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28 May 2014, Volume 18 Issue 22 Previous Issue    Next Issue

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Application of gyroscope to acetabular cup positioning in total hip arthroplasty Ge Xing-tao, Ge Xing-hua, Shang Chun-nuan, Wang Zeng-tao 2014, 18 (22):  3445-3450.  doi: 10.3969/j.issn.2095-4344.2014.22.001 Abstract ( 525 )   PDF (697KB) ( 976 )   Save  BACKGROUND: Good position of acetabular prosthesis during total hip replacement plays a key role in success of the operation. Traditional location tool has poor accuracy, is too complicated, and limits its application. OBJECTIVE: To compare the advantages and disadvantages of gyroscope with the traditional technique in acetabular component orientation in total hip arthroplasty. METHODS: Using lateral approach, physicians with different experiences used traditional technique to locate acetabular cup 100 times (20 times in each person; 40° abduction and 15° anteversion), and then used gyroscope to locate 60 times at the same angle in the same plastic hip model. The error between the planed and measured values was recorded. RESULTS AND CONCLUSION: Compared to the traditional technique, the error of the abduction and anteversion decreased obviously. These indicated that the gyroscope can make the orientation of acetabular component more precise in total hip arthroplasty. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Gamma nail versus artificial femoral head replacement for intertrochanteric comminuted fractures of femur in the elderly Hu Zheng-xia, Li Kai-nan, He Zhi-yong, Chen Er-dong, Wang Xue-jun 2014, 18 (22):  3451-3455.  doi: 10.3969/j.issn.2095-4344.2014.22.002 Abstract ( 489 )   PDF (685KB) ( 659 )   Save BACKGROUND: In recent years, many literatures compared the therapeutic effects of internal fixation and artificial femoral head replacement for treatment of intertrochanteric fractures of femur in the elderly, but their opinions are not uniform. Moreover, many literatures concerned the internal fixations including Richard screw, goose head nail and dynamic hip screw, which may lead to inaccurate conclusions. OBJECTIVE: To compare the results of Gamma nail and artificial femoral head replacement for intertrochanteric fractures of femur in the elderly, to explore the experiences, indications and complications about artificial femoral head replacement for the intertrochanteric fractures. METHODS: This study retrospectively analyzed 154 elder patients aged over 80 years old with intertrochanteric comminuted fractures. Of them, 98 cases underwent Gamma nail fixation and 56 cases underwent artificial femoral head replacement. Operation time, hospitalization day, intraoperative bleeding, off-bed time, final hip joint function recovery (Harris score) and incidence of complications after fixation were compared and evaluated for statistical analysis. RESULTS AND CONCLUSION: Average follow-up periods were respectively 6.6 years and 5.7 years in the Gamma nail group and artificial femoral head group. No significant difference in operation time, hospitalization day and intraoperative bleeding was detected between the two groups (P > 0.05), but significant difference in off-bed time was detectable (P < 0.05). No significant difference in final hip joint function score was observed between the two groups (P > 0.05). No significant differences in complications after fixation such as deep vein thrombosis, pulmonary infection and urinary tract infection were visible between the two groups (P > 0.05). Significant differences in implant loosening or rupture, subsidence, dislocation and inequality in leg length were detected between the two groups (P < 0.05). Artificial femoral head replacement for intertrochanteric fractures of femur in the elderly was helpful to patient’s off-bed activities and improved partial patients’ quality of life. After artificial femoral head replacement, no significant difference in hip joint function recovery was detectable compared with Gamma nail fixation. However, the incidence of early- and middle-stage complications was low. Prosthetic loosening, subsidence and dislocation appeared, and these were difficult to be handled and greatly impacted patient’s daily life. Operation indications and skills should be mastered strictly. 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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Anticoagulant after prosthetic implantation or plate fixation for resection/curettage of primary bone tumor around the knee joint: effect of rivaroxaban Wang Qian, Wang Zhen, Guo Zheng, Chen Guo-jing, Wang Cai-ru, Lin Yao, Wu Zhi-gang 2014, 18 (22):  3456-3462.  doi: 10.3969/j.issn.2095-4344.2014.22.003 Abstract ( 578 )   PDF (1023KB) ( 727 )   Save BACKGROUND: In patients with primary bone tumor around the knee joint, deep venous thrombosis easily occurred after prosthetic implantation, lesion resection/curettage, bone grafting and plate fixation. Thus, this should be paid enough attention in the clinic. OBJECTIVE: To explore effectiveness and safety of rivaroxaban to prevent the deep vein thrombosis of adult lap in patients with primary bone tumors undergoing prosthetic replacement or plate fixation after resection/curettage tumors. METHODS: Forty adult patients with primary bone tumor around the knee joint diagnosed in Department of Bone and Soft Tissue Oncology, Xijing Hospital, Fourth Military Medical University of Chinese PLA from March 2011 to March 2012 were randomly enrolled in this study. They did not have affected deep venous thrombosis before treatment. They were randomly assigned to two groups. Control group (n=20) received lesion resection/curettage, prosthetic replacement or plate fixation, and then received usual care and physical prophylaxis. Treatment group (n=20) received rivaroxaban 10 mg/d orally for 14 days, besides the treatment in the control group. At 1 month after treatment, deep venous thrombosis and the incidence of deep venous thrombosis were evaluated in follow-up. Whether pulmonary embolism and severe hemorrhage occurred was observed in both groups. RESULTS AND CONCLUSION: None deep venous thrombosis developed in the treatment group, however, two patients with deep venous thrombosis were found in the control group. There was no pulmonary embolism or severe hemorrhage in both groups. There was significant difference in the incidence of deep venous thrombosis between both groups (P < 0.05). Results suggested that rivaroxaban effectively reduced the occurrence of deep venous thrombosis in the patients with primary bone tumor around the knee joint, and showed good prevention and safety. 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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Modified poking closed reduction for complex femoral neck fractures and choice of implant Yang Fa-min 2014, 18 (22):  3463-3468.  doi: 10.3969/j.issn.2095-4344.2014.22.004 Abstract ( 459 )   PDF (715KB) ( 816 )   Save BACKGROUND: Femoral neck fracture was generally treated with closed reduction and internal fixation, but there are still some patients failing to get well with the conventional technique of closed reduction. OBJECTIVE: To observe clinical therapeutic effects of modified poking closed reduction technique for complex femoral neck fractures. METHODS: A total of 36 cases of complex femoral neck fracture were collected from the Department of Orthopedics, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University in China from December 2011 to October 2013. After one or two failures of conventional technique for closed reduction, they were treated with modified poking closed reduction and hollow screw fixation. According to age, type of fracture and bone density, dynamic hip screw combined with one hollow screw (n=17) or three hollow screws (n=19) were used. After fixation, clinical efficacy was evaluated with the Harris Hip Score during follow-up. RESULTS AND CONCLUSION: All 36 patients were followed up for 6 months to 2 years, with an average of 15.5 months. Osteonecrosis appeared in three cases and delayed fracture healing happened in two cases. Garden reset quality evaluation results were as follows: grade I in 23 cases, grade II in 11 cases, grade III in 2 cases, grade IV in 0 case; grade I and grade II accounted for 94.4% of the total number of patients. Harris Hip Score results were as follows: excellent in 22 cases, good in 7 cases, average in 3 cases, and poor in 4 cases, with an excellent and good rate of 80.56%. Harris scores were similar between patients receiving dynamic hip screw and one hollow screw or three hollow screws (P > 0.05). Therefore, our suggestion is that the patients with complex femoral neck fractures may try to be treated with modified poking closed reduction technique when conventional reduction technique failed. Dynamic hip screw or hollow screw did not obviously affect therapeutic outcomes. 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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Proximal femoral nail antirotation-Asia for trochanteric femoral fractures: the first choice for the elderly patients Fang Chao, Xie Jia-bing, Xu Zhu-jun, Ding Guo-zheng, Yang Min, Wang Zheng-yu, Zhou Mao-sheng 2014, 18 (22):  3469-3474.  doi: 10.3969/j.issn.2095-4344.2014.22.005 Abstract ( 398 )   PDF (806KB) ( 783 )   Save BACKGROUND: At present, there have been several intramedullary nail internal fixations being suited for the treatment of intertrochanteric fractures. PFNA-II, as the representative of new intramedullary nail internal fixations, has its unique advantages for the treatment of various types of intertrochanteric fractures. OBJECTIVE: To evaluate the clinical effect and operative skills of proximal femoral nail antirotation-Asia in treatment of intertrochanteric fractures. METHODS: A total of 39 patients with intertrochanteric fractures undergoing proximal femoral nail antirotation-Asia were retrospectively analyzed. According to AO classification, there were type A1 (n=11), type A2 (n=20) and type A3 (n=8). Duration of fixation, blood loss during fixation and proximal incision length were analyzed. Harris hip scores were used for the evaluation of clinical effect. RESULTS AND CONCLUSION: A total of 39 patients were followed up for 12 to 24 months, averagely 16.5 months. The average operation time was 77.1 minutes (ranged from 51 to 120 minutes) and the mean intra-operative blood loss was 85.41 mL (ranged from 39 to 185 mL). Various indexes in A1 and A2 patients were better than A3 patients (P < 0.05). However, no significant difference was detected between two groups. Harris hip score at 9 months postoperatively was ranged from 61 to 95. According to Harris hip score evaluation system,16 patients reached an excellent result, 16 good, 6 average and 1 poor, with the excellent and good rate of 82.1%. The excellent and good rate was best in type A1, followed by type A2, and was poorest in the type A3. Significant differences in excellent and good rate were detectable among three groups (P < 0.05). Results confirmed that proximal femoral nail antirotation-Asia is suitable for all types of trochanteric fractures. It is the first choice for elderly patients with osteoporosis. For complicated fracture, integrity of inner structure should be restored during operation. Mobile C-arm X-ray machine stitching technique can be used to evaluate reduction effects, which can be helpful to elevate the quality of fixation. 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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Proximal femoral locking plate fixation for obsolete intertrochanteric fracture in old patients Zhang Jun1, Wang Jin1, He Ai-yong2 2014, 18 (22):  3475-3480.  doi: 10.3969/j.issn.2095-4344.2014.22.006 Abstract ( 499 )   PDF (743KB) ( 1041 )   Save BACKGROUND: The cases of obsolete intertrochanteric fractures in the elderly are rare, and therapeutic manners are diverse such as plate fixation, intramedullary fixation and joint replacement. These methods have their own advantages and disadvantages. OBJECTIVE: To observe therapeutic effects of proximal femoral locking plate for obsolete intertrochanteric fracture in old patients. METHODS: This study retrospectively analyzed 16 patients with obsolete intertrochanteric fracture at the age of 58-72 years, who were recruited from Second Department of Orthopedics, Changde Municipal First People’s Hospital in China from January 2009 to December 2012. There were 10 males and 6 females with an average age of 67.3 years old. Among 16 cases, there were 12 cases caused by fall injury and 4 cases caused by traffic accident. The patients underwent open reduction + anatomic locking plate fixation at proximal femur in 4-25 weeks after injury, with an average of 6.7 weeks. C-arm X-ray machine was used for checking the reduction and fixation in all operations. RESULTS AND CONCLUSION: Reduction and fixation of all cases were satisfactory. Wounds were healed primarily and stitches were taken out on schedule. They were followed-up for 6-32 months. There were excellent in 11 cases, good in 4 cases and average in 1 case according to Harris score system with an excellent and good rate of 94%. Bone healing was observed in all patients, and no fixation loosening was found. These results indicated that using proximal femoral locking plate combined with bone graft in old patients with obsolete intertrochanteric fracture is an effective treatment. It can get good functional recovery of hip joint. 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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Construction of three-dimensional model of safe screwing in acetabular area of anterior column plate Song Ying-chun, Wang Gang, Lu Chao, Gao Bo-hua 2014, 18 (22):  3481-3486.  doi: 10.3969/j.issn.2095-4344.2014.22.007 Abstract ( 414 )   PDF (824KB) ( 559 )   Save BACKGROUND: During open reduction and plate fixation for acetabular anterior column fracture, screw penetrating the articular surface often occurred. To prevent this complication, quantitative anatomical measurement is very important for safe pedicle screw in acetabular area using anterior column plate technology. OBJECTIVE: To provide anatomical basis for screwing placement safely in acetabular anterior column plate. METHODS: Mimics Software was used to perform three-dimensional reconstruction of the 40 cases of male pelvic and 40 cases of female pelvic CT scan data. The cutting tool was used to make serial cross-sections of the acetabular anterior column and the measuring tool was used to determine the safe length and direction of screw entry on all entry points of each cross-section. All data were uploaded into SPSS 13.0 software for statistics process. RESULTS AND CONCLUSION: The distance from anterior acetabular margin to posterior acetabular margin and iliopubic eminence was as follows: in males: (56.63±2.05) mm, (12.30±1.51) mm, and in females: (49.07±5.07) mm, (16.93±1.74) mm, respectively. The distance from posterior acetabular margin to iliopubic eminence was as follows: in males: (45.46±3.44) mm, and in females: (33.72±6.85) mm. The safe entry angle of screws to iliac plate in the sagittal plane was (72.17±0.93)° in males, and (81.05±0.92)° in females. On each section of B, C and D, the maximum of the safe entry angle of screws to iliac plate in the oblique coronal plane was (53.88±3.01)°, (43.22±1.86)°, (54.60±2.97)° in males; and (49.54±1.81)°, (39.10±1.22)°, (47.91±2.23)° in females, respectively. Results indicated that three-dimensional model can be used to measure anatomic characteristics of acetabular anterior column plate and has important instruction significance for avoiding screwing into joint in acetabular anterior column plate technique. 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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Zero-profile anterior cervical interbody fusion for cervical spondylosis: short-period evaluation of support and fixation outcomes Yin Biao, Tang Long, Zhang Bo, Wang Le, Ding Qiang, Zhang Liang, Zhang Zhi, Yang Bo 2014, 18 (22):  3487-3492.  doi: 10.3969/j.issn.2095-4344.2014.22.008 Abstract ( 920 )   PDF (839KB) ( 1401 )   Save BACKGROUND: The anterior cervical discectomy and fusion has a curative effect in treatment of cervical spondylosis, but has such complications as dysphagia and esophagostoma. A new anterior cervical interbody fusion, with support, fusion and fixation function, was researched successfully and applied to clinical treatment in 2008. OBJECTIVE: To analyze the short-period clinical outcome of the zero-profile anterior cervical interbody fusion for cervical spondylosis. METHODS: A total of 20 patients (21 segments) undergoing anterior cervical discectomy and zero-profile anterior cervical interbody fusion were enrolled in this study. Visual analogue scale and Japanese Orthopaedic Association were used to evaluate the improvement of ache and neurological function. The excellent and good  rate of Japanese Orthopaedic Association was calculated in the final follow-up. Bazaz standards were utilized to assess the symptom of dysphagia after operation. The incidence of dysphagia was recorded. Anteroposterior and lateral radiographs were compared before and after treatment. Short-period clinical outcomes were evaluated using the recovery of intervertebral height, fusion condition and fixation-associated complications. RESULTS AND CONCLUSION: The operation time was between 70 and 170 minutes (averagely 93.4 minutes), blood loss was between 20 and 260 mL (averagely 107.6 mL) and length of stay was between 4 to 9 days (averagely 5.3 days). All patients were followed up for 13 to 20 months. Visual analogue scale scores were significantly lower at 2 days and 1 month posttreatment and final follow-up compared with preoperation (P < 0.05-0.01). Japanese Orthopaedic Association scores were significantly higher at 2 days and 1 month posttreatment and final follow-up compared with preoperation (P < 0.01). The excellent and good rate of Japanese Orthopaedic Association was 95% (19/20) in final follow-up. Among two patients who had dysphagia within 1 week after operation, one was mild and the other was moderate. Symptomatic treatment was conducted. The symptom disappeared in one case within 2 weeks after treatment and in one case within 2 months after treatment. Anteroposterior and lateral radiographs revealed that the intervertebral height obtained a certain increase and achieved bone fusion 95% (19/20) at final follow-up. There were no complications such as fixator loosening, breakage and shifting. Results suggested that zero-profile anterior cervical interbody fusion for cervical spondylosis is simple to operate, has small trauma on cervical tissues, can obviously lessen pain, improve neurological function, has good support fixation and fusion functions, and can effectively recover intervertebral height. Postoperative complications are rare. Short-period clinical results are satisfactory. 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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Neulen titanium plate fixation and spinal canal expansion bone grafting for cervical spondylosis: half-year follow-up of healing rate of bone graft Bu Guo-qiang, Zhang Shan-di 2014, 18 (22):  3493-3497.  doi: 10.3969/j.issn.2095-4344.2014.22.009 Abstract ( 351 )   PDF (637KB) ( 550 )   Save BACKGROUND: In traditional single open door surgery for cervical spondylosis, door shaft fixation such as suture suspension was used to maintain the open status of vertebral plate, but the fixation effect was not ideal. OBJECTIVE: To probe into the clinical application of Neulen titanium plate instrument and open-door bone grafting in patients with different types of cervical spondylosis. METHODS: A total of 32 patients were treated with Neulen titanium plate instrument and open-door bone grafting in unilateral open-door laminoplasty. RESULTS AND CONCLUSION: A total of 32 patients with cervical spondylosis were followed up for at least 6 months. Neurological function of these patients improved significantly. JOA score improved from (8.7±3.6) to (14.6±2.4), with an improvement rate of (63.3±8.9)% (P < 0.05). In follow-up at 6 months after treatment, X-ray and CT revealed that pivot side crack had disappeared, and spinal canal expansion was satisfactory. No loose, breakage, displacement or re-closing appeared. Results suggested that Neulen titanium plate fixation or open-door side bone grafting could maintain opening state in treatment using cervical posterior single door. Fusion rate of bone graft surrounding titanium plate was 78%. Fork design of both sides of titanium plate made less screws achieve high biomechanical stability. Titanium plate fixation obtained rigid support, but not elastic fixation on the door open side, obtained immediate stability of door shaft side, and easily resulted in bone fusion. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Bone fusion, correction and functional recovery after three approaches of implant fixation for lumbar burst fractures Huang Xiao-nan, Zhang Yong 2014, 18 (22):  3498-3503.  doi: 10.3969/j.issn.2095-4344.2014.22.010 Abstract ( 533 )   PDF (983KB) ( 495 )   Save BACKGROUND: Currently, the treatment methods of lumbar burst fractures include anterior spinal approach, posterior spinal approach, and anterior combined with posterior approach. However, it is still controversial which the best approach is for lumbar burst fracture and what are their indications. OBJECTIVE: To assess clinical outcomes of surgical treatments through anterior, posterior approaches, and anterior combined with posterior approach for lumbar vertebrae burst fractures. METHODS: A total of 79 patients with lumbar burst fractures were treated by operation. Different approaches were selected according to conditions of injury: posterior approach (57 patients), anterior approach (12 patients), and anterior combined with posterior approach (10 patients). ASIA was used to assess the recovery of neurological function before and after treatment. Cobb angle, correction loss of Cobb angle, bone fusion rate, failure rate of internal fixation, operative time and intraoperative bleeding loss were observed before and after treatment. RESULTS AND CONCLUSION: All 79 patients were followed up for at least 19 months. Except no changes in the 5 complete paralysis cases, the ASIA classification of postoperative nerve function in 63 incomplete paralysis cases was improved by 1 grade or more. ASIA grade and the Cobb angle were obviously improved after operation, showing significant differences between preoperation and last follow-up (P < 0.05). The Cobb angle correction loss in patients with posterior approach was significantly larger than those with anterior approach and anterior combined with posterior approach (P < 0.05). Operative time and blood loss were significantly less in posterior approach compared with anterior approach and anterior combined with posterior approach (P < 0.05). Five cases with posterior approach suffered from screw breakage. There were no significant differences in the rate of bone fusion and postoperative neurological function recovery in three approaches (P > 0.05). Results suggested that the three surgical approaches can effectively treat lumbar burst fractures, and can achieve satisfactory clinical outcomes. Posterior approach easily affected fixation breakage and postoperative correlation loss. Anterior approach and anterior combined with posterior approach obtained less correlation loss. The surgeons should choose the surgical approach according to the characteristics of patients, and aim to achieve the best clinical outcomes. 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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Observations and measurements of Wiltse paraspinal sacrospinalis splitting approach in Chinese people Gui Ke-ke, Yu Yong-lin, Zhao Ming-dong, Tan De-yan, Yin Wang-ping 2014, 18 (22):  3504-3509.  doi: 10.3969/j.issn.2095-4344.2014.22.011 Abstract ( 1636 )   PDF (871KB) ( 1257 )   Save BACKGROUND: Application of Wiltse paraspinal sacrospinalis splitting approach can reduce paraspinal muscle injuries caused by operations, but there are still no precise criteria to determine anatomic locations of longissimus-multifidus cleavage planes. OBJECTIVE: To have an intimate knowledge of structural characteristics of Wiltse paraspinal sacrospinalis splitting approach, to determine specific locations of longissimus-multifidus cleavage planes in different lumbar segments, and to provide experiences and references for its clinical applications by observations and measurements of autopsies and magnetic resonance images in Chinese people. METHODS: Ten embalmed adult cadavers were used for anatomical observations. The natural cleavage planes between longissimus and multifidus were noted and bluntly dissected bilaterally. Measurements were done between these planes and the midline at levels of spinous processes of L2 and L4. 400 patients’ images of lumbar spines were also used for observations. Measurements were taken bilaterally between longissimus-multifidus cleavage planes and the midline at levels of discs from L2/L3 to L5/S1. The correlations between these distances and sex or age were analyzed. RESULTS AND CONCLUSION: No important vessels or nerves were found in the longissimus-multifidus cleavage planes of all 10 cadavers. Superior facets and roots of transverse processes could be exposed at the bottom of the planes. At L2, the mean distance was (2.3±0.3) cm; at L4, (3.4±0.6) cm. Of all 400 images, the mean distances from L2/L3 to L5/S1 were respectively (19.71±1.93) mm, (23.49±2.49) mm, (27.49±2.84) mm and (31.36±3.15) mm. No strong correlation was discovered between sex or age with respect to measured distances. This study provides valuable references for clinical application of Wiltse paraspinal sacrospinalis splitting approach. We suggest routine measurements of magnetic resonance imaging before surgeries to reduce iatrogenic injuries. 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 of posterolateral fracture of tibial plateau using three types of internal fixation Fan Xin-bin, Zhang Yan, Yang Tie-yi, Luo Cong-feng, Gong Lu-lu, Liang Xu, Liu Shu-yi, Wu Liang, Liu Yue 2014, 18 (22):  3510-3516.  doi: 10.3969/j.issn.2095-4344.2014.22.012 Abstract ( 471 )   PDF (724KB) ( 1117 )   Save BACKGROUND: Studies on tibial plateau fractures had gradually focused on “360° stereochemical structure” from medial and lateral “double track structure” nowadays. Scholars pay great attention on the stability and reposition of posterior plateau and functional recovery after reduction. The choice of fixation material of posterior plateau was controversial. OBJECTIVE: To discuss the biomechanical characteristics of posterolateral fracture of tibial plateau using three types of internal fixation. METHODS: Using three-dimensional finite element analysis, we simulated 1/2 and 1/4 posterolateral tibial plateau fractures. Three types of internal fixation were used: two anterior 6.5 mm lag screws, lateral 4.5 mm L-shape plate, and posterior 3.5 mm T-shape plate. 500 N was loaded at the center of the tibial plateau vertically, and biomechanical status of three types of fixation was compared. RESULTS AND CONCLUSION: In 1/2 fracture model, anterior lag screw group and posterior plate group gained least displacement in all directions, as lateral plate group gained more. In 1/4 model, the advantage in displacement of anterior lag screw group was more apparent, the second was posterior plate group, and the last was lateral plate group. In 1/2 fracture model, the maximum stress of anterior lag screw was 36.523 MPa, which of lateral plate group was 153.372 MPa and posterior plate group was 115.922 MPa. The maximum stress left in the separate bone of lag screw group was 4.309 MPa, which of lateral plate group was 4.37 MPa and posterior plate group was 3.124 MPa. In 1/4 fracture model, the maximum stress of anterior lag screw was 36.803 MPa, which of lateral plate group was 153.336 MPa and posterior plate group was 104.234 MPa. The maximum stress left in the separate bone of lag screw group was 1.195 MPa, which of lateral plate group was 0.827 MPa and posterior plate group was 1.196 MPa. Results indicated that anterior lag screw could bear more stress and gained least displacement after loading, and the fixation was more stable. Posterior plate can give more stabilization when the separate bone was bigger (1/2), similar to anterior lag screw. When the separate bone was smaller (1/4), posterior plate model was less stable than anterior lag screw. Lateral plate model, with poor stabilization, was the worst choice in three types of fixation. 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 of screw layout of locking plate for treating the distal femur fracture Lin Zhen-en, Xie Dan, Zhang Sen 2014, 18 (22):  3517-3522.  doi: 10.3969/j.issn.2095-4344.2014.22.013 Abstract ( 705 )   PDF (709KB) ( 820 )   Save BACKGROUND: Distal femoral fractures mainly used distal femoral locking plate as internal fixation. The failure of internal fixation has been frequently reported. The distribution of steel screws was controversial in the clinic. Whether the distribution of screws was associated with the failure of internal fixation lacks of experimental evidence on mechanics. OBJECTIVE: To investigate the screw layout of locking plates for treating the distal femoral fracture. METHODS: By using ANSYS software modeling, fractures and plate models were established. Four screws were fixed on the proximal and distal ends of fracture. 128 kinds of screw layout were designed. Stress and fracture displacement of different screws and plates were analyzed. Screw holes 1 and 6 fixed single and double cortex groups were analyzed using one-way analysis of variance. Screw hole 5 fixed single and double cortex groups and no screw group were analyzed using one-way analysis of variance. RESULTS AND CONCLUSION: In the distribution of 128 kinds of screws, maximum stress of the first hole was “-2 distribution group” (-2 means hole 2 without screw), and minimum stress distribution was “-4 distribution group” (-4 means hole 4 without screw). Biggest stress distribution of fifth hole was “-4 distribution group”, and  minimum stress distribution was “-3 distribution group” (-3 means hole 3 without screw). The distribution of the maximum stress in the screw hole 6 was “-4 distribution group”, and minimum stress distribution was “-2 distribution group”. The distribution of maximum stress in the plate was “-4 distribution group”, and minimum stress distribution was “-5 distribution group” (-5 means hole 5 without screw). The distribution of the maximum displacement was “-5 distribution group”, minimum distribution was “-3 distribution group”. Of the 128 kinds of screws, no significant difference was detected in screws, plate stress and fracture displacement in the first and sixth holes of single and double cortex distributed groups. Fracture displacement in no screw group was bigger than in hole 5 single and double cortex groups (P < 0.05). No significant difference was detectable in screw stress and plate stress among the three groups. Results indicated that the proximal first hole and second hole in the plate should be fixed. Two holes were close to the proximal end of the fracture (for example holes 4 and 5). The hole 4 should be fixed. Whether the hole 5 should be fixed was judged according to the stability of the fracture. The middle hole could not be fixed. The hole 6 was recommended to be fixed. ANSYS analysis is an effective orthopedic clinical research method. 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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Safe pathway of screw implantation via posterior thoracic vertebra outside pedicle: anatomical and radiographic measurement of costotransverse groove Wang Huan-xi, Yan Hao-jun, Yao Yi-yong, Deng Zhan-sheng 2014, 18 (22):  3523-3526.  doi: 10.3969/j.issn.2095-4344.2014.22.014 Abstract ( 435 )   PDF (594KB) ( 894 )   Save BACKGROUND: Many present scholars do a large number of researches on anatomical structure in the thoracic costotransverse binding region so as to seek a safe pathway of screw entrance besides posterior thoracic approach outside pedicle, but their conclusions are controversial. OBJECTIVE: To measure the anatomical and radiological structures of costotransverse groove and to explore the safe pathway of screw implantation via posterior thoracic vertebra outside pedicle of vertebral arch. METHODS: Eight embalmed adult cadaveric thoracic spines were harvested with the medial 5.0-6.0 cm of rib. Intercostal soft issue and parietal pleura were left intact. All nonstructural soft issue was removed. Specimens were scanned with CT, and three-dimensional reconstruction was performed. The angles of the costotransverse groove were obtained. Anatomical analysis was performed in specimens. The distance from the superior limit of the rib superiorly to the superior limit of adjacent transverse process and the distance from the inferior limit of the rib inferiorly to the inferior limit of adjacent transverse process were measured. RESULTS AND CONCLUSION: There exists a costotransverse groove between rib and transverse process. Both distance from the superior limit of the rib superiorly to the superior limit of adjacent transverse process and the distance from the inferior limit of the rib inferiorly to the inferior limit of adjacent transverse process of T6-10 were significantly larger than other levels (P < 0.05). The costotransverse groove was most obvious at T6-10 segments. Results verified that adult costotransverse groove directed to vertebra, and provided a new idea for the pathway of screw implantation via posterior thoracic vertebra outside pedicle. 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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Relationship of mechanical strength of iliolumbar ligament with L5/S1 disc herniation and L5 spondylolisthesis: an imaging analysis Che Chun-qing, Chen Liang, Gu Yong, Feng Yu, Zhang Chi, Shan Zhong-shu, Wang Ling-jun, Yang Hui-lin 2014, 18 (22):  3527-3531.  doi: 10.3969/j.issn.2095-4344.2014.22.015 Abstract ( 501 )   PDF (670KB) ( 573 )   Save BACKGROUND: Studies have shown that morphological characteristics of iliolumbar ligament are controversial. Few Chinese studies concerned anatomical structure and biomechanical features of Chinese iliolumbar ligament, and no detail statistical data were found. OBJECTIVE: To study the relationship of L5/S1 disc herniation and the L5 spondylolisthesis with iliolumbar ligament. METHODS: A total of 28 cases receiving health examination, 26 patients with L5/S1 disc herniation and 26 patients with L5 spondylolisthesis were recruited from First Affiliated Hospital of Soochow University in China in 2013. Normal group contained 9 males and 19 females. L5/S1 disc herniation group contained 14 males and 12 females. L5 spondylolisthesis group contained 7 males and 19 females. Of them, there were 13 cases of spondylolysis and 13 cases degenerative spondylolisthesis; as well as 24 cases with degree I spondylolisthesis and 2 cases of degree II spondylolisthesis. The relative widths of the L5 transverse process (RT value) on the X-ray of the lumbar vertebra of each case were measured and calculated. RESULTS AND CONCLUSION: No significant difference in age and gender was detected in the normal group, L5/S1 disc herniation group and L5 spondylolisthesis group. RT value was higher in the normal group than in the L5/S1 disc herniation and L5 spondylolisthesis groups (all P=0.000). RT value was greater in the L5/S1 disc herniation group than in the L5 spondylolisthesis group (P=0.000). No significant difference in RT value was detectable between males and females. No significant difference in RT values was visible between the left and right sides. In patients with L5 spondylolisthesis, RT values were lower in the degenerative spondylolisthesis patients than in spondylolysis patients (P=0.004). Results indicated that the strength of iliolumbar ligament in normal person was higher than that with L5/S1 disc herniation and L5 spondylolisthesis. The strength of iliolumbar ligament in L5/S1 disc herniation patients was higher than that with L5 spondylolisthesis patients. The strength of iliolumbar ligament in spondylolysis patients was higher than that with L5 degenerative spondylolisthesis patients. The mechanical strength of iliolumbar ligament was possibly associated with L5/S1 disc herniation and L5 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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Wedging index of thoracolumbar vertebrae in healthy persons measured by magnetic resonance imaging Zhang Bin, Wu Guang-zhong, Wu Peng 2014, 18 (22):  3532-3536.  doi: 10.3969/j.issn.2095-4344.2014.22.016 Abstract ( 1046 )   PDF (688KB) ( 749 )   Save BACKGROUND: MRI was extensively used in spinal trauma, but morphological parameters of MRI on thoracolumbar segments of normal persons were not established in China. OBJECTIVE: To measure wedging index of thoracolumbar vertebra in healthy population using MRI, and to proved MRI morphology data for differentially diagnosing thoracolumbar vertebra fracture and wedging of normal persons. METHODS: 120 healthy volunteers aged 20-50 years old were recruited from November 2011 to August 2013. All volunteers underwent 1.5T MRI scan for thoracolumbar vertebra. Heights of leading and trailing edges of T11-L2 vertebrae were measured using sagittal fast spin-echo T2WI and wedging index was calculated. RESULTS AND CONCLUSION: Wedging indexes of T11-L2 vertebrae were respectively 0.91±0.05, 0.91±0.05, 0.88±0.08 and 0.91±0.08. Numbers of wedging of T11-L2 vertebrae were respectively 103 (23.52%), 112 (25.57%), 115 (26.26%) and 108 (24.66%). No significant difference in wedging indexes was detected among groups, but wedging index was small in older volunteers. Wedging indexes were smaller in males than females. Wedging indexes of T11 and L2 were smaller in heavy manual workers than in non-heavy manual workers. Wedging indexes were associated with height and body mass index. Results indicated that wedging changes to different degrees existed in thoracolumbar vertebrae of normal persons, and the degree of wedging was correlated with many factors. 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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Microscopic imaging of three-dimensional reconstructed scaphoid bone measured by Micro CT Liu Wei-hua, Tang Xi, Wang Zhi, Li Xin 2014, 18 (22):  3537-3541.  doi: 10.3969/j.issn.2095-4344.2014.22.017 Abstract ( 535 )   PDF (642KB) ( 577 )   Save BACKGROUND: At present, scholars have made many studies on applied anatomy of scaphoid fracture in surgical therapy. Few studies concerned microsurgical imaging of scaphoid bone. OBJECTIVE: Image data of scaphoid bone were measured using Micro CT to provide anatomic basis for surgical treatment on scaphoid fracture. METHODS: A total of 80 sides (40 left sides and 40 right sides) of dry scaphoid bone samples of adult Chinese were randomly selected from the Laboratory of Topography, Chengdu Medical College, no matter male or female. A vernier caliper was utilized to measure scaphoid bone and Micro CT was used to scan the samples. Three-dimensional structure of the scaphoid bone was analyzed using the three-dimensional reconstruction system of Micro CT. Moreover, the following data were measured: ① the length of longitudinal axis of scaphoid bone; ② proximal width of scaphoid crest; ③ lumbar width of scaphoid crest; ④ distal width of scaphoid crest; ⑤ height of tubercle of scaphoid bone; ⑥ thickness of tubercle of scaphoid bone; ⑦ width of tubercle of scaphoid bone; ⑧ minimum thickness of scaphoid body; ⑨ thickness of scaphoid waist; ⑩ width of scaphoid waist. RESULTS AND CONCLUSION: Micro CT three-dimensional images demonstrated that the width and thickness of tubercle of scaphoid bone were close. The tubercle of scaphoid bone was conoid. Scaphoid waist connected to tubercle and body. The anteroposterior diameter of the scaphoid body was obviously larger than the left-right diameter. The bone closed to head articular surface and radial articular surface was thinnest place of the scaphoid bone. Apparent vascular lake was seen on the radial dorsal side of tubercle, waist and body of scaphoid bone. Thus, longitudinal axis and dorsal ridge formed. Measure results were statistically analyzed. Results revealed that no significant difference in each diameter line value measured by Micro CT and data measured by vernier caliper was detected (P > 0.05). No significant difference in measured values of three-dimensional images of each part of left and right scaphoid bones measured by Micro CT was observed (P > 0.05). Results indicated that data measured by Micro CT were precise. The anatomic characteristics of data and images of reconstructed scaphoid bone measured by Micro CT provide theoretical evidence for fixator design after scaphoid fracture in surgical treatment. 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 versus open transforaminal lumbar interbody fusion for lumbar degenerative disease: a meta-analysis Ran Bing, Yan Lei, Zhao Xiao-lei, Xie Yuan-long, Cai Lin 2014, 18 (22):  3542-3550.  doi: 10.3969/j.issn.2095-4344.2014.22.018 Abstract ( 431 )   PDF (1207KB) ( 567 )   Save BACKGROUND: A large number of studies have confirmed that minimally invasive and open transforaminal lumbar interbody fusion approaches for single-segment and multi-segment lumbar degenerative diseases were effective, but their advantages and disadvantages remain inconclusive. OBJECTIVE: To systematically evaluate the effectiveness and safety of minimally invasive versus open transforaminal lumbar interbody fusion for lumbar degenerative disease. METHODS: Databases including The Cochrane Library (Issue 2, 2014), PubMed, EMbase, MEDLINE, SCI, CNKI, CBM, Wanfang Data were searched to collect the randomized controlled trails and non-randomized controlled trails about minimally invasive and open transforaminal lumbar interbody fusion for lumbar degenerative disease. The retrieval time was from foundation to February 2014. The studies were screened according to inclusion and exclusion criteria. The data were extracted and the quality was evaluated by two reviewers independently. Meta-analysis was conducted using RevMan 5.2 software. RESULTS AND CONCLUSION: A total of 1 randomized controlled trail and 18 non-randomized controlled trails involving 1 400 patients were included. The results of meta-analysis showed that: compared with open transforaminal lumbar interbody fusion, minimally invasive transforaminal lumbar interbody fusion had many advantages, such as small paraspinal muscle injury, less blood loss, short hospital stay, good early effects and high long-period remission rate of lumbago. However, minimally invasive transforaminal lumbar interbody fusion was not superior to open transforaminal lumbar interbody fusion in improving long-period motor function, long-term remission rate of leg pain and in reducing complications. Moreover, the operation time of minimally invasive transforaminal lumbar interbody fusion was longer. Therefore, under the premise of strict indications, minimally invasive transforaminal lumbar interbody fusion could better solve the complaint of patients with lumbar degenerative disease. For the quantitative and qualitative limitation of the included studies, this conclusion still requires to be further proved by performing a larger scale and a higher quality of randomized controlled trails. It suggests that doctors should choose a best therapy for patients according to an integrative disease assessment. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Two surgical methods for osteoporotic vertebral compression fractures: a meta-analysis on safety and efficacy Mahmootjan•Muhammat, Zhu Shao-bo, Li Jing-feng, Jin Lin, Su Ri-han, Wang Xi 2014, 18 (22):  3551-3559.  doi: 10.3969/j.issn.2095-4344.2014.22.019 Abstract ( 527 )   PDF (974KB) ( 781 )   Save BACKGROUND: Percutaneous kyphoplasty and percutaneous vertebroplasty are effective safe minimally invasive treatment methods for osteoporotic vertebral compression fracture. Percutaneous kyphoplasty has a certain advantage on long-period pain release, incidence rate of bone cement leakage, vertebral height recovery, and long-term kyphotic angle reduction compared with percutaneous vertebroplasty. However, we cannot deny the effects of percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fracture. OBJECTIVE: A meta-analysis was performed to assess the safety and efficacy of percutaneous kyphoplasty and percutaneous vertebroplasty for treating osteoporotic vertebral compression fractures. METHODS: A systematic computer-based search of all studies published till May 2013 was conducted in PubMed, Web of science, Ovid medline, Embase, Cochrane central database and CNKI for controlled studies concerning percutaneous kyphoplasty and percutaneous vertebroplasty in treatment of osteoporotic vertebral compression fracture. Study selection was done by two reviewers independently according to inclusion and exclusion criteria. Meta analysis was performed using Revman5.2 (5.2.5 edition) software provided by Cochrane Collaboration. RESULTS AND CONCLUSION: A total of 12 studies containing 1 081 patients were included. The results of meta-analysis indicated that there were no significant differences between the two groups in the short-term pain relief, short-term and long-term Oswestry Dability Index scores, incidence of adjacent-level fracture, short-term restoration of kyphosis angle and operation time (P > 0.05). However, there were significant differences in the long-term pain relief, the incidence of cement leakage, postoperative anterior vertebral heights and long-term restoration of kyphosis angle (P < 0.05). Results suggested that percutaneous kyphoplasty was superior to percutaneous vertebroplasty in the long-term pain relief, the incidence of cement leakage, restoration of postoperative anterior vertebral body and long-term restoration of kyphosis angle. Percutaneous kyphoplasty and percutaneous vertebroplasty both are safe and effective surgical procedures. Due to lack of high-quality randomized controlled trails in the original studies, more randomized controlled trails are required and a prudent choice is suggested. 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 of complications after volar and dorsal plate fixations for repair of distal radius fractures Zhang Yi, Yang Tuo, Li Hui, Deng Zhen-han, Yang Ye, Zeng Chao, Lei Guang-hua 2014, 18 (22):  3560-3566.  doi: 10.3969/j.issn.2095-4344.2014.22.020 Abstract ( 547 )   PDF (717KB) ( 699 )   Save BACKGROUND : Dorsal and volar plate fixation for distal radius fracture is a common fixation in the clinic. It is controversial whether complications after fixation have difference. OBJECTIVE: To compare the difference in complications following dorsal and volar plate fixation for distal radius fracture. METHODS: A computer-based search was performed on PubMed database for articles on controlled trials of comparison between complications following dorsal and volar plate fixation for distal radius fractures published before August 25, 2012. Data were analyzed using STATA 11.0 software. Simultaneously, meta-analysis was conducted using RevMan 5.2 software. RESULTS AND CONCLUSION: A total of 12 studies (952 cases) of meta-analysis were accumulated. Sufficient evidence demonstrated that there was no statistic difference in the overall rate of complications after dorsal and volar plate fixation. However, compared with dorsal approach, neuropathy [relative risk (RR)=2.19, 95% confidence interval (CI) 1.27-3.76, P < 0.05] and carpal tunnel syndrome [RR=4.56, 95% CI (1.02-20.44), P < 0.05] easily occurred after volar fixation, but tendon irritation seldom appeared [RR=0.38, 95% CI (0.17-0.86), P < 0.05]. Results indicated that compared with volar plate fixation, a low incidence of neuropathy and carpal tunnel syndrome, but a high risk of tendon irritation were found after dorsal approach. No significant difference in other complications was detected between volar and dorsal approaches. 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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Implant fixation versus conservative treatment for clavicle fractures: a meta-analysis Yang Fan, Wang Dong, Sun Hai-yu, Xu Kun, Ning Si-min, Li Yang, Zhao Chen 2014, 18 (22):  3567-3573.  doi: 10.3969/j.issn.2095-4344.2014.22.021 Abstract ( 487 )   PDF (767KB) ( 585 )   Save BACKGROUND: It is still disputed at present about the treatment selection for clavicle fractures, operative or conservative treatment. OBJECTIVE: To evaluate the effects of operative and non-operative (conservative) treatment for clavicle fractures with the method of meta-analysis. METHODS: We retrieved PUBMED, EMBASE, OVID, Cochrane library, Science Direct, Springer Link, China National Knowledge Infrastructure and Wanfang Database for articles on treatment of clavicle fractures published from January 2000 to December 2013. According to specific inclusion and exclusion criteria, relevant literatures about treatments of clavicle fractures were searched for data source extraction, which were used for meta-analysis using Review Manager 5.0 software. RESULTS AND CONCLUSION: Six randomized controlled trials were included, including 570 patients. Meta-analysis results demonstrated that for clavicle fractures, implant fixation could decrease nonunion rate [RR=0.16, 95%CI(0.07, 0.38), P < 0.000 1], malunion rate [RR=0.15, 95%CI(0.07, 0.34), P < 0.000 01], delayed union rate [RR=0.20, 95%CI(0.06, 0.70), P=0.01] and the incidence of residual pain at 1 year after treatment [RR=0.24, 95%CI(0.12, 0.51), P=0.000 2], could elevate Constant Score [MD=3.68, 95%CI(1.61, 5.76), P=0.000 5]. However, it was not concluded that fixation could reduce the incidence of neurological complications [RR=0.63, 95%CI(0.06, 0.70), P=0.22]. It is suggested that implant fixation for clavicle fractures obtained good clinical effects. However, due to the disadvantages of the included literatures, we still needed high-quality multicenter randomized controlled trials to further verify conclusions, and should pay more attention on patients’ individual conditions when the therapeutic methods for clavicle fractures were selected in the clinic. 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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Imaging evaluation for lumbar spinal instability: qualitative features and location of anatomy and function Nitin Tandra, Zhu Xiao 2014, 18 (22):  3574-3580.  doi: 10.3969/j.issn.2095-4344.2014.22.022 Abstract ( 881 )   PDF (723KB) ( 778 )   Save BACKGROUND: Spinal instability, lacks of precise definition, is still a controversial concept due to lack of regular clinical experience or radiological evaluation. OBJECTIVE: To review the definition of lumbar spinal instability (especially degenerative lumbar spinal instability) and the imaging methods of diagnosing lumbar spinal instability. METHODS: We retrieved SLIDE SHARE, MEDLIND and NCBI database for literatures published in recent 30 years. Key words were “lumbar instability, traction spurs, ligament, disc space narrowing” in English. Finally 49 literatures were included. RESULTS AND CONCLUSION: Lumbar spinal instability possibly was a reason for low back pain and sciatica, and was a key condition for spinal fusion and decompression. Clinical symptoms and physical signs of lumbar spinal instability did not have specificity, so effective diagnosis and treatment for this disease are controversial. Functional lateral plain films are extensive important method to diagnose lumbar spinal instability. CT provides more exact images for spinal degeneration and intervertebral joint direction. Magnetic resonance is generally considered to be the most precise method for the diagnosis of degenerative changes in the spine, and has been widely applied to diagnose chronic low back pain besides vacuum phenomenon. 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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Orthopedic treatment of degenerative lumbar spinal stenosis: implant fixation and bony fusion Chen Bin, Wang Wen-ji, Li Wang-li 2014, 18 (22):  3581-3586.  doi: 10.3969/j.issn.2095-4344.2014.22.023 Abstract ( 543 )   PDF (672KB) ( 1009 )   Save  BACKGROUND: There were no uniform standards or conclusion in the diagnosis of lumbar spinal stenosis, choice of therapeutic manner, location of affected segment, range of decompression, choice of fixation and fusion, indication of surgical treatment and the judgment of posttreatment effects. OBJECTIVE: To search abundant literatures on the advantage and disadvantages of surgical therapies and the range of decompression therapy is of great value on reducing the injury to spine structure and keeping spine stability. METHODS: The first author retrieved PubMed, China National Knowledge Infrastructure and Wanfang Database by computer for related articles published from January 1990 to January 2014. Literatures were about treatment progress of lumbar spinal stenosis, non-surgery therapy and various surgical manners (Laminectomy, fusion, fusion and fixation, non-fusion fixation and minimally invasive decompression) in treatment of lumbar spinal stenosis. A total of 42 literatures were included. RESULTS AND CONCLUSION: Patients’ age, type and degree of stenosis and morphology of intervertebral disc and vertebral canal were comprehensively evaluated. The indication of surgical treatment was strictly analyzed. The correlation of decompression and stability was handled during surgical therapy. On the basis of thorough decompression, spinal column was kept maximally. In accordance with patients’ clinical symptoms, signs and imaging characteristics, the range of decompression, fusion and (or) fixation were considered to avoid blindness decompression and non-symptomatic area decompression. Only careful choice could elevate the clinical therapeutic efficacy of lumbar spinal stenosis, make surgical therapy target, save time, and reduce trauma. 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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Standardization of extramedullary and intramedullary fixations for subtrochanteric fracture Meng Wei-ming, Li Yan-mei, Xu Hong-sheng, Fu Wei-jie, Zhao Zhi-jiang 2014, 18 (22):  3587-3592.  doi: 10.3969/j.issn.2095-4344.2014.22.024 Abstract ( 407 )   PDF (704KB) ( 869 )   Save BACKGROUND: The classification and treatment of subtrochanteric fracture experienced a long process of development. Surgical treatment was currently used popularly, including extramedullary and intramedullary fixation. It should be selected according to the type of fracture and clinical practice, and it is inconclusive in the clinic.   OBJECTIVE: To summarize the study and present application of intramedullary and extramedullary fixation in the subtrochanteric fracture in recent years. METHODS: The first author researched two books, and retrieved PubMed, Wanfang Database, and Chinese Journal Full-text Database for articles about clinical trials on fixation for subtrochanteric fractures, and the safety and efficacy of fixation for subtrochanteric fractures published until March 2014. A total of 42 clinical studies on type, intramedullary and extramedullary fixations were selected. RESULTS AND CONCLUSION: With the progress of fixation methods of subtrochanteric fracture, there was a great progress in improving the rate of fracture healing and reducing hip malunion, and limited mobility. Whether extramedullary fixation, intramedullary fixation or arthroplasty, clinical reports have achieved satisfactory results at present. The intramedullary fixation was still dominated among various therapeutic methods. However, the type of fracture, age and osteoporosis fractures were different in patients. There was no uniform standard of the specific choice of surgical approach, which still should be further studied. Authors believed that when fracture line was below the lesser trochanter, interlocking intramedullary nail could be used. High subtrochanteric fracture could utilize proximal femoral nail anti-rotation. However, if the medullary cavity was narrow, the fracture was involved in the greater trochanter or piriformis fossa area, locking proximal femoral plate or less invasive stabilization system could be employed. No matter intramedullary or extramedullary fixation, minimal invasion and biological fixation were the present trend of development. The new minimally invasive techniques and internal fixation are still the goal. Although intramedullary fixation has advantages, but cannot completely replace the current extramedullary fixation. It is important to have a perfect surgery plan, standardized surgical approach and long-term postoperative follow-up, in order to achieve better clinical outcomes. 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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Biological properties of expandable bridge-arch interbody fusion cage Li Ying, Zeng Zhao-feng, Zhang Chun-lin, Yan Xu 2014, 18 (22):  3593-3596.  doi: 10.3969/j.issn.2095-4344.2014.22.025 Abstract ( 556 )   PDF (571KB) ( 579 )   Save BACKGROUND: As spine endoscope and other microinvasive techniques develop, various fusion cages in particular expanded cage become the hot topic. OBJECTIVE: To introduce the design concept and biological characteristics of the novel expandable bridge-arch interbody fusion cage to treat lumbar degenerative disease. METHODS: A computer-based online search of Wanfang, CMB and VIP databases was performed for articles published between January 2000 and April 2011 related to the application of fusion cages in lumbar degenerative disease, with key words “lumbar degenerative disease, interbody fusion cage”. Insufficiency in present cages was analyzed and a novel cage should be designed. RESULTS AND CONCLUSION: A total of 50 relevant literatures were collected, and 27 were included. Results showed that ideal expandable cage should have small size, convenience to placement, excellent biomechanical stability, and prevent postoperative loss of intervertebral height. Therefore, this novel expandable bridge-arch interbody fusion cage was developed. The novel cage has a very good perspective of application for many advantages, such as mini-invasive implantation, excellent stability and powerful ability to prevent sink. 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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Telemedicine in orthopedics: a Web of Science-based literature analysis Zhai Yun-kai, Zhu Wei-jun, Sun Dong-xu, Zhao Jie 2014, 18 (22):  3597-3602.  doi: 10.3969/j.issn.2095-4344.2014.22.026 Abstract ( 464 )   PDF (721KB) ( 740 )   Save BACKGROUND: Telemedicine technology has been widely used in many fields including plastic surgery, burns and dermatology. However, there are few reports on telemedicine in orthopedics. OBJECTIVE: Based on Web of Science literature, telemedicine in orthopedics was analyzed from multiple perspectives.  METHODS: An online retrieval of Web of Science was performed by the first author using key words “tele*medicine” “orthopaedic”. The retrieved data were statistically and quantitatively analyzed and the publication distribution information was demonstrated in words and graphs. The peer-reviewed published original articles regarding telemedicine in orthopedics were included. Articles excluded are those meeting one of the following criteria: (1) articles on telemedicine but unrelated to orthopedics; (2) articles that required manual searching or telephone access; (3) documents that were not published in the public domain; (4) reviews, commentaries and corrected papers from the total number of articles. RESULTS AND CONCLUSION: 165 papers regarding telemedicine in orthopedics were retrieved from Web of Science. Among these papers, 126 were original articles and rank first in number, with 6 papers highly cited (total citations > 50). The number of included papers gradually increased over the study period. Among the included journals, Journal of Telemedicine and Telecare published a great number of papers (n=36, 30.95%), followed by Telemedicine and E Health (n=8). Telemedicine in orthopedics has become one of the latest areas of interest since 2000. A SCI database-based literature analysis on telemedicine in orthopedics can help understand the current status and progress within this research field and provide valuable information for future studies. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Autologous platelet-rich plasma and autologous bone graft for comminuted fractures: randomized controlled follow-up Yue Yong, Paerhati•Rexiti, Wang Qiang, Lu Jie, Yilixiati•Alifu, Han Xue-ying, Xu Xiao-xiong, Adeli•Abudurexiti, Julaiti•Jilili, Li Jing-ting, Pan Jie, Zhao Li-ying, Sun Gai-sheng 2014, 18 (22):  3603-3608.  doi: 10.3969/j.issn.2095-4344.2014.22.027 Abstract ( 488 )   PDF (793KB) ( 716 )   Save BACKGROUND: Studies showed that platelet-rich plasma + bone transplantation for repair of bone defects not only can accelerate new bone formation, but also increase bone density. OBJECTIVE: To observe autologous platelet-rich plasma and autologous bone graft for treatment of comminuted fractures, and the efficacy. METHODS: This was a clinical prospective randomized controlled study. A total of 42 patients with limb comminuted fracture and bone defects were enrolled and randomly assigned to two groups. In the experimental group, 20 patients received treatment with autologous platelet-rich plasma and mixture of autologous ilium and cancellous bone. In the control group, 22 patients underwent plate, screw or intramedullary nail fixation. At 1, 3, 6 and 12 months after surgery, X-ray examination was conducted. Healing conditions, healing speed and functional recovery were compared between the experimental and control groups. RESULTS AND CONCLUSION: The time of bone healing was respectively 12 weeks in the experimental group and 18 weeks in the control group on average, showing significant differences. There were two cases of plate breakage, one case of nonunion reoperation, three cases of delayed fracture healing in the control group. No autologous blood transfusion or other complications appeared in the experimental group. Results suggested that autologous platelet-rich plasma and autologous bone graft for comminuted fractures can facilitate and accelerate bone healing. 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