. References | Related Articles | Metrics

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Relationship of lumbar interbody fusion with anterior column structure and biomechanics Xie Hong-ru, Wang Huan 2011, 15 (35):  6611-6614.  doi: 10.3969/j.issn.1673-8225.2011.35.036 Abstract ( 284 )   PDF (705KB) ( 408 )   Save BACKGROUND: Lumbar spine fusion is one of the most common operations for low back pain in spinal surgeons, but the clinical spine fusion rate is still low-level. How to availably promote spine fusion, raise fusion rate and clinical effect, and decrease complications is a problem for the spinal surgeon to work out. OBJECTIVE: To summarize the relation between lumbar interbody fusion and anterior column, and to analyze the influence of structural and biomechanical changes on fusion rate. METHODS: A computer online retrieval of CBM/CNKI/Medline for articles and reviews about lumbar interbody fusion published 1995-2009 was performed. RESULTS AND CONCLUSION: The stability and integrality of the anterior column have notable effects on interbody fusion. In anterior lumbar interbody fusion and the fixations of anterior column fracture, we would better protect the structure and blood supply of the anterior column, and resume the integrality and stability of the anterior column to maintain the biomechanics environment of the lumbar, aiming to achieve the better fusion effect. Related Articles | Metrics

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Mining gene functional modules associated with rheumatoid arthritis and their corresponding topological properties analysis Hua Lin, Zhou Ping, Liu Hong 2011, 15 (35):  6615-6618.  doi: 10.3969/j.issn.1673-8225.2011.35.037 Abstract ( 237 )   PDF (668KB) ( 321 )   Save BACKGROUND: Rheumatoid arthritis (RA) is a complex polygene genetic disease. High throughput SNP genotype data made traditional genetics analysis get into trouble to identify important markers associated with disease. OBJECTIVE: To mine gene functional modules associated with RA and to perform their corresponding topological properties analysis. METHODS: For GWA data set-Wellcome Trust Case Control Consortium (WTCCC) for RA, we extracted risk SNPs firstly and mapped these risk SNPs to genes with UCSC database. The acquired risk genes were mapped to protein-protein interaction network and the gene function modules were extracted by analyzing the structure of network. Especially, for some significant risk gene modules, we focused on their topological properties analysis. RESULTS AND CONCLUSION: When comparing the network topological properties of the gene function modules with pathways from the KEGG database, we found that they clearly differ from those of most disease-related KEGG pathways. Related Articles | Metrics

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Development and application of measurement methods for ankle proprioception Zhang Qiu-xia, Hua Xiu-qin, Shi Yong-jian 2011, 15 (35):  6619-6623.  doi: 10.3969/j.issn.1673-8225.2011.35.038 Abstract ( 393 )   PDF (672KB) ( 756 )   Save BACKGROUND: The loss of the ankle proprioception is an important reason for ankle sprain. But there is no standard in the measurement methods of the ankle proprioception. OBJECTIVE: To review the measurement methods of the ankle proprioception. METHODS: This study was retrived by the author with the key words of “joint position sense, muscle force sense; balance capacity; proprioception; ankle joint” in English and “proprioception; balance capacity; ankle joint” in Chinese from PubMed databaseand VIP database. Articles related with the measurement methods of ankle proprioception were included. The duplicated articles were excluded. A total of 53 articles, 2 in Chinese and 51 in English, were included in the final analysis. RESULTS AND CONCLUSION: There are such measurement methods of proprioception, as joint position sense, muscle force sense, threshold to detect passive motion, joint movement sense, balance measurement. The selection of measurement methods of the ankle proprioception should be based on actual needs. Related Articles | Metrics

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Research advances in quantitative assessment of early enamel caries on the smooth surface based on optical coherence tomography Li Yan-ni, Yao Hui 2011, 15 (35):  6624-6627.  doi: 10.3969/j.issn.1673-8225.2011.35.039 Abstract ( 326 )   PDF (601KB) ( 486 )   Save BACKGROUND: Early enamel caries on the smooth surface is the subsurface demineralization limited in the enamel with an intact surface. It is difficult for routine clinical methods to make a definite diagnosis of early caries. OBJECTIVE: To summarize the histological characteristics and detecting methods of early enamel caries on the smooth surface, and the progress of quantitative assessment by optical coherence tomography. METHODS: Literatures about quantitative assessment of early caries on the smooth surface based on optical coherence tomography from CNKI and EBSCO HOST databases published from 1979 to 2011 were searched by the first author. The key words were “optical coherence tomography, early caries, smooth surface, quantitative assessment” both in English and Chinese. Papers published recently or in authoritative journals were selected. Totally 78 documents were initially searched and 31 included in this review. RESULTS AND CONCLUSION: The new technology, optical coherence tomography, which can image the demineralized enamel through detecting the back scatter signals and quantify early enamel caries with the parameters such as depth, reflectivity and attenuation coefficient, provides a new evidence to the diagnosis of early enamel caries. Related Articles | Metrics

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Effect of articular surface wear of different-material artificial hip joints on aseptic loosening Xiao Jin-ying, Xiao Xiao-yan, Tang Fang-gen, Liu Jian-ting 2011, 15 (35):  6628-6631.  doi: 10.3969/j.issn.1673-8225.2011.35.040 Abstract ( 347 )   PDF (585KB) ( 402 )   Save OBJECTIVE: To analyze the advantage and problems of artificial hip joints made of different materials in clinical applications, and to evaluate the effects of articular surface wear on aseptic loosening. METHODS: A computer search of relevant articles published from January 1990 to December 2009 was performed by using the keywords of “biological materials, hip, prosthesis, hip resurfacing” in Chinese and English. Repetitive studies or Meta analysis were excluded. RESULTS: The life of artificial hip joints is closely related to the articular surface wear. The appearance of aseptic loosening is not only related to the design of prostheses, but also associated with prosthetic materials. Based on the comparison of different hip prosthesis material properties, we provide the basis for the selection of an ideal hip prosthesis material with good wear resistance and biocompatibility. CONCLUSION: Surface modification of hip prosthesis materials and frictional behavior of human hip joint are biological hot spots in the future. The evaluation system for hip prosthesis materials is a serious problem to be solved. Related Articles | Metrics

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Association of LMX1A gene polymorphisms with susceptibility to congenital scoliosis in a Chinese Han population Fei Qi, Wu Zhi-hong, Wang Yi-peng, Zhou Xi, Wang Hai, Li Xiang, Qiu Gui-xing 2011, 15 (35):  6632-6638.  doi: 10.3969/j.issn.1673-8225.2011.35.041 Abstract ( 464 )   PDF (696KB) ( 470 )   Save BACKGROUND: Congenital scoliosis (CS) is caused by the abnormal development of embryonic spinal vertebrae, and its genetic etiology hypothesis has begun to attract the attention of many scholars. OBJECTIVE: To investigate whether polymorphisms of LMX1A gene are associated with CS in a Chinese Han population, and further, to study the relationship between polymorphisms of LMX1A and the clinical phenotypes of CS. METHODS: A total of 127 patients diagnosed with CS and the scoliosis-free control subjects (127 cases) were enrolled in this study. Genomic Based on genotype data from the International HapMap project, the key single nucleotide polymorphisms (SNPs) initially were selected using Haploview 4.1 software. Hardy-Weinberg equilibrium both in control and in case groups was analyzed. Case group were classified into different clinical phenotypes according to vertebral defect type, the location of deformity, the extent of developmental disruption, combined rib malformations and neural canal deformity. Genotying of all selected SNPs was done by SNPstream technology (Beckman Coulter SNPstream). All the data of SNPs with polymorphism are analyzed by the association analysis based on a single SNP. And pairwise linkage disequilibrium was calculated in the control population using Haploview 4.1 software. RESULTS AND CONCLUSION: Six SNPs of LMX1A gene (SNP1: rs1819768, SNP2: rs12023709, SNP3: rs16841013, SNP4: rs4656435, SNP5: rs4657412, SNP6: rs4657411) were genotyped and all polymorphisms were in Hardy-Weinberg equilibrium both in control and in case groups. The single locus analysis revealed the genotype distributions of SNP1 and SNP2 were statistically significantly different between case patients and control subjects (P=0.026 and P=0.026). In the unconditional logistic regression analysis, SNP1 and SNP2 both showed significant difference in both Ressessive model (OR=0.38; 95%CI=0.15-0.94) and overdominant model (OR=1.73; 95%CI=1.05-2.8), and the P values were 0.029 and 0.032, respectively. The Ressessive model was accepted as the best inheritance model because of the smaller AIC (Akaike information) value (354.9). SNP1, SNP2, SNP3 and SNP6 were in strong linkage disequilibrium. Both SNP4 and SNP5 were also in strong linkage disequilibrium. But no association was observed between all haplotypes polymorphisms and risk of CS. In the association analysis between the genotyhpes and the phenotype 1 (according to vertebral defect type) of CS, we got 3 positive SNPs. SNP1, SNP2 and SNP3 polymorphisms of LMX1A gene may related to CS with failure of formation. In the association analysis between the genotyhpes and other phenotypes of CS, no positive SNPs were obtained. It was suggested that genetic variants of LMX1A gene may be associated with the susceptibility to CS and different clinical phenotypes of CS in the Chinese Han population. Related Articles | Metrics

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Test-retest reliability of joint position in the knee and ankle of older people Wang Xue-qiang, Zheng Jie-jiao, Yu Zhuo-wei, Liu Jing, Feng Yan, Zeng De-ming, Chen Qian-hong 2011, 15 (35):  6639-6642.  doi: 10.3969/j.issn.1673-8225.2011.35.042 Abstract ( 301 )   PDF (491KB) ( 567 )   Save BACKGROUND: At home and abroad there are many studies of joint position in young people, but in older people, studies about test-retest reliability of joint position are lack. OBJECTIVE: To determine the test-retest reliability of joint position in the different position of knee and ankle in older people. METHODS: Ankle and knee joint position of 28 healthy older people was measured with passive replication test on the Biodex system 3 dynamometer. The absolute error angle of passive replication test was used to assess ankle position sense. The indicator of test-retest reliability of joint position was intraclass correlation coefficient (ICC). RESULTS AND CONCLUSION: The test-retest reliability of joint position was modest in the different positions of both knee, and the values of ICC were from 0.851 to 0.973. The test-retest reliability of joint position was also modest in plantarflexion and dorsiflexion of both ankle, and the values of ICC were from 0.742 to 0.964. The absolute error angle of passive replication test in the left ankle was better than the right (P < 0.05); the test-retest reliability of the left ankle (ICC was from 0.870 to 0.964) was better than that of the right ankle (ICC was from 0.742 to 0.944). The test-retest reliability of joint position is good in the knee and ankle of older people, and the correlation of the left ankle is better than the right. Related Articles | Metrics

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Treatment for intertrochanteric fractures in elderly patients Percutaneous compression plating system versus dynamic hip screw system Jing Cheng-wei, Ni Dong-kui, Zheng Dao-ming, Wang Pei, Zhu Fu-liang, Pang Xiao-jian 2011, 15 (35):  6643-6646.  doi: 10.3969/j.issn.1673-8225.2011.35.043 Abstract ( 362 )   PDF (320KB) ( 595 )   Save BACKGROUND: Expectant treatment for intertrochanteric fractures in elderly patients with osteoporosis and other chronic diseases can easily lead to complications of lying in bed. OBJECTIVE: To evaluate the results of percutaneous compression plating system (PCCP) for intertrochanteric fractures in elderly patients. METHODS: Thirty-two cases of elderly intertrochanteric fractures treated with PCCP admitted from June 2007 to June 2009 and 40 cases of elderly intertrochanteric fractures treated with dynamic hip screw system (DHS) were reviewed. The operative bleeding, operative time and curative effect were compared. RESULTS AND CONCLUSION: The operative bleeding and operative time in the patients receiving PCCP were significantly lower than those in the patients receiving DHS. There was not statistical significance between the curative effects about the two methods. PCCP applied in elderly patients with intertrochanteric fracture can get satisfactory effects, and the system is operated simply with minimally invasive surgery, which is beneficial to reduce surgical complications.  Related Articles | Metrics

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Association of the interleukin-16 gene polymorphisms with primary knee osteoarthritis susceptibility in female population of Guangxi Zhuang Autonomous Region Luo Shi-xing, Qin Xue, Zhao Jin-min, Su Wei, Deng Yan 2011, 15 (35):  6647-6650.  doi: 10.3969/j.issn.1673-8225.2011.35.044 Abstract ( 299 )   PDF (624KB) ( 435 )   Save BACKGROUND: Current genetic researches show that the risk factors for knee osteoarthritis (OA) mostly related to interleukin (IL) 1, 6, 10 and other interleukin genes. OBJECTIVE: To investigate whether the IL-16 gene polymorphisms is related to genetic susceptibility to primary OA in female. METHODS: Blood samples were obtained from 71 primary OA patients defined by a Kellgren–Lawrence score of 2 or greater, and 85 controls of Guangxi Han female population. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect IL-16 gene (rs11556218, rs4072111, rs4778889) distribution between the two groups. Genotype and allele frequencies were calculated by SPSS, and Hardy-Weinberg equilibriums and non-conditional logistic regression was performed to evaluate the association between OA susceptibility and genotype using the SNPstats.  RESULTS AND CONCLUSION: All genotype distributions of three single-nucleotide polymorphisms between the case and control group met Hardy-Weinberg equilibrium criteria (P>0.05). The results of non-conditional logistic regression analysis in codominant model showed that the T/T genotype of the rs11556218 might be a protective factor (OR=0.41, 95%CI=0.21-0.83, P=0.02) and the C/T genotype of the rs4072111 might be a risk factor (OR=2.36, 95%CI=1.19-4.68, P=0.03). It is indicated that the genetic polymorphisms of IL-16 gene may be associated with OA susceptibility in the Guangxi Han female population. Related Articles | Metrics