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26 February 2014, Volume 18 Issue 9 Previous Issue    Next Issue

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Alterations in imaging and histopathology after aspiration of nucleus pulposus of rabbit lumbar intervertebral disc Liu Hang-tao, Wang Wan-ming, Lin Zhi-jun, Chen Guo-xian, Lin Guo-ye, Li Ping-sheng 2014, 18 (9):  1313-1318.  doi: 10.3969/j.issn.2095-4344.2014.09.001 Abstract ( 415 )   PDF (717KB) ( 676 )   Save BACKGROUND: It remains unclear what kind of changes in imaging and histopathology would appear in intervertebral disc after removal of nucleus pulposus over time. OBJECTIVE: To observe the alteration in imaging and histopathology of rabbit lumbar intervertebral disc after nucleus pulposus aspiration. METHODS: A total of 32 Japanese rabbits were subjected to nucleus pulposus aspiration in posterior lateral L 3/4 intervertebral disc with a 21-gauge hypodermic needle. L 2/3 intervertebral disc served as a normal control. At 2, 4, 8 and 12 weeks after aspiration, eight rabbits according to grouping received radiograph in the lateral position of lumbar vertebra. The height of L 3/4 and L 2/3 intervertebral space was measured and intervertebral disc height index was calculated. Rabbits received median sagittal MRI examination and histopathological examination of intervertebral disc. RESULTS AND CONCLUSION: The intervertebral disc height degraded slowly at 2, 4, 8, and 12 weeks after aspiration. However, the difference between 8 and 12 weeks was reduced. Compared with normal control, intervertebral disc height index significantly reduced at various time points (P < 0.05). The nucleus pulposus signal intensity was gradually reduced at 2, 4, 8, and 12 weeks after aspiration, and reached grade 4 of modified Thompson grading criteria at 8 weeks. After aspiration, gelatinous nucleus pulposus of disc slowly exhibited fissures with time, morphous was slowly disordered and showed significant fibrosis performance at 12 weeks. In nucleus pulposus region, more cartilage-like cells were found at 4 weeks after operation. The cells were active. Nucleus pulposus cells decreased significantly. At 8 and 12 weeks after operation, fibroblasts increased in nucleus pulposus region, and the number of cartilage-like cells reduced. The annulus fibrosus gradually became distorted, disordered, with processes and layers, and fiber breakage appeared. These results indicated that after puncturing lateral annulus fibrosus and aspirating the nucleus pulposus, radiograph height of the intervertebral disc and MRI T2-weighted signal intensity gradually reduced. Pathological changes were observed. However, the degeneration alleviated between 8-12 weeks. 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 methods for small vascular network distribution and counting around the knee joint in rats Wang Le, Lou Ai-ju, Ding Qiang, Yang Bo, Chen Tao, Tang Long, Zhang Bo, Yin Biao, Song Ting, Zhang Zhi 2014, 18 (9):  1319-1324.  doi: 10.3969/j.issn.2095-4344.2014.09.002 Abstract ( 321 )   PDF (401KB) ( 499 )   Save BACKGROUND: With the deepening of bone tissue engineering research and bone metabolism understanding, it is a hotspot to analyze the blood supply and nutritional status of tissue-engineered bone. OBJECTIVE: To compare different methods for evaluating small vascular network distribution around the knee joint in rats in order to provide a guideline for the study of microvascular network in tissue-engineered bone. METHODS: Eighteen Sprague-Dawley rats were randomly divided into three groups, with six rats in each group. Three commonly methods were used to evaluate the small vascular network around the knee joint in rats: immunohistochemistry analysis, angiography analysis, and CT scans and reconstruction analysis. RESULTS AND CONCLUSION: The microstructure of vascular network could be observed by immunohistochemistry, but the spatial distribution of vessels could not be evaluated. The spatial distribution of vessels could be showed by angiography and CT scans. However, some of micro vessels were showed unclearly by CT scans. The number of blood vessels detected by immunohistochemistry was (26.50±3.02) vessels, significantly higher than those detected by angiography and CT scans that were (14.12±1.47) and (9.00±1.79) vessels, respectively. Combination of immunohistochemistry and angiography can evaluate the microvascular network at microscopic and macroscopic levels, which can provide the whole information of the vascular network. 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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Analgesic effects of intraarticular cocktail versus intravenous parecoxib injection after total hip arthroplasty Du Xue-ping, Lu Jian-quan, Xu Ping, Zhu Yu-chang, Dong Da-yong 2014, 18 (9):  1325-1330.  doi: 10.3969/j.issn.2095-4344.2014.09.003 Abstract ( 961 )   PDF (284KB) ( 597 )   Save BACKGROUND: Intraarticular cocktail analgesic injection is a popular postoperative analgesia method and can effectively control postoperative pain and relieve side effects after total hip arthroplasty. OBJECTIVE: To compare and assess the effectiveness and safety of intraarticular analgesic injection or intravenous injection of parecoxib after total hip arthroplasty. METHODS: A total of 60 patients undergoing total hip arthroplasty were randomly assigned to: treatment group (intraarticular cocktail analgesic injection with morphine, bupivacaine, and compound betamethasone), and control group (intravenous injection of parecoxib). All patients received tramadol hydrochloride at 24 hours after replacement. Analgesic consumption, visual analog scale at rest and during activity, range of motion, and postoperative complication of patients in each group were recorded. RESULTS AND CONCLUSION: Intraarticular cocktail analgesic injection significantly reduced analgesic consumption. When comparing visual analog scale scores, rest pain scores were significantly less in the treatment group at 12, 24 and 48 hours after replacement than that in the control group (P < 0.05). Scores on range of motion were significantly less in the treatment group at 24 and 36 hours than that in the control group(P < 0.05). No significant differences in total complications were detectable between the treatment and control groups (P > 0.05). Results suggested that intraarticular cocktail analgesic injection lessened analgesic consumption after replacement, relieved early pain after replacement, and contributed to early rehabilitation of patients. Moreover, no significant adverse reactions were visible. 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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High risk factors in 128 elderly patients undergoing hip replacement Zhang Ke-yun, Yu Li-ming, Zhang Xu-hua, Lin Xin, Zhang Ren-ming, Liu Jun, Chen Chao, Wang Jian-chao 2014, 18 (9):  1331-1336.  doi: 10.3969/j.issn.2095-4344.2014.09.004 Abstract ( 672 )   PDF (320KB) ( 901 )   Save BACKGROUND: Deep vein thrombosis after hip replacement has a high incidence rate. Moreover, deep vein thrombosis can induce pulmonary embolism that can endanger patients’ life and dysfunction of distant deep vein. The appearance of deep vein thrombosis is a great obstacle for the gradually increased hip replacement. OBJECTIVE: To observe the occurrence of deep vein thrombosis of lower limb after total hip replacement in elderly patients, and to screen the risk factors for the occurrence of deep vein thrombosis of lower limbs. METHODS: Clinical data of 128 elderly patients with hip replacement were analyzed retrospectively. All patients were examined with color Doppler ultrasound in double lower limbs at 1 day before replacement and 7 days after replacement. Multifactor unconditional logistic analysis was conducted on clinical related factors and the formation of lower limb deep vein thrombosis. RESULTS AND CONCLUSION: At 7 days after the operation, 16 patients affected deep vein thrombosis of lower limb. The factors for deep vein thrombosis contained female, general anesthesia, bilateral hip replacement and the application of bone cement (P < 0.05). The risk for deep vein thrombosis after total hip replacement significantly increased in elderly patients aged over 70 years. Multifactor unconditional logistic analysis exhibited that the multiple risks of sex, obesity and the use of bone cement in elderly patients with deep vein thrombosis increased to 11.398, 3.109 and 8.925. The patients with a blood type O at the age of over 70 years experienced a decreased risk for deep vein thrombosis after total hip replacement. The occurrence of deep vein thrombosis decreased to 0.186 times after replacement. Blood type O could be considered as a protective factor for the occurrence of deep vein thrombosis. 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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Effect of total knee arthroplasty via different approaches on extensor mechanism Zhou Chao, Peng Wei, Si Zhi-ping 2014, 18 (9):  1337-1342.  doi: 10.3969/j.issn.2095-4344.2014.09.005 Abstract ( 448 )   PDF (270KB) ( 588 )   Save BACKGROUND: Traditional total knee arthroplasty adopts medial parapatellar approach, which induces severe trauma, requires long-term rehabilitation, and interferes the end point of quadriceps femoral tendon on superior patellar pole. Total knee arthroplasty by subvastus approach has no impact on the knee-extension equipment, but it cannot provide sufficient exposure of surgical field and can induce damage to femoral muscle, so its application and safety need further exploration. OBJECTIVE: To explore clinical effect of total knee arthroplasty by subvastus approach and medial parapatellar approach. METHODS: A total of 78 patients with 82 knees who were candidates for total knee arthroplasty were randomly divided into two groups. Treatment group (39 cases; 41 knees) was given subvastus approach and control group (39 cases; 41 knees) was given median parapatellar approach. The knee function, range-of-motion of knee joint and complications after total knee arthroplasty were observed and compared. RESULTS AND CONCLUSION: Compared with control group, the operation time in treatment group was significantly increased, while the postoperative wound drainage, straight leg raising time and walking time were obviously reduced (P < 0.05). The scores of HSS before surgery and 12 weeks after surgery were not significantly different between the two groups (P > 0.05), while at 1 and 6 weeks after surgery the scores in treatment group were significantly higher than those in control group (P < 0.05). The range-of-motion of knee joint and MMT rank for quadriceps muscle were significantly improved in two groups after treatment (P < 0.05), and those indicators in treatment group were more significant than the control group (P < 0.05). The incidences of complications in treatment group and control group were 2.6% and 15.4%, respectively, with statistically significant difference (P < 0.05). The total knee arthroplasty by subvastus approach has less impact on the extensor mechanism, improves the recovery of knee function and range-of-motion of knee joint, and reduces the incidence of complications. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Total knee arthroplasty for treatment of valgus knee deformity Zhang Rui, Liu Hai-ping, Xie Xing-wen, You Cong-xin, Wang Cheng-xiang 2014, 18 (9):  1343-1349.  doi: 10.3969/j.issn.2095-4344.2014.09.006 Abstract ( 823 )   PDF (313KB) ( 960 )   Save BACKGROUND: Valgus knee deformity is rare in the clinic. The therapeutic effects of artificial knee arthroplasty are worse than varus knee deformity. There is no unified opinion for replacement approach, soft tissue release method and procedure and prosthetic choice at present. OBJECTIVE: To summarize case data and to observe clinical effects of total knee arthroplasty for valgus knee deformity. METHODS: Clinical data of 37 cases of valgus knee deformity (42 knees) undergoing total knee arthroplasty, who were treated by the same group of physicians in the First Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine from January 2010 to December 2012 were retrospectively analyzed. There were 11 males (13 knees) and 26 females (29 knees), at the age from 56 to 78 years, with an average age of 63.7 years. The differences in range of motion, femorotibial angle and Hospital for Special Surgery knee score were compared before and after replacement. Clinical effects of total knee arthroplasty for valgus knee deformity were evaluated. RESULTS AND CONCLUSION: The postoperative follow-up lasted from 6 to 36 months. Knee joint range of motion increased from preoperative 68.5° to an average of postoperative 108.5°. Femorotibial angle reduced from preoperative 16.82° to postoperative 5.62° on average. The average Hospital for Special Surgery knee score increased from preoperative 39 points to postoperative 88 points (P < 0.05). These results suggested that the curative effect of total knee arthroplasty for valgus knee deformity is proved. Total knee arthroplasty is an effective way to improve deformity. 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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Primary development and biomechanics of single vertebrae internal fixation system for thoracolumbar compression fracture Li Ji-cai, Liu Ping-jun, He Yong-li, Zhao Wei-dong, Liang Dong-zhu, Mao Bing-yan 2014, 18 (9):  1350-1355.  doi: 10.3969/j.issn.2095-4344.2014.09.007 Abstract ( 386 )   PDF (395KB) ( 1139 )   Save BACKGROUND: For severe thoracolumbar compression fracture (> 1/3 compression), ideal therapeutic method is minimally invasive internal fixation, which has good biomechanical functions. Moreover, bone graft is reliable. Injured vertebra reduction and bone graft stability achieved. Motor unit of spinal column and normal physiological function were retained, resulting in lessening nearby segmental degeneration. OBJECTIVE: To discuss the design of single vertebrae internal fixation system and evaluate its biomechanical performance which apply to treat thoracolumbar compression fracture by endoscope. METHODS: A brand-new single vertebrae internal fixation system was designed in accordance with data of anatomic measurement of adult thoracolumbar vertebra. Six fresh adult corpse specimens were prepared to produce models of L1 compression fracture, and assigned to control group, fracture injury group, single vertebrae internal fixation system group, AF reduction internal fixation group and anterior plate internal fixation group. Three-dimensional movement range experiments were conducted separately. RESULTS AND CONCLUSION: The biomechanical comparison showed that there was no significant difference in three-dimensional range of motion among single vertebrae internal fixation system group (anteflexion, left and right lateroflexion), AF reduction internal fixation group and anterior plate internal fixation group (P > 0.05). However, range of motion significantly increased at backward extension, left and right rotation (P < 0.05). Results suggested that the design of single vertebrae internal fixation system was novel and the system had good biomechanical performance at anteflexion, left and right lateroflexion. However, it needs to be improved in which lacks of stability of extension and rotation. 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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Mechanical property of different cross-sectional area screws in middle and upper thoracic vertebral pedicle-rib complex Xin Da-qi, Huo Hong-jun, Yang Xue-jun, Xing Wen-hua, Zhao Yan, Fu Yu, Zhu Yong, Li Feng 2014, 18 (9):  1356-1361.  doi: 10.3969/j.issn.2095-4344.2014.09.008 Abstract ( 355 )   PDF (358KB) ( 547 )   Save BACKGROUND: Due to the importance of pedicle adjacent structures, once the screw replacement appears a deviation, adjacent structures may be damaged, leading to extremely serious consequences. Although the security of screw placement in thoracic vertebral pedicle-rib complex is significantly greater than that of pedicle screws, the mechanics of the pedicle-rib complex at different cross-sectional areas of the screw are rarely reported. OBJECTIVE: To observe mechanical property of different cross-sectional area screws in the middle and upper thoracic vertebral pedicle-rib complex. METHODS: Five specimens of adult cadaveric thoracic spine (T1-T10) and adjacent rib segment (50-60 mm long) were used. The bone density of specimens was measured using difunctional bone density testing machine, and osteoporotic vertebral body was excluded. The position of the screws was detected with CT images. The maximal withdrawal force of the pedicle screw was measured with biomechanical force test machine. RESULTS AND CONCLUSION: Thirty-eight specimens at normal bone density were implanted with 25 screws (5.5 mm), 25 screws (6.0 mm) and 26 screws (6.5 mm). Because the pedicle screws destroyed the pedicle-rib complex and perforated the vertebral body, we finally obtained the withdrawal force of 68 screws. The axial  withdrawal force of pedicle screws at different diameters was (812.36±147.22) N, (868.64±160.48) N and (946.48±157.58) N, respectively. There were significant differences between the 5.5 mm screws and the 6.5 mm screws (P < 0.05). Experimental findings indicate that, the pedicle screws (diameter > 5.5 mm) are suitable in the middle and upper thoracic vertebral pedicle-rib complex due to strong internal fixation and clinical requirement. 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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Postoperative coronal plane imbalance and model construction for adolescent idiopathic scoliosis Li Shi-hao, Deng Qiang, Xun Chuan-hui, Sheng Wei-bin 2014, 18 (9):  1362-1367.  doi: 10.3969/j.issn.2095-4344.2014.09.009 Abstract ( 425 )   PDF (236KB) ( 509 )   Save BACKGROUND: Adolescent idiopathic scoliosis is a common disease that can affect physical appearance of adolescents in the clinic at present. However, there are lacks of studies on coronal plane imbalance after fixation using Logistic regression equation at present. OBJECTIVE: To investigate the reasons for coronal plane imbalance after fixation in patients with Lenke type II adolescent idiopathic scoliosis. METHODS: 141 cases of Lenke type II adolescent idiopathic scoliosis admitted by Department of Spinal Surgery of the First Affiliated Hospital of Xinjiang Medical University in China from January 2001 to November 2012 were chosen as subjects. Multivariate single factor and multiple-factor Logistic regression were performed. Risk factors for the coronal plane imbalance after fixation in adolescent idiopathic scoliosis patients were screened, and predictive models were established. RESULTS AND CONCLUSION: Coronal plane imbalance occurred in 30 of the 141 patients, accounting for 21.28%. For Lenke type II adolescent idiopathic scoliosis patients, preoperative apical vertebral Nash-More rotation level 3-4, Risser grade 4-5, major curve correction rate/flexibility > 1, lower thoracic Cobb angle > 70° were vulnerable to postoperative coronal plane imbalance. Multivariate logistic regression showed that vertebral rotation, Risser grade, major curve correction rate/flexibility, lower thoracic Cobb angle were independent risk factors for postoperative coronal plane imbalance in Lenke type II adolescent idiopathic scoliosis patients. The predictive model was Y=1/[1+exp(-1.182X1+1.228X2+1.671X3-0.71X4+0.407)]. 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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Multi-segment transpedicle spinal fixation for thoracolumbar fractures with ankylosing spondylitis: one-year follow-up Wu Xing-guo, Huang Jian, Jiang Yu-qing, Guo Wei-kang, Wang Jun 2014, 18 (9):  1368-1373.  doi: 10.3969/j.issn.2095-4344.2014.09.010 Abstract ( 389 )   PDF (333KB) ( 711 )   Save BACKGROUND: Because of osteoporosis, short-segment transpedicular fixation or screw-rod system fixation is prone to screw loosening depending on its poor anti-pull-out strength in patients with thoracolumbar fracture with ankylosing spondylitis. OBJECTIVE: To probe the clinic outcomes of multi-segment transpedicle spinal fixation for thoracolumbar fractures with ankylosing spondylitis. METHODS: Eleven patients with ankylosing spondylitis combined with thoracolumbar fracture in the Fourth Department of Orthopedics, Meizhou Hospital, Sun Yat-sen University, China from January 2009 to December 2012 were selected. All the patients underwent posterior reduction and multi-segment transpedicle spinal fixation, among whom, six cases were subjected to internal fixation through the pedicle of fractured vertebra. RESULTS AND CONCLUSION: All of the 11 patients were followed up for 13 to 36 months. Solid bone healing was achieved in all of the patients, and there were no complications related to the internal fixation systems such as loosening or breakage. Three cases of spinal cord injury achieved Frankel’s class E from class C recovery. Lumbodorsal pain rate achieved 100% according to the Japanese Orthopaedic Association scoring. Results confirmed that it is effective to treat thoracolumbar fractures with ankylosing spondylitis by posterior reduction and multi-segment transpedicle spinal fixation. Strong internal fixation and fracture union can be achieved by 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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Posterior screw-rod fixation for idiopathic scoliosis: factors affecting the results Bi Zhong-pu, Xia Lei, Xu Jing-lei, Zhou Ya-qi, Ke Guang-shui, Sang Liang 2014, 18 (9):  1374-1379.  doi: 10.3969/j.issn.2095-4344.2014.09.011 Abstract ( 673 )   PDF (413KB) ( 671 )   Save BACKGROUND: Idiopathic scoliosis is most common among all the scoliosis. Accompanied by the nervous system, the endocrine system as well as nutritional and metabolic abnormalities, patients usually cannot be redressed and cured by conservative treatment, but often require surgical operation. Surgery for malformation is a very complicated project, and is really of great significance for an in-depth research on treatment and turnover of idiopathic scoliosis. OBJECTIVE: To observe the correction effect of posterior screw-rod fixation for idiopathic scoliosis, and explore the relevant factors influencing its effectiveness. METHODS: We retrospectively analyzed 80 cases receiving pedicle screw fixation in the treatment of idiopathic scoliosis in the latest four years. Age, gender, disease duration, preoperative and postoperative X-ray measurement of coronal Cobb’s angle, and trunk deviation were recorded, and statistically analyzed. RESULTS AND CONCLUSION: Univariate analysis showed that gender and disease duration were not significantly correlated with postoperative correction results (P > 0.05). However, the age distribution of patients, the location of scoliosis, and scoliosis flexibility were associated with curative effects of internal fixation (P < 0.05). Posterior screw-rod fixation for idiopathic scoliosis can achieve significant effects. The patient’s age, location and flexibility of scoliosis have a significant effect on the effects of fixation. The patient’s gender and disease duration had no significant effect on fixation effects. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Minimally invasive cervical laminoplasty versus single-door laminoplasty for treatment of cervical spondylotic myelopathy Wang Jing-yu, Zhang Chun-lin, Zhai Fu-ying, Li Zhen-wei 2014, 18 (9):  1380-1385.  doi: 10.3969/j.issn.2095-4344.2014.09.012 Abstract ( 569 )   PDF (415KB) ( 848 )   Save BACKGROUND: In recent years, a single-door laminoplasty for cervical spondylotic myelopathy was performed in the Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University. This surgery achieved spinal decompression while remaining the important structure of cervical vertebra. OBJECTIVE: To comparatively analyze the therapeutic effects of minimally invasive cervical laminoplasty and single-door laminoplasty on cervical spondylotic myelopathy. METHODS: A total of 78 cases of cervical spondylotic myelopathy were randomly divided into two groups, which respectively received minimally invasive cervical laminoplasty and single-door laminoplasty. RESULTS AND CONCLUSION: All cases were followed-up for 3-36 months. No significant difference in excellent and good rate of Japanese Orthopaedic Association score was detected between the two groups in final follow-up (P > 0.05). The apparent rate of axial symptoms was significantly lower in the minimally invasive cervical laminoplasty group than that in the single-door laminoplasty group after treatment (P < 0.05). Cervical curvature loss was significantly lower in the minimally invasive cervical laminoplasty group than that in the single-door laminoplasty group (P < 0.05). In final follow-up, in the minimally invasive cervical laminoplasty group, two titanium screws of one patient were slightly loose, and no abnormal symptom was observed. In the single-door laminoplasty group, hinge breakage was visible in six patients. The broken vertebral plate was excised. Artificial spinal dura mater was coated on the surface of spinal cord for protection. Results suggested that the effect of two surgical methods in promoting functional recovery of spinal cord is identical. However, complications in the minimally invasive cervical laminoplasty group are further fewer than those in the single-door laminoplasty group. 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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Radiographic anatomy features of teenagers’ upper-middle thoracic vertebrae Zhang Zhi-feng, Shi Jun, Wei Jing, Wang Xing, Zheng Lei-gang, Huo Hong-jun, Li Zhi-jun 2014, 18 (9):  1386-1391.  doi: 10.3969/j.issn.2095-4344.2014.09.013 Abstract ( 433 )   PDF (320KB) ( 413 )   Save BACKGROUND: The conditions of teenager and adult skeletons have great differences. Thus, it is dangerous to place screw on teenagers using the methods for adults. OBJECTIVE: To observe the anatomical features of teenagers’ upper-middle thoracic vertebra images, and to provide experimental basis for pedicle nailing and pedicle-rib head unit nailing in teenagers’ upper-middle thoracic vertebrae. METHODS: We chose 30 teenagers (13 to 18 years old) without spine lesions, and then they were scanned (0.625-1.25 mm) from T1 to T12 segments using CT. The original data were loaded into a three dimensional software in DICOM format for measuring related indicators. At last, we analyzed the data according to different segments. RESULTS AND CONCLUSION: The trend between the width of pedicle and pedicle-head unit was similar,  showing a “V” shape. The minimum of width was located in the T4, and there were significant differences between the corresponding vertebral bodies (P < 0.05). The trend between pedicle nail road length and pedicle-rib head unit nail road length was similar, and the trend between them was gradually increasing. The minimum of length was located in T1, and the maximum of length was located at T10, and there were significant differences between the corresponding vertebral bodies (P < 0.05). The trend between the pedicle transverse angle and pedicle rib-head unit transverse angle was similar. The trend from T1 to T10 was on a decline, and there were significant differences in corresponding vertebrae (P < 0.05). The trend of curves between pedicle sagittal angle and pedicle rib-head unit sagittal angle was similar, showing a wavy shape, and there were significant differences in corresponding vertebrae (P < 0.05). These results confirmed that the same segmental pedicle rib-head unit can provide a safer nailing place than the pedicle relatively. 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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Alterations in cross-sectional area of paraspinal muscle induce degenerative lumbar spondylolisthesis Zhu Kang, Sun Gen-wen, Qiao Pei-liu, Tayier•Abuduhadeer 2014, 18 (9):  1392-1397.  doi: 10.3969/j.issn.2095-4344.2014.09.014 Abstract ( 604 )   PDF (433KB) ( 680 )   Save BACKGROUND: Recently, the effects of lumbar facet joint morphology on the onset of degenerative lumbar spondylolisthesis have been a discussion point. However, the discussion mainly concerned CT manifestations of joint angle and osteoarthritis. Studies have shown that the changes in cross-sectional area of paraspinal muscle were considered as the essential marker for the pathological diagnosis of degenerative lumbar spondylolisthesis. However, previous studies limited the accuracy of the conclusion due to small sample size, young age, and measurement. OBJECTIVE: To observe changes in MRI images of bilateral paraspinal muscles after degenerative lumbar spondylolisthesis. METHODS: This study adopted the method of retrospective study, selected 80 cases of degenerative lumbar spondylolisthesis as lumbar spondylolisthesis group, and 80 healthy persons as control group. Image J software was utilized to measure cross-sectional areas of bilateral erector spinae and psoas major muscle on the L 3-5 vertebral endplate levels using T2-weighted MRI in both groups. The ratio of relevant data was calculated. RESULTS AND CONCLUSION: Compared with the control group, the ratio of cross-sectional area of paraspinal muscle was increased on the same side and the same level in the lumbar spondylolisthesis group (P < 0.05), and the mean value of cross-sectional area of bilateral psoas major muscle was decreased on the same level (P < 0.05). No significant difference in the mean value of cross-sectional area of left and right erector spinae was detected on the same level (P > 0.05). Results indicated that the changes in cross-sectional area of paraspinal muscle could induce degenerative lumbar spondylolisthesis, and could be considered as a diagnostic standard for degenerative lumbar spondylolisthesis. 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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Three-dimensional virtual reality imaging combined with two-dimensional ultrasound images for the visual evaluation of hip dysplasia in infants Li Ping, Zhang Yuan-zhi, Dou Rui, Guo Zhi-ying 2014, 18 (9):  1398-1403.  doi: 10.3969/j.issn.2095-4344.2014.09.015 Abstract ( 679 )   PDF (470KB) ( 533 )   Save BACKGROUND: Ultrasound has been widely used in developmental hip dysplasia screening in infants and young children, but there are significant differences among different inspection findings, even in the reexamination by the same examiner. Therefore, the accuracy of ultrasound imaging in the diagnosis is of insufficient evidence. OBJECTIVE: Through virtual reality three-dimensional reconstruction images showing the structure of acetabulum and femoral head space, to obtain a new parameter in order to enrich measurement standards of Graf ultrasonic diagnosis technology and to further improve the credibility of the diagnosis of developmental dysplasia of the hip.  METHODS: Ten fresh cadaver specimens of Chinese infants were selected, including five males and five females. Two-dimensional ultrasonic method was employed for hip screening, and at the same time, multi-slice spiral CT was used for three-dimensional reconstruction followed by volume reconstruction and fitting of surface reconstruction to display the anatomic structure around the hip and to simulate Graf’s two-dimensional ultrasound method to measure a and β angles on three-dimensional virtual reality images. RESULTS AND CONCLUSION: As confirmed by three-dimensional reconstruction, Graf’s two-dimensional ultrasound could be used to measure a and angles, truly reflecting the development of bony and cartilaginous acetabulum. Graf’s two-dimensional ultrasound contributed to the proper evaluation of beonatal hip dysplasia, which can be used as a routine examination for developmental dysplasia of the hip. These indicate that to master Graf’s ultrasound technology and strictly grasp the evaluation standards for developmental dysplasia of the hip is the important guarantee for diagnosis of developmental dysplasia of the hip. 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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Meta-analysis on application of computer-assisted navigation in lumbar pedicle screw fixation Wang Peng, Jin Ge-le, Yang Yi 2014, 18 (9):  1404-1409.  doi: 10.3969/j.issn.2095-4344.2014.09.016 Abstract ( 508 )   PDF (305KB) ( 450 )   Save BACKGROUND: Computer-assisted navigation technique has been widely applied in spinal surgery, but there is still lack of systematic reviews on this technique in lumbar pedicle screw fixation. OBJECTIVE: To evaluate the application of computer-assisted navigation technique in lumbar pedicle screw fixation. METHODS: Databases such as PubMed, Embase and China journal full-text database CNKI were searched for articles about computer-assisted navigation in lumbar pedicle screw fixation, and related studies and literatures were hand-searched as well, and then insertion accuracy, intraoperative blood loss, operative time consumption and rate of insertion-related complications between computer-assisted navigation technique group and conservative technique group were compared. RESULTS AND CONCLUSION: Finally 7 studies which met the inclusion criteria were included with 784 patients and 4 101 lumbar pedicle screws in total. Meta-analysis indicated that malposition rate [relative risk (RR)=0.44, 95% confidence interval (CI): (0.27, 0.69), P=0.000 4] and intraoperative blood loss [weighted mean difference (WMD)=-172.40, 95%CI: (-246.26, -98.53), P < 0.000 01] had statistically significant differences between computer-assisted navigation technique group and conservative insertion group. However, operative time consumption [WMD=-31.45, 95%CI: (-85.56, 22.66), P=0.25] and incidence of complications [RR=0.41, 95%CI: (0.12, 1.41), P=0.16] did not show significant differences between groups. Application of computer-assisted navigation technique in lumbar pedicle screw fixation would improve insertion accuracy. However, further study is still needed to make clear whether this technique can improve final outcome in post-operative patients. 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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Mobile-bearing STAR prosthetic system: present situation and application Lin Qing, Du Bin, Wei Pan-deng, Chen Zhi-xin 2014, 18 (9):  1410-1415.  doi: 10.3969/j.issn.2095-4344.2014.09.017 Abstract ( 585 )   PDF (331KB) ( 563 )   Save BACKGROUND: STAR ankle prosthesis can follow free movement of the ankle joint, and ancillary equipment of this prosthesis has advantages of easy operation, accurate positioning, ensuring prosthesis balance, and minimal resection. OBJECTIVE: To summarize the brief history, design features, indications, contraindications, efficacy and evaluation system of STAR prosthesis. METHODS: Using the search terms “ankle replacement AND star”, “ankle arthroplasty AND star”, “ankle prosthesis AND star”, “ankle”, “replacement”, “STAR prosthesis”, the relevant literature published from January 2000 to December 2012 were searched from MEDLINE, PubMed, EMbase，and Cochrane library database. We selected literatures that involve progress of ankle prosthesis, indications, contraindications, and Kofoed, Mazur，AOFAS evaluation system. Thirty-six studies were identified as meeting the eligibility criteria. RESULTS AND CONCLUSION: So far, three generations of total ankle prosthesis have been developed. The prosthesis that most widely used in our country is STAR. Prosthetic ankle load design greatly improves the inner part of the bone prosthesis, bone resection method, fixation method and the elimination of harmful stress. Failure of STAR prosthesis in 15 papers results from prosthesis loosening, power line abnormalities, infection. The anatomy and unique biomechanics characteristics of the ankle elicit complex complications after ankle replacement, and patient’s selection and improving ankle replacement technology can both reduce the incidence of complications after replacement. 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 three-dimensional reconstruction in pelvic and acetabular fractures Huang Wan-jing, Tian Jing 2014, 18 (9):  1416-1421.  doi: 10.3969/j.issn.2095-4344.2014.09.018 Abstract ( 588 )   PDF (388KB) ( 643 )   Save BACKGROUND: Diagnosis of pelvic and acetabular fractures is difficult with a high misdiagnosis rate. It is necessary to diagnose pelvic and acetabular fractures rapidly and accurately. And patients suffer great injury, blood loss, from traditional open pelvis and acetabulum surgery, often complicated by neurovascular injury. Correct positioning and placement of internal fixator can reduce surgical complications. OBJECTIVE: To explore the new progress of three-dimensional reconstruction of pelvic and acetabular fractures in order to promote its clinical application. METHODS: A computer-based online search of PubMed database, CNKI database and Vip database between September 1996 and October 2013 was performed to search related articles using the key words of “3D, three dimensional reconstruction, pelvic fracture, acetabular fracture” in English and Chinese, respectively. The duplicate research or Meta analysis articles were eliminated. Finally, 41 articles were enrolled for further analysis. RESULTS AND CONCLUSION: Through a three-dimensional reconstruction using a variety of post-processing techniques, such as multi-planar reformation, maximum intensity projection, shaded surface display and volume rendering, we can get high quality images at any angle. Various post-processing techniques interact with each other that can reduce missed diagnosis rate and misdiagnosis of pelvic and acetabular fractures. Moreover, three-dimensional reconstruction techniques can be used to design surgical approach, guide surgeon’s surgical program designed to simulate surgical procedures, reduce the complications caused by the dislocation of internal fixation, and reduce the surgical risk. Three-dimensional reconstruction is also used for postoperative follow-up review of fracture 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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Prosthesis selection and complication treatment in elderly femoral neck fractures Sun Hai-bo, Wang Yang, Pan Jin-she 2014, 18 (9):  1422-1425.  doi: 10.3969/j.issn.2095-4344.2014.09.019 Abstract ( 500 )   PDF (327KB) ( 744 )   Save BACKGROUND: Elderly patients with femoral neck fractures have poor regulatory mechanism, accompanied by a variety of comorbidities and complications, so the treatment and rehabilitation of perioperative femoral neck fracture is very important. OBJECTIVE: To review the prosthesis selection and complication treatment in perioperative femoral neck fracture in elderly patients. METHODS: A computer-based research was conducted in PubMed database and CNKI database for the articles published since 2000, the key words were “elderly, femoral neck fracture, perioperative, treatment and rehabilitation, hip fracture” in Chinese and English. The clinical researches were selected. The subjects were the femoral neck fracture patients with the age over 65 years. The review literatures and the literatures with small cases and old were eliminated, and finally 20 literatures were included for analysis. RESULTS AND CONCLUSION: Due to the osteoporosis of the elderly patients, the internal fixation often failed. For the Garden Ⅲ and Ⅳ femoral neck fracture patients with the age over 65 years, as long as there is no clear contraindication for surgery, the hip replacement is often used for the treatment. The tolerance of the patients should be accurately evaluated before replacement, and the blood pressure, blood glucose and various medical complications should be controlled; the rehabilitation training after replacement is also essential. The common complications in elderly patients after replacement include stress ulcer, deep venous thrombosis, neuropsychiatric symptoms, urinary tract infections and the surgical infection. 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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Femoral neck fracture: problems and countermeasures  Ma Wen-hui, Zhang Ying-ze 2014, 18 (9):  1426-1433.  doi: 10.3969/j.issn.2095-4344.2014.09.020 Abstract ( 789 )   PDF (339KB) ( 747 )   Save BACKGROUND: The femoral neck fracture is a common skeletal injury, with high mortality and disability rate. Nonunion and avascular necrosis in femoral head are the main problems in treatment of femoral neck fracture. Up to now, the guidelines for its management continue to be unsolved and are still evolving. OBJECTIVE: This study aims to summarize the incidence of two femoral neck fracture complications, as well as the advance in prevention and treatment. This work can help to better understand the mechanism of non-union and avascular necrosis, and to choose the optimal management of this fracture. METHODS: Papers in terms of femoral neck fracture published in core periodicals were reviewed. Studies which are not directly related to femoral neck fracture or articles regarding poly-trauma were excluded. Literatures concerning non-union and avascular necrosis after femoral neck fracture were preferred. RESULTS AND CONCLUSION: A total of 241 articles were screened out, and those were mainly published in the last five to ten years. 182 unrelated papers were excluded, and 59 papers were included in the analysis. The femoral neck fracture has a high incidence. Nowadays, there are a variety of treatments for this fracture, but the stability and healing result of fractures depend on many factors, such as age, classification of fracture, general condition of patient, and accompanying diseases. Up to now, the choice of management is still controversial. Imaging representation and patient’s age are not the main factors for the selection of treatment. Hence, a comprehensive assessment of the risk factors that influence fracture healing is necessary for surgeons to choose an optimal treatment of this fracture. Femoral neck fractures, therefore, represent an enormous socio-economic and medical problem and challenge surgeons to find the cheapest and most effective way to treat them. Internal fixation of the fracture in combination with the use of osteo-inductive materials may be a new way to further improve the treatment effects of femoral neck fracture. 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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Diagnosis and repair of chronic ankle instability Yang Zhen, Hu Ya-zhe 2014, 18 (9):  1434-1440.  doi: 10.3969/j.issn.2095-4344.2014.09.021 Abstract ( 1592 )   PDF (368KB) ( 944 )   Save BACKGROUND: Chronic ankle instability affects normal life severely. Therefore, chronic ankle instability causes more and more attention of experts, and choice of reasonable and effective diagnosis and targeted treatment method for chronic ankle instability in early stage has become an important issue in the clinic. OBJECTIVE: To review literature research on the diagnosis and treatment of chronic ankle instability in recent years, and to provide reference and evaluation criteria for the diagnosis and reasonable and effective treatment of chronic ankle instability in clinical practice. METHODS: We searched PubMed database, China National Knowledge Infrastructure, Wanfang database and VIP database for clinical and basic experimental research on chronic ankle instability. Keywords were “chronic ankle, instability, diagnosis, rehabilitation exercises, surgery methods, research progress” in Chinese and “chronic ankle, instability, diagnosis, rehabilitation exercises, surgical methods, research” in English. Totally 40 literatures were analyzed. RESULTS AND CONCLUSION: Because of the special anatomical features and biomechanical advantages of the ankle, we should first consider the early diagnosis and effective treatment in chronic ankle instability patients. The treatment should focus on the anatomic characteristics, biomechanic characteristics, etiology of chronic ankle and diagnostic methods of the ankle joint. Conservative treatment and rehabilitation exercises after surgery play a major role in the recovery of chronic ankle instability. The use of balance board, tilting board, and climbing machines is an effective rehabilitation exercises for chronic ankle instability. The application of AOFOS-hind foot and ankle fibula reaction time is important for the assessment of functional recovery of the ankle joint. The emergence of arthroscope is an important clinical research direction of ankle surgery. This plays a significant effect on the treatment of chronic ankle instability. 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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Dynamic hip screw combined with trochanter stabilizing plate versus Gamma nail fixation in repair of intertrochanteric fracture Zhou Qiang, Lu Hua, Yu Si-ming, Wang Zhan-chao, Mao Yu-lun, Yao Bing, Zhang Tian-hao 2014, 18 (9):  1441-1446.  doi: 10.3969/j.issn.2095-4344.2014.09.022 Abstract ( 545 )   PDF (401KB) ( 563 )   Save BACKGROUND: Intertrochanteric fracture can obtain good curative effects after active effective internal fixation in early stage. OBJECTIVE: To compare dynamic hip screw + trochanter stabilizing plate and Gamma nail fixation for treatment of Evans type IIIB and type IV intertrochanteric fracture. METHODS: A total of 67 patients with Evans type IIIB and type IV intertrochanteric fracture, including 28 cases undergoing dynamic hip screw + trochanter stabilizing plate and 39 cases undergoing Gamma nail, were selected from Chongming Branch, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from February 2009 to November 2012. All patients received antibiotics and functional exercises after treatment. Time of therapy, intraoperative bleeding amount, fracture healing time and Harris Hip Score were retrospectively analyzed in patients of both groups. RESULTS AND CONCLUSION: All patients were followed up for 6-45 months, averagely 21 months. (1) One patient affected infection in the dynamic hip screw + trochanter stabilizing plate group. He was healed after fixation removal half a year after drug exchange. One obese patient experienced injury again during out-of-bed activity at 3 weeks after treatment in the Gamma nail group. Fracture appeared at distal end of lock pin, and healed after replaced by Gamma nail. Trochanteric stabilizing plate was unstable in four patients of the Gamma nail group. They affected severe pneumonia after over 6 weeks of lying in bed, and healed after treatment in the medical department (2) Coxa vara appeared in two cases of the dynamic hip screw + trochanter stabilizing plate group, and three cases in the Gamma nail group. Fracture healing was achieved in all patients. (3) The time of therapy was longer, and intraoperative bleeding amount was significantly more in the dynamic hip screw + trochanter stabilizing plate group compared with the Gamma nail group (P < 0.05). No significant difference in healing time and Harris Hip Score was detected between the two groups (P > 0.05). Dynamic hip screw + trochanter stabilizing plate and Gamma nail are effective methods for treatment of Evans type IIIB and type IV intertrochanteric fracture. To choose a suitable fixator, we should aggregately analyze fracture stability, healing state and the degree of osteoporosis. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Scientific research and education of three dimensional B spline curve of the distal femur of the knee using computer aided design Shi Geng-qiang, Chen Lan 2014, 18 (9):  1447-1452.  doi: 10.3969/j.issn.2095-4344.2014.09.023 Abstract ( 340 )   PDF (885KB) ( 444 )   Save BACKGROUND: Department of Biomedical Engineering, College of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology designed a course Basic Training of Scientific Research. This course enables students to write an academic paper using AUTOCAD computer aided design software. OBJECTIVE: To help students build the basic ability of scientific research, and to provide data for further implementing individual artificial knee design and production. METHODS: Knee joint CT two dimensional images were provided by the Shanghai Minhang Central People’s Hospital in China. Students were asked to extract the profiles of CT two dimensional images of the patients using AUTOCAD software. Three dimensional B spline curve of the distal femur of the knee could be obtained, which can prepare individual design and artificial knee joint manufacture, better adapt to demand for personalized knee implants in Chinese medical science, and give a better service for patients with knee replacement. RESULTS AND CONCLUSION: The students processed CT file images of femoral distal human knee joint. Vector and extraction of two-dimensional profile of knee joint in distal femur were conducted using image processing software such as computer aided design. Three dimensional data of patients with distal femoral CT fault film were established, which provides an effective manner for individual design of knee joint in clinical medicine. 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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Optimal position of locking compression plate for proximal humeral fractures: choice of lateral deltoid splitting approach? Bai Li-cheng, Gu Shao, Xiong Ying, Liu Bai-lian, Zhao Feng, Wang Da-xing 2014, 18 (9):  1453-1458.  doi: 10.3969/j.issn.2095-4344.2014.09.024 Abstract ( 1001 )   PDF (463KB) ( 1029 )   Save BACKGROUND: Classical deltopectoral approach leads to a great injury to soft tissues. It is difficult to lay the steel plate on the lateral side. The steel plate is frequently laid on the anterolateral side of humerus. Fixed position is not ideal. OBJECTIVE: To evaluate the safety and feasibility of lateral deltoid-splitting approach in treatment of proximal humeral fractures. METHODS: From August 2008 to August 2013, 114 patients with fracture of surgical neck of humerus, who were treated in the Department of Orthopedics, Yan’an Hospital Affiliated to Kunming Medical University in China, were enrolled in this study. They were treated with locking compression plate, and assigned to deltoid splitting approach group and deltopectoral approach group (n=57). Surgical trauma, fracture healing, curative effects, functional recovery and Constant shoulder score were compared between the two groups. RESULTS AND CONCLUSION: All patients were followed up for at least 8 months. Compared with the deltopectoral approach group, the proximal humeral fractures were healed as scheduled in the deltoid splitting approach group, and the anteflexion, abduction, shoulder lifting of the shoulder joint, and sensation of lateral skin of the upper arm were not impacted. No significant difference in Constant shoulder score was detectable between the two groups (P > 0.05), which suggested that deltoid splitting approach for treating the proximal humeral fractures was safe and feasible. In addition, in accordance with the Neer’s classification system, the excellent and good rate in the deltoid splitting approach group (91%) was significantly higher than that in the deltopectoral approach group (75%) (P < 0.05). Therefore, the deltoid splitting approach can be used as the first choice for the treatment of proximal humeral fractures.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Internal fixation via medial and lateral approaches for the middle and inferior humeral fracture Wang Wei, Aierken•Yumaier, Zhang Qing-chun, Ahemaitijiang•Yusufu 2014, 18 (9):  1459-1464.  doi: 10.3969/j.issn.2095-4344.2014.09.025 Abstract ( 467 )   PDF (376KB) ( 701 )   Save BACKGROUND: The open reduction and internal fixation in treatment of middle and inferior humeral fractures often choose anterolateral approach. As the rapid development of microsurgical technique in recent years, some domestic hospitals try to adopt the medial approach, but the operation safety and efficacy are rarely reported. OBJECTIVE: To evaluate the clinical efficacy of two different approaches of open reduction and internal fixation for treating the middle and inferior humeral fractures. METHODS: A total of 68 patients with the middle and inferior humeral fractures were selected from Orthopedic Center of Xinjiang Medical University from January 2010 to January 2012, and were retrospectively analyzed. According to the approach of incision, the involved patients were divided into anterolateral approach group (n=33) and medial approach group (n=35). The blood loss in two groups was analyzed using Gross equation. The postoperative complications and functional recovery were compared. RESULTS AND CONCLUSION: During the follow-up at 12-18 months, X-ray results showed that the fractures achieved bone healing, fracture healing time was 16.9±3.9 weeks in anterolateral approach group and 15.5±2.2 weeks in the medial approach group. Shoulder Neer system score was 86±5 points in anterolateral approach group and 84±4 points in the medial approach group; elbow Mayo system score was 78±7 points in anterolateral approach group and 81±8 points in the medial approach group. Three cases in anterolateral approach group and one case in medial approach group presented postoperative radial nerve numbness and wrist dorsiflexion weakness, which were self-healed after 3 months. There was no nonunion, chronic osteomyelitis for other complications. The fracture healing time, the incidence of complications and the functional recovery between the two groups showed no significant difference (P > 0.05). The medial approach is a feasible and safe surgical approach of internal fixation for treating the middle and inferior humeral fractures. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Allogeneic blood transfusion alleviates hip joint pain induced by ankylosing spondylitis Zhang Xin, Wang Peng, Wu Yan-feng, Yang Rui, Huang Lin, Tang Yong, Li Yu-xi, Gao Liang-bin, Shen Hui-yong 2014, 18 (9):  1465-1470.  doi: 10.3969/j.issn.2095-4344.2014.09.026 Abstract ( 579 )   PDF (681KB) ( 486 )   Save BACKGROUND: Pain is the main clinical manifestation for ankylosing spondylitis. At present, nonsteroid anti-inflammatory drugs are orally taken, but the effects are limited and toxic and side effects are more. Thus, there is no effective scheme for treatment of pain induced by ankylosing spondylitis. OBJECTIVE: To investigate the correlation between postoperative joint pain alleviation and allogeneic blood transfusion, and the mechanisms.  METHODS: We retrospectively analyzed clinical data of 88 ankylosing spondylitis patients combined with kyphosis who received only one section of osteotomy surgery merging hip joint pain. We compared the visual analog scale score of hip joint and detected the variation of leucocytes, lymphocytes and immunoglobulin concentrations before and after the operation in the groups of fresh allogeneic whole blood transfusion, autologous whole blood transfusion, and mixed transfusion of allogeneic and autologous whole blood. Flow cytometry was used to analyze the number and ratio of peripheral blood Th17 cells and Treg cells which were both highly associated with autoimmune diseases. RESULTS AND CONCLUSION: The symptom of hip arthralgia obviously improved in both groups transfused by fresh allogeneic whole blood or allogeneic-autologous mixed whole blood. However, no obvious variation was detected in leucocytes, lymphocytes and immunoglobin concentration. However, flow cytometry results indicated that Th17/Treg proportion associated with autoimmune diseases was increased remarkably in peripheral blood of ankylosing spondylitis patients. Results suggested that allogeneic whole blood transfusion can alleviate patients’ joint pain by correcting the imbalance of Th17/Treg which may improve their immune state. 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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Balloon kyphoplasty for osteoporotic vertebral fracture: key point of bone cement injection Yan Xiong-wei, Zhang Hong-yan 2014, 18 (9):  1471-1476.  doi: 10.3969/j.issn.2095-4344.2014.09.027 Abstract ( 606 )   PDF (307KB) ( 438 )   Save BACKGROUND: Balloon kyphoplasty is a new technique of microtraumatic surgery of spine developed in recent years, and brings a new pathway for the treatment of osteoporotic vertebral fracture in the elderly. OBJECTIVE: To investigate the therapeutic effect of percutaneous balloon kyphoplasty on osteoporotic vertebral fracture, and to explore the main point of injecting bone cement. METHODS: A total of 22 patients with osteoporotic vertebral fracture at the age of 60-78 years underwent percutaneous balloon kyphoplasty under C-arm fluoroscopy. In accordance with the standards of WHO, antalgic effects were evaluated. The injection time, manner and dose of bone cement were analyzed. RESULTS AND CONCLUSION: All patients were followed up for 1-12 months. Postoperative pain was completely lessened in 15 patients, and partially relieved in 7 cases, with an effective rate of 100%. Spinal mobility increased. No incision surgery was needed in all patients. No complications such as pulmonary embolism or nerve injury appeared. These results indicate that percutaneous balloon kyphoplasty for treatment of osteoporotic vertebral fractures is minimally invasive and simple, has less complication and effectively reconstructs vertebral body strength, and can better alleviate the pain, is an effective minimally invasive spinal  treatment technology. To strictly understand the main treatment point can obtain satisfactory clinical curative effects, including precise diagnosis of the disease, identification whether patient’s pain is induced by fractures, preoperative intraoperative exact localization of the affected vertebra, perfect puncturing technique, suitable postoperative treatment and nursing. It is also important to strictly master the time of injecting bone cement and the dose of bone cement. Bone cement injection was commonly done in drawing-wire stage. Too early injection easily induced leakage and toxic reaction. Too late injection affected the expansion of bone cement and therapeutic effects. The injection of bone cement should be finished under a perspective environment, which can effectively avoid bone cement leakage. 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