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22 January 2014, Volume 18 Issue 4 Previous Issue    Next Issue

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Anchor fixation in posterior surgery for cervical spinal canal stenosis combined with cerebral infarction shows less effect on the cerebral circulation Li Deng, Lou Chao-hui, Sun Dong-fang, Sun Hai-dong, Li Ying, Zhang Chun-lin 2014, 18 (4):  493-498.  doi: 10.3969/j.issn.2095-4344.2014.04.001 Abstract ( 428 )   PDF (2468KB) ( 453 )   Save BACKGROUND: There is a high risk for the elderly cervical spine surgery combined with cerebral infarction, whereas conservative treatment is often unable to resolve serious cervical lesions. OBJECTIVE: To discuss the surgical effects of anchor fixation via posterior approach on cervical spinal canal stenosis combined with cerebral infarction. METHODS: A total of 21 patients with cervical spinal canal stenosis combined with cerebral infarction who were admitted over the past 5 years accepted cervical posterior expensive open-door laminoplasty and fixation with wire anchors. Therapeutic effects were evaluated according to the Japanese Orthopaedic Association (JOA) scores. RESULTS AND CONCLUSION: All the patients were followed up 6 to 24 months, averagely 15 months. All patients were smoothly through the perioperative period. There were no acute severe cerebral infarction cases. Preoperative JOA score was (7.6±2.0) points averagely, and postoperative JOA score was (13.3±1.8) points averagely, showing a significant difference (P < 0.01). Of the 21 patients, excellent effects were in 11 cases and good in 7 cases. The effective rate was 95% (20/21), and the excellent-good rate was 86% (18/21). The risk of surgical treatment of patients with cerebral infarction is higher, but it is not the absolute contraindication. Choosing the proper operation way is highly important. Cervical posterior expensive open-door laminoplasty and fixation with wire anchors can be used to reduce the risk of cerebrovascular accidents to some extent, and obtain an excellent clinical effect. 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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MRI and pathological discrimination of early pyogenic spondylitis from brucella spondylitis Liu Tao, Sun Jian-min, Cui Xin-gang, Jiang Zhen-song 2014, 18 (4):  499-504.  doi: 10.3969/j.issn.2095-4344.2014.04.002 Abstract ( 530 )   PDF (2175KB) ( 507 )   Save BACKGROUND: Pathological examination and MRI have been widely used in clinic, but their combination is rarely reported in discrimination of early spine infections. OBJECTIVE: To determine the accuracy of pathology and MRI for discrimination between early pyogenic spondylitis and brucella spondylitis. METHODS: Twenty-two patients with pyogenic spondylitis and 20 patients with brucella spondylitis who had CT-guided percutaneous biopsy and MRI of the spine were retrospectively reviewed. Pathological observations included structure and activity of bone lesions, tissue cells and their main components; MRI observations included signal and sign changes at lesion sites. Statistical analysis was performed with the chi-square test. RESULTS AND CONCLUSION: The patients with pyogenic spondylitis had a significantly higher incidence of pathological and MRI findings as follows (P < 0.05): neutrophil infiltration; intervertebral disc abnormal signal, location of vertebral body lesions anterior+posterior, obviously shape change in the vertebral body, paraspinal abnormal signal, presence of intraosseous or paraspinal abscess. Pathological and MRI examination was accurate for early differentiation of pyogenic spondylitis from brucella spondylitis. 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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Effects of femoral offset reconstruction or non-reconstruction on hip joint function in total hip arthroplasty Li Yong-wang, He Rong-li, Bai Xiao-liang, An Ming, Zhang Qian, Ma Wen-hai, Song Xing-jian, Sun Jun-ying 2014, 18 (4):  505-510.  doi: 10.3969/j.issn.2095-4344.2014.04.003 Abstract ( 1120 )   PDF (801KB) ( 836 )   Save BACKGROUND: Femoral offset reconstruction is significant for recovering strength of abductor and the balance of soft tissue tension surrounding hip joint, maintaining joint stabilization, restoring joint function, reducing limping after replacement, decreasing prosthetic abrasion, and the incidence of joint prosthesis dislocation. OBJECTIVE: To discuss effect of femoral offset reconstruction on hip joint function in total hip arthroplasty. METHODS: We comparatively analyzed 20 patients (20 hips) undergoing the modular prosthesis (S-ROM) total hip arthroplasty and 19 patients (20 hips) undergoing the one modular prosthesis (Corail) total hip arthroplasty at the same time. According to Harris hip score and radiography results, hip joint function and femoral offset reconstruction rate were comparatively studied in both groups. RESULTS AND CONCLUSION: No infection, fracture, dislocation, deep venous thrombosis or neurovascular injury occurred in either group. Clinical follow-up results: In the modular prosthesis and one modular prosthesis  groups, there was no significant difference in preoperative Harris hip score between the femoral offset reconstruction and non-reconstruction groups (P > 0.05). At 12 months and the latest follow-up, the Harris hip score was higher in the patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P < 0.05). The range of abduction of hip joint was larger in patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P < 0.05). Radiographic follow-up results: significant differences in the rate of femoral offset reconstruction were detected between the modular prosthesis and one modular prosthesis groups (χ2 = 3.956, P < 0.05). 39 (98%) femoral stems were in neutral position and one (2.5%) was in mild valgus. There was no significant difference in the abduction angle and the anteversion angle between patients with and without femoral offset reconstruction (P > 0.05). These results indicated that functional recovery and the range of abduction were better in patients with femoral offset reconstruction than those without femoral offset reconstruction. Modular prosthesis has a high rate of femoral offset reconstruction. 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 for Crowe type IV developmental dysplasia of hip in adults Qi Xiao-peng, Zhang Yuan-kai, Li De-qiang, Li Ming 2014, 18 (4):  511-516.  doi: 10.3969/j.issn.2095-4344.2014.04.004 Abstract ( 589 )   PDF (842KB) ( 490 )   Save BACKGROUND: Total hip arthroplasty is an optimal choice for patients with late hip dysplasia. Crowe type IV developmental dysplasia of the hip increases the difficulty of the operation, and the surgery is controversial. OBJECTIVE: To evaluate the clinical effects of total hip arthroplasty on Crowe type IV developmental dysplasia of the hip and the method of reconstruction of acetabulum and the treatment of proximal femur. METHODS: A total of 12 patients (14 hips) with Crowe type IV developmental dysplasia of the hip underwent total hip arthroplasty. Preoperative Harris hip score was averagely (35.0±6.8) points. All hips were treated with small acetabular components combined with medial protrusion technique in acetabular reconstruction, as well as subtrochanteric shortening osteotomy in femur. Joint function of hips was evaluated according to the Harris hip score. RESULTS AND CONCLUSION: All patients were followed up with an average of 4.6 years (ranged 1 to 7 years). Two cases (two hips) suffered from infraction of greater trochanter of femur during replacement, and it was fixed with wire. There was complete sciatic nerve injury in one case, which partially restored after conservative treatment for 1 month. No infection, prosthesis loosening, or deep venous thrombosis with obvious clinical manifestations was visible. Bone union was observed at the site undergoing osteotomy at the side of femur. After replacement, final follow-up showed that Harris hip score was averagely (84.0±7.0) points. The mean amount of postoperative leg lengthening was 5 cm (range 4-6 cm). Shortened limbs were corrected satisfactorily. These results suggested that total hip arthroplasty using small acetabular component, medial protrusion, and femoral subtrochanteric shortening osteotomy technique for the Crowe type IV developmental dysplasia of the hip can effectively restore hip function and leg length. The long-term curative effects require further investigations. 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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Preoperative prediction of early physical function in elder patients undergoing hip arthroplasty using a subjective physical activity questionnaire Qiu Shun-min, Chen Xiao-pu, Zheng De-zhi, Lin Yong-bing, Lin Jing, Ma Huan-lin, Zeng Run-ming 2014, 18 (4):  517-522.  doi: 10.3969/j.issn.2095-4344.2014.04.005 Abstract ( 561 )   PDF (887KB) ( 754 )   Save BACKGROUND: Preoperative walking ability and activities are good predictors of functional recovery of patients after hip replacement. But these objective assessment tools are invalid to predict postoperative function of patients with no preoperative walking ability. OBJECTIVE: To assess the effect of preoperative subjective physical activity questionnaire to predict the 6-month postoperative physical functioning outcomes in elder patients receiving hip arthroplasty, and to determine which aspects of patient’s characteristics influence 6-month postoperative physical activity. METHODS: A two-center prospective audit was carried out in elder patients who underwent hip arthroplasty between November 2010 and February 2013. These patients were divided into three groups, including the group of total hip arthroplasty for fractures of the femoral neck, the group of total hip arthroplasty for osteoarthritis and the group of hemiarthroplasty for fractures of the femoral neck. All patients had fulfilled Longitudinal Aging Study Amsterdam-Physical Activity Questionnaire (LAPAQ) and Short Form 36 (SF-36) recalling their physical activity at 2 weeks before the fall accident (for fractures of the femoral neck) or admission (for hip osteoarthritis). Preoperative demographic data were also collected. Postoperative assessment regarding subjective physical activity assessment including LAPAQ and SF-36, and objective physical activity assessment including timed up and go test and six-minute walk test were evaluated at the time of 6-month postoperation. RESULTS AND CONCLUSION: Totally 115 patients finished the study. Both preoperative LAPAQ and SF-36 can play a predictor to probe 6-month postoperative function of objective and subjective activity in patients with femoral neck fractures or hip osteoarthritis undergoing hip arthroplasty. Preoperative LAPAQ seems better than preoperative SF-36 to predict postoperative physical activity. For hip fracture patients, because preoperative objective function cannot be assessed, preoperative LAPAQ can play an effective and subjective index to predict postoperative function of objective activity, and physical functions can recover 70%-80% at 6 months postoperatively. For hip osteoarthritis patients, postoperative physical function can be increased by approximately 27% compared with before hip arthroplasty. Patient’s characteristics also affect the postoperative physical activity, and the occurrence of preoperative complications is a most important factor. 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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Rotating hinge prosthesis replacement for treatment of malignant bone tumors of the distal femur: evaluation of limb function and survival rate Jiang Zheng, Yin Zong-sheng, Hu Yong, Liu Bi-quan, Wang Wei 2014, 18 (4):  523-528.  doi: 10.3969/j.issn.2095-4344.2014.04.006 Abstract ( 445 )   PDF (716KB) ( 547 )   Save BACKGROUND: Distal femur is a predilection site for primary bone tumors, most of which are treated with salvage treatment. There are many reports on the early-stage, mid-term and prognosis of the distal femur tumor-type artificial knee joint prosthesis, but reports on long-term function and prognosis are less. OBJECTIVE: To study the long-term prognosis and limb function after treatment with rotating-hinge knee prosthesis. METHODS: Thirty-four patients with distal femoral bone tumors admitted to the Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University between January 2000 and June 2008 were retrospectively analyzed, including 19 males and 15 females. All patients were subjected to rotating hinge knee prosthesis replacement. RESULTS AND CONCLUSION: The mean follow-up period was 62.4 months (range 11 to 126 months). At the final of follow-up, 23 patients were event-free alive and 11 patients were dead. Seven of 23 survival patients suffered from prosthesis related complications, including four cases of prosthesis revision and three cases of amputation. The event-free survival rate of 23 patients undergoing replacement of domestic tumor prosthesis around the knee was 67.6% in 5 years. The mean functional score of affected limb was 19.30 (7 to 27 points): excellent in 6 cases, good in 16, fine in 5 and poor in 2. The excellent-good rate was 75.9%. The clinical outcomes suggested that the satisfactory limb function and survival rate could be achieved with the application of domestic tumor prosthesis replacement for treatment of malignant bone tumors around the knee. 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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Continuous analgesia of local infiltration after total knee arthroplasty Lu Hui-hong, Li Gui-feng, Bai Lang, Sun Ji-xiong, Jiang Zhen, Yin Feng 2014, 18 (4):  529-534.  doi: 10.3969/j.issn.2095-4344.2014.04.007 Abstract ( 518 )   PDF (733KB) ( 742 )   Save  BACKGROUND: Accumulating studies have confirmed the excellent effectiveness of local infiltration analgesia, but the literature analysis is mainly limited to within 1 day after total knee arthroplasty or shorter period. OBJECTIVE: To study the effectiveness of local infiltration analgesia (LIA) at low concentration after total knee arthroplasty, and to observe the analgesic effect at rest and movement states. METHODS: Thirty patients undergoing total knee arthroplasty were randomly allocated to control group and LIA group, receiving oral non-steroidal antiinflammatory drug (celebrex) and low concentration of ropivacaine (0.1%) for epidural analgesia. Control group was injected with 0.9% saline 150 mL, while LIA group was injected with equal volume of solution include ropivacaine 300 mg, morphine 5 mg and epinephrine 10 μg. The rest pain and motion pain of patients in two groups were evaluated at 6, 12, 24, 36, 48 hours after operation by using visual analogue scale. The incidence rate and degree of nausea, vomiting, numbness and muscle weakness of the legs were observed after operation. The incision healing was also recorded. RESULTS AND CONCLUSION: Visual analogue scale pain scores in the LIA group were significantly lower than the control group at 6, 12, 24 and 36 hours at rest (P < 0.05), at 6, 12, 24, 36, 48 hours on movement (P < 0.05). At 6 and   12 hours, there was no difference in the rest and motion pains in the LIA groups (P > 0.05). No patient appeared drowsiness, nausea, and vomiting in both groups. Two patients in each group complained of slight numbness in legs. No case influenced function exercise because of muscle weakness. All the wounds healed and there were no incision infections in two groups. Combined with oral non-steroidal anti-inflammatory drug and low concentration of ropivacaine for epidural analgesia, the local infiltration analgesia technique in total knee arthroplasty is effective in early post-operative pain management, and produces no analgesia related adverse reactions. 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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Anterior approach or combined anterior and posterior approaches for severe ossification of cervical posterior longitudinal ligament Liu Chun-yu, Jin Li, Peng Bao-gan 2014, 18 (4):  535-540.  doi: 10.3969/j.issn.2095-4344.2014.04.008 Abstract ( 488 )   PDF (792KB) ( 419 )   Save BACKGROUND: It is controversial whether anterior approach alone, or combined anterior and posterior approaches were used for high level and multiple segments of severe ossification of cervical posterior longitudinal ligament. OBJECTIVE: To explore the difference of anterior approach versus combined anterior and posterior approaches for the treatment of high level and multiple segments of severe ossification of cervical posterior longitudinal ligament. METHODS: A total of 21 cases of high level and multiple segments of severe ossification of cervical posterior longitudinal ligament were included in this study. There were 9 males, aged 56-72 years, and 12 females, aged 58-70 years. We used anterior decompression and titanium mesh bone graft fusion in 11 cases which lesion located between C2-5 vertebra, and ossification excision, combined anterior (titanium mesh plate and screw) and posterior (lateral mass screw) approaches in 10 cases which between C3-7 vertebra. Japanese Orthopaedic Association score system was used to evaluate the results. The excellent and good rate and improvement rate were calculated. RESULTS AND CONCLUSION: The excellent and good rate was 90% and improvement rate was 82% in 10 cases using combined anterior and posterior approaches. The excellent and good rate was 73% and improvement rate was 73% in 11 cases using anterior treatment alone. Significant differences in the excellent and good rate and improvement rate were detected between the two groups (P < 0.05). These suggested that combined anterior and posterior approaches for high level and multiple segments of severe ossification of cervical posterior longitudinal ligament is a better operative procedure. 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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Lateral and posterior single cage combined with unilateral pedicle screw fixation for lumbar degenerative disease Yan Dong-xue, Huang Yong-ji, Ma Guang-bin, Luo Jun, Hu Jun-zu, Xiao Rong-chi 2014, 18 (4):  541-546.  doi: 10.3969/j.issn.2095-4344.2014.04.009 Abstract ( 431 )   PDF (854KB) ( 602 )   Save BACKGROUND: Most of lumbar degenerative diseases, such as lumbar instability, lumbar disc herniation and discogenic lumbago, need lumbar spinal fusion for the spine stability, but the choice of internal fixation approaches is controversial. OBJECTIVE: To compare the effectiveness between lateral lumbar interbody fusion with single cage and single cage combined with unilateral pedicle screw fixation for the 4th and 5th single-level lumbar degenerative disease. METHODS: The clinical data of patients with single-level lumbar degenerative diseases (L4 and L5) undergoing lateral lumbar interbody fusion with single cage in 30 cases (experimental group) and single cage combined with unilateral pedicle screw fixation in 45 cases (control group) were analyzed retrospectively, and the curative effects were compared between the two groups. RESULTS AND CONCLUSION: All patients in the two groups were followed up for 13 months on average (ranged from 10 to 37 months). The incisions in the two groups were stage I healing. One case in the experimental group occurred cage displacement, but no obvious syndromes were detected. No significant difference in the effective rate after operation, hospital stay, and volume of drainage was detected (P > 0.05). The operative time and bleeding volume in experimental group were better than those in the control group (P < 0.05). ODI and JOA scores were significantly improved after treatment when compared with preoperative ones in the two groups (P < 0.05), but no significant difference was visible between the two groups (P > 0.05). The effectiveness of lateral lumbar interbody fusion with single cage and single cage combined with unilateral pedicle screw fixation for single-level degenerative lumbar diseases was similar. However, the former has the advantages of less invasion and quick recovery. 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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Application of pedical screw visualization technique in screw placement of lumbar vertebrae fracture   Yu Hai-long, Liu Jun, Chen Yu, Wang Hong-wei, Wang Qi, Ma Jun-xiong, Ren Wei-jian, Meng Ling-zhi, Xiang Liang-bi 2014, 18 (4):  547-552.  doi: 10.3969/j.issn.2095-4344.2014.04.010 Abstract ( 380 )   PDF (788KB) ( 541 )   Save BACKGROUND: Three-dimensional visualization technique has been widely used in clinical treatment. Preoperative visualization technique allows safe demonstration on the complex spine fracture models, and also prepare screw placement scheme according to three-dimensional model of patients. OBJECTIVE: To discuss the clinical result of treating short-segment lumbar vertebrae fracture with pedicle screw visualization. METHODS: A total of 32 patients with lumbar vertebrae fracture were treated with 182 pedicle screws. Before the screw implantation, the structure of bilateral pedicle was observed using Mimics software and the implantation parameters were measured. The operation methods and related complications were told to the patients through the reconstructed three-dimensional images. The satisfaction of the patients, operation time, and the position of pedicle screws by postoperative CT scan were assessed. The percentages of anterior vertebral height and Cobb’s angle were measured before operation, 2 weeks after operation and 8 months after operation. RESULTS AND CONCLUSION: The excellent satisfaction rate of the patients was 100%, the mean operation time was 185 minutes, and 173 pedicle screws (95.1%) were totally inserted within the pedicle. All patients were followed up for 7-22 months. The results showed that the fracture healed well. The percent of anterior vertebral height and Cobb’s angle at 2 weeks after operation were significantly decreased compared with them before operation (P < 0.05). There were no significant difference about the percent of anterior vertebral height and Cobb’s angle between 2 weeks and 8 months follow-up (P > 0.05). Single-segment lumbar vertebrae fracture was well treated by the pedicle screw visualization technique. This method assists to make up preoperation plan, increase the rate of patients’ satisfaction, shorten operation time, and increase the accuracy of pedicle screw insertion. 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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Posterior pedicle screw fixation and interbody fusion in the treatment of recurrent lumbar disc herniation: an evaluation of vertebral stability  Liu Feng-song, Wang Kai, Jing Cheng-wei, Zhang Liang, Liu Bin, Yang Ya-lin 2014, 18 (4):  553-558.  doi: 10.3969/j.issn.2095-4344.2014.04.011 Abstract ( 854 )   PDF (796KB) ( 496 )   Save BACKGROUND: Discectomy is an important therapy for lumbar disc herniation, but a small number of patients undergoing discectomy will relapse. OBJECTIVE: To investigate the spinal stability following posterior pedicle screw fixation combined with interbody fusion cage for treatment of recurrent lumbar disc herniation. METHODS: Twenty-six patients with recurrent lumbar disc herniation from January 2007 to December 2011 were enrolled and subjected to posterior pedicle screw fixation combined with interbody fusion cage. Pain relief and lumbar stability were observed postoperatively. We analyzed the spinal stability in recurrent lumbar disc herniation patients after posterior pedicle screw fixation combined with interbody fusion cage depending on literature search. RESULTS AND CONCLUSION: All the 26 patients were followed up for 12-36 months. After treatment, all patients effectively alleviated the symptoms of low back pain, and lumbar interbody fusion was good, with a good rate of 96.2%. There was no pedicle screw loosening, broken, non-fusion phenomenon. Posterior decompression and interbody fusion cage combined with posterior pedicle screw fixation for recurrent lumbar disc herniation, characterized as fast symptom relief, strong fixation, exact interbody fusion exact, is an ideal treatment for recurrent lumbar disc herniation. 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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Biomechanical properties of internal fixation plate for patellar fracture Guan Zhi-hai, Wang Qin-ye, Wang Yi-jin, Luo Ya-ping, Chang Xiao-bo, Feng Xia-ying 2014, 18 (4):  559-564.  doi: 10.3969/j.issn.2095-4344.2014.04.012 Abstract ( 478 )   PDF (922KB) ( 529 )   Save BACKGROUND: There are currently various surgical methods of patella fracture, and they have advantages and disadvantages, thus cannot well meet the requirements of patients. OBJECTIVE: To evaluate biomechanical properties of internal fixation plate to treat patellar fracture and to provide theoretical evidence for clinical application. METHODS: According to the statistics of patella in the Chinese population, a titanium alloy spider internal fixation plate was designed and manufactured for the treatment of patellar fractures. Knee joint specimens in six fresh cadavers were randomly divided into two groups and the comminuted fracture model of patella were established. The models were fixed with internal fixation plate of patella and NiTi patellar concentrator. Biomechanical tests were carried out to compare the biomechanical properties. RESULTS AND CONCLUSION: Both the two fixation methods could meet the 1-kN quadriceps femoris contraction. The internal fixation plate of patella was superior to NiTi patellar concentrator in the patellar isolation shift, muscle strength and joint strength, as well as mechanical properties of patella-point surface. There were significant differences between the two groups (P < 0.05). The internal fixation plate of patella is designed in accordance with the anatomical and biomechanical properties of the patella, the fixation strength can completely meet clinical requirement and deserve further application. 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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Comparison of the stability of three internal fixators for distal femoral fracture Yang Kang-hua, Yang Jing, Yang Guang-zhong 2014, 18 (4):  565-570.  doi: 10.3969/j.issn.2095-4344.2014.04.013 Abstract ( 742 )   PDF (788KB) ( 699 )   Save BACKGROUND: There are various internal fixators in treatment of distal femoral fracture. The commonly used fixators are locking compression plate, anterograde intramedullary nails and retrograde intramedullary nails. However, the efficacy of three common fixation is controversial. OBJECTIVE: To compare the effect of locking compression plate, anterograde intramedullary nails and retrograde intramedullary nails for treatment of distal femoral fracture, and to select the appropriate internal fixation method. METHODS: From May 2007 to November 2007, 118 patients with distal femoral fractures were treated with internal fixation in the hospital and their clinical data were analyzed retrospectively. Among them, 38 cases received locking compression plate, 21 cases received anterograde intramedullary nails, and 59 cases received retrograde intramedullary nails. The intraoperative blood loss, operative time, fracture healing time and rate of good postoperative recovery of knee joint in three groups were compared. RESULTS AND CONCLUSION: All the involved 118 patients were followed up for 14-26 months, average 20 months. No patients developed infection. Except one case delayed bone defect healing due to the fractures and was completely healed after bone filling at 19 weeks, the other cases healed within 4.5 months. There was no significant difference in fracture healing time among three groups (P > 0.05). Intraoperative blood loss and operation time in anterograde intramedullary nail group and retrograde intramedullary nail group were superior to locking compression plate group. In addition, anterograde intramedullary nail group was superior to retrograde intramedullary nail group, with significant difference (P < 0.05). Kolment grading fine rate in locking compression plate, anterograde intramedullary nail and retrograde intramedullary nail groups was 76.3%, 52.4% and 76.3% respectively. Retrograde intramedullary nail fixation is firm, stable and reliable, with less intraoperative blood loss, shorter operation time, small trauma, and easy fracture reset, especially in the recovery of knee joint function. Compared with locking compression plate and anterograde intramedullary nail, retrograde intramedullary nailing treatment of distal femoral fractures has more advantages. 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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Effective fixation of double plates for delayed treatment of type C pilon fractures Wang Ti-hui, Su Yu, Wang Xu, Liu Shou-kun, Wang Xiao-lu 2014, 18 (4):  571-576.  doi: 10.3969/j.issn.2095-4344.2014.04.014 Abstract ( 582 )   PDF (750KB) ( 611 )   Save BACKGROUND: Traditional open reduction and internal fixation for type C pilon fractures is characterized extensive periosteal stripping, severe soft tissue injury, many postoperative complications, and unsatisfactory recovery of joint function. Minimally invasive technology or external fixation combined with limited internal fixation for type C pilon fractures are usually difficult to achieve anatomical reduction. OBJECTIVE: To explore the curative efficacy of anterolateral “L” type locking plate implantation combined with interior minimally invasive plate osteosynthesis in treatment of type C pilon fractures and postoperative complication occurrence in order to find out the efficient fixation method for type C pilon fractures. METHODS: Twenty-six patients with type C pilon fractures (15 males and 11 females, aged from 19 to 68 years, mean age of 39.2 years) were selected and subjected to anterolateral “L” type locking plate implantation combined with interior minimally invasive plate osteosynthesis. CT three-dimensional reconstruction was performed before and plate implantation. X-ray examination was carried out before and after fixation. All patients were followed up for observation of clinical efficacy and complications. The therapeutic effects were evaluated using the Johner-Wruhs scoring system. RESULTS AND CONCLUSION: The 26 patients were followed up for 16 months (from 9 to 24 months). Delayed healing occurred in one case (after 12 months), and the average healing time was 15 weeks (from 11 to 52 weeks). There was no deformity healing. Two patients developed superficial incision infections of Staphylococcus aureus, healed by open wound and dressing change every day for 2 weeks. No deep infection or osteomyelitis was found. One patient was found to have traumatic arthritis of ankle joint, improved by the injection of sodium hyaluronate. There was no flap necrosis and tendon irritation, broken nail or screw withdrawal, and nerve injury. Johner-Wruhs scores were excellent in 11 cases, good in 12 cases, fair in 3 cases, with the total excellent to good rate of 88.5%. These findings indicate that anterolateral “L” type locking plate implantation combined with interior minimally invasive plate osteosynthesis for delayed treatment of type C pilon fractures can achieve satisfactory fracture reduction, rigid fixation, early functional exercise, less complications, and good recovery of joint function. 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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Parameter selection for steel ring of Ilizarov external fixation in the treatment of tibial bone defects Yu Kai, Yang Jing, Yang Guang-zhong, AiHeMaiTiJiang, Chen Ke-yi, Zhao Di-qing, Yuan Chun-xiao 2014, 18 (4):  577-582.  doi: 10.3969/j.issn.2095-4344.2014.04.015 Abstract ( 363 )   PDF (883KB) ( 757 )   Save BACKGROUND: There was no effective method to thoroughly treat tibial bone defect and soft tissue defect. The application of Ilizarov technique solved shortening deformity, soft tissue injury and joint contracture to some degrees. OBJECTIVE: To discuss the effects of Ilizarov external fixation on treatment of tibial bone defect and the parameter selection of Ilizarov steel ring. METHODS: We retrospectively analyzed the clinical data of 67 patients with tibial bone defects, who were treated and followed up from March 2007 to January 2012. All patients had fracture of tibia and received one- stage operation. After treatment, postoperative limb suffered from tibia osteomyelitis and soft tissue injury. Ilizarov external fixation was placed in the limb. The length of defected tibia and area of defected soft tissues were compared at 1, 3 and 6 months after external fixation and final follow-up. The ankle joint Kofoed score and knee joint ROM score were observed before and after external fixation. In final follow-up, functional recovery was evaluated in accordance with diagnosis and treatment criteria of Johner-Wruhs fracture of shaft of tibia. RESULTS AND CONCLUSION: A total of 67 patients were followed up for 6 to 35 months. Bone defects in 67 cases were rebuilt and the fracture was healed, but five cases had poor healing. Among 44 cases of soft tissue injury, wound had healed in 40 cases, and wound had not healed in 4 cases. The length of tibia defect and the area of soft tissue defects were improved at 1, 3, and 6 months after the operation (P < 0.05). After operation, the ankle joint Kofoed score and knee joint ROM were significantly better than those before operation (P < 0.05). During final follow-up, the excellent and good rate of each therapeutic plan was 85%. For the tibial osteomyelitis bone defect with the merged skin defect, the trauma was small using Ilizarov technique, which can avoid several complicated operations, shorten the time and reduce the expenses of treatment, but there were some weaknesses and limitations. The size and material of Ilizarov external fixation affect the efficiency of the fixation and postfixation adjustment. 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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Fixation of proximal clavicle and sternum through the intramedullary cavity for sternoclavicular joint dislocation with wire rope: an anatomic and clinical research Dong Jia-chun, Zhi Zhong-zheng, Yan Bing-shan, Ding Lei, Yin Wang-ping, Dai Zeng-shou 2014, 18 (4):  583-588.  doi: 10.3969/j.issn.2095-4344.2014.04.016 Abstract ( 625 )   PDF (837KB) ( 699 )   Save BACKGROUND: Surgical management of sternoclavicular joint dislocation takes relatively larger risks for its adjacent mediastinal and other important structures. However, the surgical methods are varied and remain controversial. OBJECTIVE: To investigate the feasibility and validity of intramedullary fixation of the proximal clavicle and sternum for sternoclavicular joint dislocation. METHODS: On 22 adult cadaver upper limb specimens, the anatomical features of the sternoclavicular joints and associated ligaments, the size of articular surface between the medial clavicle and manubrium and the morphology of articular disc, costoclavicular ligament and sternoclavicular ligament were observed and measured. From January 2009 to July 2012, three patients with sternoclavicular joint dislocation received the intramedullary fixation with wire rope or absorbable suture in figure-of-eight shape. They were males, aged 9, 45 and 62 years, with an average age of 38.6 years. The outcome was evaluated by upper limb function DASH score. RESULTS AND CONCLUSION: Anatomic results demonstrated that the anteroposterior and coronal diameters of the surface of the medial clavicle were greater than that of the sternum, so they did not match each other. The minimum thickness of the manubrium sterni was at the superior margin of articular surface and the largest was at the sternal angle. The minimum width of the manubrium sterni was at the superior margin of articular surface and the largest was at the inferior margin. The articular disc, liked an ellipse and matched with the articulating surface of the manubrium sterni more, whose anteroposterior diameter was greater than its coronal diameter. Central thickness was greater than the edge thickness. The costoclavicular ligament was thicker and denser than the anterior and posterior sternoclavicular ligament. The anterior and posterior sternoclavicular ligaments were close in length, width and thickness. Clinical trial results demonstrated that all cases were followed up for 14 to 36 months. DASH score was 10-16, 13.3 in average. Effects of internal fixation were satisfactory. Surgical management of sternoclavicular joint dislocation by the fixation of the proximal clavicle and sternum through the intramedullary cavity with wire rope or absorbable suture is reliable and effective. 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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Intramedullary nailing support combined with tissue-engineered bone filling for treating fibrous dysplasia of the proximal femur Chen Peng, Wu Xue-jian, Zhu Xu, Xiao Peng 2014, 18 (4):  589-594.  doi: 10.3969/j.issn.2095-4344.2014.04.017 Abstract ( 404 )   PDF (905KB) ( 677 )   Save BACKGROUND: Tissue-engineered bone in the treatment of large bone defects has obvious advantages especially when the autologous ilium transplantation is limited, which can effectively fill bone defects. OBJECTIVE: To investigate the rationality of intramedullary nailing support and tissue-engineered bone filling in the treatment of fibrous dysplasia of the proximal femur and the biocompatibility of the tissue-engineered bone. METHODS: Seven patients with fibrous dysplasia of the proximal femur were subjected to intramedullary nailing support and tissue-engineered bone filling. RESULTS AND CONCLUSION: All of the seven patients underwent more than 8 months of follow-up, no rejection reaction and other complications occurred. After 4-6 weeks of fixation, all the seven patients removed hip spica braces, with a good hip mobility. After 10-12 weeks, X-ray review showed no pathological fracture, internal fixation loosening and narrow neck stem angle. Using the Harris hip score evaluation of the hip function, the affected side of the seven patients was optimized. After 16-18 weeks, X-ray films reviewed good creeping substitution in the affected area treated with the intramedullary nailing support and bone graft. After 24-26 weeks, new bone appeared within the scope of lesions. After 1.0-1.5 years, bone creeping substitution was basically completed in the intertrochanteric region, and original lesions were invisible on X-ray films. These findings confirmed that intramedullary nailing support and tissue-engineered bone filling for treating fibrous dysplasia of the proximal femur has good effectiveness, exhibiting stable internal fixation and avoiding resection of autogenous iliac bone. Tissue-engineered bone has a good biocompatibility in the medium-term follow-up, with good hip function activities. 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 versus short proximal femoral nail antirotation in treatment of intertrochanteric fractures Chen Xing-hua, Liu Tao, Huang Zhen-gu 2014, 18 (4):  595-600.  doi: 10.3969/j.issn.2095-4344.2014.04.018 Abstract ( 409 )   PDF (673KB) ( 652 )   Save BACKGROUND: There are few clinical controlled trials about the clinical effects in patients with pertrochanteric femur fractures after treatment with short or long proximal femoral nail antirotation. OBJECTIVE: To compare the clinical outcomes in patients with AO/ASIF-A1/2 pertrochanteric femur fractures after treatment with short or long proximal femoral nail antirotation. METHODS: A total of 98 patients with AO/ASIF-A1/2 pertrochanteric femur fractures were treated by proximal femoral nail antirotation. They were divided into two groups according to the type of proximal femoral nail antirotation: short nail group (n=50) and long nail group (n=48). The operative time, blood loss, and hospital stay were recorded in both groups. In follow-up, fracture healing time, imaging and clinical complications were evaluated. In the final follow-up, Harris hip score was used to evaluate functional recovery. RESULTS AND CONCLUSION: Compared with the short nail group, operative time was shorter and blood loss was less in the long nail group (P < 0.05). No significant difference in hospital stay was detected between the short nail and long nail groups (P > 0.05). Average follow-up periods were respectively (15.8±6.4) months and (16.2±5.7) months in the long nail and short nail groups. “Cutting-out” or infection occurred in five patients in the long nail group and three in the short nail group. Besides above-mentioned patients, the remaining patients in the two groups achieved fracture healing. No significant difference in average fracture healing time was detected between groups (P=0.588). In the final follow-up, no significant difference in Harris hip score was detectable in the two groups (P=0.204). The incidence rates of total postoperative complications in the long and short nail groups were 31.2% and 16.0%, respectively (P=0.075). Results suggested that no differences in the union and complication rates between the two groups were identified, suggesting that long nails offer no advantage compared with short nails for stabilizing AO/ASIF-A1/A2 pertrochanteric femur 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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Evaluation of bone structure of hip joint using three-dimensional visualization system Zhou Yong, Zou Chun-hua, Zhang Chao-yue 2014, 18 (4):  601-606.  doi: 10.3969/j.issn.2095-4344.2014.04.019 Abstract ( 717 )   PDF (614KB) ( 1383 )   Save BACKGROUND: It remains hard to judge characterization of lesion tissues using two-dimensional sectional image at present. Medical three-dimensional reconstruction technique could obviously improve work efficiency and accuracy of medical working staff on disease diagnosis. OBJECTIVE: To develop a three-dimensional medical visualization system can rebuild three-dimensional model of corresponding parts by reading DICOM data, and observe the appearance of affected hip joint using reconstructed models. METHODS: A three-dimensional (3D) medical visualization system was developed using the MFC in a PC with Windows XP operating system, development environment VC++6.0, VTK 5.6 installation, and necessary settings were made. Precise procedures are as follows: ① create a drawing object; ② create a drawing window, and draw objects was added in draw window; ③ read the CT image sequences, and set the path of the read image sequence; ④ isosurface (generate triangular facets) were extracted using MC algorithm, depending on the gray, skin and bones. Data of the input image sequence were set; gray value of tissue contour was set; ⑤ the establishment of a V-belt objects and data mapping object; ⑥ graphics rendering, to receive the properties of the geometric data, and a different colors and transparency of bones and skin were set; ⑦ the viewing position was set to observe the position of the object and focus; ⑧ to create a human-computer interaction function. RESULTS AND CONCLUSION: VC++6.0 and VTK could meet the needs of medical 3D visualization systems development. Developed 3D visualization system software could perform 3D reconstruction through reading CTimages of DICOM format files. Thus, the relevant parts of the reconstructed 3D model could be observed by rotating, zooming, and panning so as to visually observe the bone structure of hip joint, fractured appearance andtype. It provided a reference for relevant therapy and operation. 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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Digital orthopedic technology in the positioning of volar plate in distal radius fracture Chen Gang, Lian Kai, Cui Lu, Wu Nong-xin, Lu Xin-yan, Wang Bang-jun, Chen Feng-wen 2014, 18 (4):  607-612.  doi: 10.3969/j.issn.2095-4344.2014.04.020 Abstract ( 682 )   PDF (891KB) ( 743 )   Save BACKGROUND: Volar locking plate is the dominant treatment of distal radial fractures, but it is difficult to judge the distance between the plate position and the carpal articular surface, thus leading to screw penetration of the articular surface. Arthroscopy or operative perspective has their pros and cons, there is no simple and effective method of positioning the plate. OBJECTIVE: To find the optimal position of Volar LCP in distal radius fractures and explore the role of computer simulation in this treatment. METHODS: The CT data of the wrists in 20 adult patients were collected to calculate 3D models of the radius by MIMICS software. 3D model of the LCP was calculated by UG in working station. The distance between the plate and the distal radius joint was measured by computer simulation, and the mean value was calculated. A total of 33 Patients with distal radial fractures were divided into two groups: conventional treatment group (regular X-ray and CT) and computer simulation group (preoperative plan based on the computer-measured data). RESULTS AND CONCLUSION: The safe distance between the screw center and the articular facet was 11.13 mm in males and 10.97 in females. The number of radiation and operating time were shortened significantly in computer simulation group (P < 0.05). Experimental findings indicate that, computer simulation is a powerful tool to find the optimal position of volar LCP in the distal radius fractures. The time of the operation and X-ray fluoroscopy are also shortened significantly. 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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Occipitocervical fusion angle and lower cervical spine degeneration in patients with craniocervical junction malformation Wang Xin-xin, Wang Li-min, Wang Wei-dong, Liu Yi-lin 2014, 18 (4):  613-618.  doi: 10.3969/j.issn.2095-4344.2014-04-021 Abstract ( 557 )   PDF (759KB) ( 692 )   Save BACKGROUND: Occipitocervical fusion is a major method for malformation of craniocervical junction. In patients without osteoporosis, the degeneration of cervical vertebra mainly presents in the intervertebral disk. The height of the vertebral body is constant basically. Thus, the ratio (S value) of the height of cervical disc and the height of cervical vertebra can be used to measure the degeneration of cervical vertebra. The small S value indicates severe degeneration of cervical vertebra. OBJECTIVE: To measure the lateral radiograph of cervical vertebra in patients with craniocervical malformation undergoing occipitocervical fusion, to analyze the relationship between occipitocervical fixed angle during fusion and lower cervical spine degeneration after fusion, and to identify an optimal angle of occipitocervical fusion. METHODS: A total of 21 patients with craniocervical malformation undergoing occipitocervical fusion were included. According to the occipitocervical angle (0c-C2 angle) immediately after fusion, the patients with craniocervical malformation undergoing occipitocervical fusion were assigned to three groups: occipitocervical     angle 9°-22° group, occipitocervical angle <9° group, and occipitocervical angle >22° group. Immediate postoperative 0c-C2 angle in 9°-22° belonged to the normal angle range. S value and JOA score in each group were measured before and after fusion, during final follow-up. The statistics were compared. RESULTS AND CONCLUSION: JOA scores in the occipitocervical angle 9°-22° group, occipitocervical angle <9° group, and occipitocervical angle >22° group, were respectively, (7.3±1.7) points, (7.2±1.6) points, and (7.3±1.5) points, before fusion, and (14.2±1.5) points, (13.5±1.6) points and (13.3±1.5) points after fusion. JOA scores were improved significantly in the three groups. JOA improvement was significantly better in the occipitocervical angle 9°-22° group than that in the occipitocervical angle <9° and >22° groups. Preoperative S values were respectively 0.440±0.017, 0.441±0.016, and 0.440±0.018 in the occipitocervical angle 9°-22° group, occipitocervical angle <9° group, and occipitocervical angle >22° group, and no significant difference was detected among the three groups. No significant difference in S value was detectable in the occipitocervical angle 9°-22° group between postoperative final follow-up and pre-operation. The S value was significantly smaller at postoperative final follow-up than pre-operation in the occipitocervical angle <9° and >22° groups. These results indicated that during occipitocervical fusion, occipitocervical angle should try to be normal, more than or less than normal range will accelerate the degeneration of lower cervical spine. 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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Theoretical verification of a new spinal dynamic stabilization system Li Zhao-wen 2014, 18 (4):  619-624.  doi: 10.3969/j.issn.2095-4344.2014.04.022 Abstract ( 823 )   PDF (1016KB) ( 830 )   Save BACKGROUND: There are many unavoidable defects after the traditional lumbar vertebral fusion operation, which can cause and aggravate the adjacent segment degeneration. Presently, primary clinical effects of dynamic internal fixation system are encouraging, but further clinical application exhibited some shortcomings in the design of internal fixation in the spinous process. Some complications related to instrument appeared. OBJECTIVE: To research and develop a new type of spinal internal fixation with dynamic stabilization system. METHODS: A new spinal dynamic stabilization system was designed. It can not only adapt spinal multidirectional activity, but also reserve supraspinal ligament to satisfy the normal range of spinal movement in the aspect of design principle. RESULTS AND CONCLUSION: The implantation of the spinal dynamic stabilization system can stabilize spine dynamical without sacrificing immediate stability of spine, can disperse load transmission and avoid stress shielding with strong internal fixation, also increase capacity of spinal canal and size of intervertebral foramina, restore height of intervertebral space, reduce the load of anulus fibrosus and facet joint’s load. Nevertheless, because of high price and design defects, the use of this system was limited. The multidirectional active interspinous dynamic stabilization system designed by ourselves could be implanted in root of spinous process, implemented flexible fixation in spinous process, between spinous process and lamina of vertebral, and adapted spinal multidirectional activity, and expected to overcome the deficiencies of technology and reduced the price. 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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Application of titanium cages and poly(ether-ether-ketone) cages in anterior cervical discectomy and fusion surgery Duan Wen1, Kong Rong1, Huang Wei1, Zhou Ran2 2014, 18 (4):  625-630.  doi: 10.3969/j.issn.2095-4344.2014.04.023 Abstract ( 604 )   PDF (566KB) ( 701 )   Save BACKGROUND: The two main cages used in anterior cervical surgery are titanium cages and poly(ether-ether-ketone) cages, but it is still controversial in imaging performances and clinical outcomes. OBJECTIVE: To systematically evaluate imaging performances and clinical outcomes between titanium cages and poly(ether-ether-ketone) cages in anterior cervical discectomy and fusion surgery. METHODS: The Cochrane library (issue 5, 2013), Medline database, EMBASE, CNKI and Wanfang database were retrieved by computer. The deadline of all the retrieves concerning control study of uses of titanium cages and poly(ether-ether-ketone) cages was June 1st, 2013. Two reviewers assessed literatures independently, and the meta-analysis was conducted by RevMan 5.2 software. RESULTS AND CONCLUSION: A total of four literatures including 235 patients, 128 of titanium cages and 107 of poly(ether-ether-ketone) cages, were included. Meta-analysis results showed that there was no statistically significant difference between the groups in fusion rates, subsidence and dislocation rates of short-term follow-up and clinical outcomes (all P > 0.05). There were statistically significant differences between the groups in subsidence and dislocation rates of long-term follow-up (P < 0.05). Poly(ether-ether-ketone) cage group was superior to titanium cages group in maintenance of cervical curvature and intervertebral height. This meta-analysis showed that poly(ether-ether-ketone) cages had good fusion rates and clinical outcomes, less subsidence and dislocation rates, and can better maintain cervical curvature and intervertebral height compared with titanium cages.  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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Plate fixation and small splint for intraarticular fracture of distal radius: comparison of curative effects Huang Hai-jing, Wen Jian-min 2014, 18 (4):  631-636.  doi: 10.3969/j.issn.2095-4344.2014.04.024 Abstract ( 567 )   PDF (725KB) ( 432 )   Save BACKGROUND: At present, there are many clinical trials concerning plate fixation and small splint for distal radius fracture, but there is lack of systemic evaluation. OBJECTIVE: To evaluate the curative effect of the plate fixation and small splint in the treatment of intraarticular fractures of the distal radius. METHODS: We retrieved the Chinese biomedical database (1979-2008), China National Knowledge Infrastructure (1979–2008), VIP database (1989-2008) and Wanfang Digital Periodical Group (1998-2008). Of them, China National Knowledge Infrastructure contained Chinese periodical databases, important meeting full-text databases, and Master-Doctor thesis database. Foreign databases included PubMed (1966-2008), EMbase (1980–2008) and the Cochrane Library (2008, 4th). The full text that could access was supplemented by manual search back issues of Traditional Chinese Medicine, Tianjin University Library repository. Clinical randomized controlled trials addressing plate fixation with small splint in the treatment of intraarticular distal radius fractures were collected. The data were extracted independent by two evaluators and methodological quality assessment was performed. According to the search strategy and data collection methods, 363 English articles and 488 Chinese articles were found, including 401 periodical literatures, 79 conference proceedings, and 8 theses. After reading title, abstract, full text, 12 articles met the inclusion criteria. Meta analysis was conducted with RevMan 5.0.20 software provided by the Cochrane Collaboration Network. RESULTS AND CONCLUSION: The evaluation of this system involves locking compression plate, normal internal fixation with plate, small splints and plaster external fixation methods. Meta analysis of the results shows that the curative effects of locking compression plate in the treatment of intraarticular fracture of distal radius were better than that of common plate, small splint or gypsum. Moreover, there were few complications. There is no significant difference in the effects between common plate fixation in treatment of intraarticular fracture of distal radius and the fixation with small splint or gypsum. 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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Various approaches for multilevel cervical spondylotic myelopathy: a meta-analysis on clinical effectiveness and safety Wang Guo-qi, Xu Tao, Sheng Wei-bin, Deng Qiang, Chen Ke-yi, Song Yang, Zhang En-feng 2014, 18 (4):  637-644.  doi: 10.3969/j.issn.2095-4344.2014.04.025 Abstract ( 507 )   PDF (795KB) ( 689 )   Save BACKGROUND: A large number of studies have confirmed that anterior approach and posterior approach for multilevel cervical spondylotic myelopathy were effective, but there is still no conclusion in which one is better. OBJECTIVE: To systematically assess the clinical effectiveness and safety of anterior approach versus posterior approach for multilevel cervical spondylotic myelopathy. METHODS: The databases such as The Cochrane Library (Issue 3, 2013), PubMed (from 1966 to March 2013), OVID (from 1950 to March 2013), EMbase (from 1966 to March 2013), Chinese Biomedical Literature Database (from 1978 to March 2013), WanFang Database (from 1998 to March 2013), China National Knowledge Infrastructure (from 1999 to March 2013) were electronically searched and five relevant journals were searched by hand to collect the randomized controlled trials or non-randomized controlled trials about the clinical effectiveness and safety of anterior approach versus posterior approach for multilevel cervical spondylotic myelopathy. Two reviewers independently screened the literature according to the inclusive and exclusive criteria, extracted the data, and assessed the methodological quality of included studies. Then the meta-analysis was performed by using RevMan5.2 software. RESULTS AND CONCLUSION: A total of 11 controlled trials involving 814 patients were included. Meta-analysis results showed that, compared with posterior approach, postoperative Japanese Orthopaedic Association scores were better (P < 0.000 01), improvement rate of neurological function was higher (P=0.000 3), the incidence of C5 root palsy was lower (P=0.007), but operation time was longer (P < 0.000 01), amount of intraoperative bleeding was larger (P=0.000 7), incidence of adjacent segments degeneration was higher (P=0.01), incidence of postoperative complications was higher (P < 0.000 01) and the rate of secondary surgical procedures was higher (P=0.003) after anterior approach. Additionally, there were no differences between the two groups in the cervical range of motion (P=0.56). For quantity limitation and low methodological quality of included studies, this conclusion still needs to be further proved by performing more high-quality and large-scale randomized controlled trials. 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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Periprosthetic femoral fractures after total hip arthroplasty Miao Shao-gang, Lu Ning, Yang Yang, Chen Lei-jie, Bassam A. Masri 2014, 18 (4):  645-650.  doi: 10.3969/j.issn.2095-4344.2014.04.026 Abstract ( 803 )   PDF (842KB) ( 887 )   Save BACKGROUND: As the patients undergoing total hip replacements and revision increase, the incidence and complexity of postoperative periprosthetic femoral fractures are accordingly increasing and its treatment becomes a challenge. OBJECTIVE: To review the literatures related to periprosthetic femoral fractures after total hip arthroplasty, to explore related risk factors, Vancouver classification, and treatment. METHODS: A computer-based online search was performed in the Chinese National Knowledge Internet (CNKI) database, FMJS database and PubMed database from September 1994 to June 2012 for the literatures related to periprosthetic femoral fractures after total hip arthroplasty. The key words were “total hip arthroplasty, periprosthetic femoral fractures” in Chinese and English. The articles published earlier and repetitive researches were excluded. RESULTS AND CONCLUSION: Postoperative periprosthetic femoral fractures after total hip arthroplasty are increasing in frequency with the increasing numbers of total hip arthroplasty patients. The risk factors mainly include aging and gender of the patients, trauma, fixation pattern, prosthetic loosening, revision, osteolysis, diseases before replacement, osteoporosis, type of prosthesis, and surgical technique. It is very important to understand the risk factors involved for the prevention and treatment of periprosthetic femoral fractures. Vancouver classification of periprosthetic femoral fractures is based on the site and stability of fractures, prosthetic loosening, and proximal bone mass. This classification is very common in clinical practice. Clinical treatment should consider the type of fracture, loosening of the prosthesis and bone loss of proximal femur. 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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Finite element analysis in treatment of scoliosis Huang Sheng-jia, Huo Hong-jun 2014, 18 (4):  651-656.  doi: 10.3969/j.issn.2095-4344.2014.04.027 Abstract ( 377 )   PDF (568KB) ( 462 )   Save BACKGROUND: Scoliosis is a complex spinal pathology characterized as a three-dimensional spine deformity combined with vertebral rotation. The finite element analysis can replace traditional biomechanical experiment for repeated experimental analysis and for processing digital simulation. It has been widely used in the study of scoliotic biomechanics. OBJECTIVE: To emphasize the application of finite element analysis on the brace and surgical treatment of scoliosis. METHODS: An online search of PubMed and Wanfang database was performed by using key words of “scoliosis, finite element” in Chinese for articles published between January 1986 and May 2013. A total of 38 papers related to finite element of scoliotic treatment, published in authorized journal and considered to be a representative, were selected. RESULTS AND CONCLUSION: How to design an individualized brace in accordance with biomechanical characteristics of scoliosis is the hot topic. By using multi-imaging technology, the rib, chest bone and pelvis are introduced into the finite element models, in a broader attempt to analyze the optimal three-dimensional     orthopedic force pattern for scoliosis. The results of relative research showed that, the ideal loading pattern is given at the protruding area of scoliosis. Finite element analysis can predict and evaluate the orthopedic procedure and effect of patients, thus assisting the design of reasonable orthopedic treatment scheme. Through finite element analysis, we can simulate and analyze the stress distribution of internal fixator in spine, which contributes to prevent the 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