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27 May 2012, Volume 16 Issue 22 Previous Issue    Next Issue

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Effect of femoral head surface replacement on the histology of normal femoral head Ma Jiang-chuan1, Shi Zhu1, Chen Jiang1, Mao Jian1, Wang You-hua2, Liu Pan2 2012, 16 (22):  3991-3995.  doi: 10.3969/j.issn.1673-8225.2012.22.001 Abstract ( 358 )   PDF (492KB) ( 309 )   Save BACKGROUND: The author plans to investigate whether prosthesis design of hip surface replacement reaches mature, and whether causes femoral head necrosis by establishing animal models. OBJECTIVE: To observe the histological changes of normal femoral head after femoral head surface replacement through the experimental study of the New Zealand rabbits. METHODS: Sixty healthy rabbits had undergone left femoral head surface replacement, and the right side served as the normal control group. They were killed at time intervals of 3, 6, 9 and 12 weeks to remove the femoral head. Macroscopic, light microscopy, scanning electron microscope had used to observe the removed femoral head. RESULTS AND CONCLUSION: After the femoral head surface replacement, a small region of bone necrosis, granulation tissue hyperplasia fibrosis and bone resorption were found at the bone-cement interface. At the bone-implant interface, a smaller region of bone necrosis and granulation tissue hyperplasia fibrosis were also found, but without bone resorption. In the region of far from cement and implant, neither bone necrosis nor bone resorption was found. The pathological character was same to the healthy bone. This histological evaluation indicated that femoral head surface replacement cannot cause femoral head necrosis, and there is no cause and effect relationship between operation type, implant and femoral head necrosis, which confirmed the security and superiority of the femoral head surface replacement for the treatment of hip disease. Related Articles | Metrics

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Establishing three-dimensional finite element model of the rib vertebral unit of the middle and Zhao Yan1,2, Jiang Jian-ming1, Li Xiao-he3, Huo Hong-jun2, Zuo Yuan2, Xiao Yu-long2, Yang Xue-jun2　 2012, 16 (22):  3996-4000.  doi: 10.3969/j.issn.1673-8225.2012.22.002 Abstract ( 299 )   PDF (416KB) ( 358 )   Save BACKGROUND: It has the great significance to establish the finite element model of the rib vertebral unit of the middle and lower thoracic vertebra for more mechanical analysis. OBJECTIVE: To establish the three-dimensional finite element model of the rib vertebral unit of the middle and lower thoracic vertebra through the CT scanning combined with reverse engineering software. METHODS: One case without disorders of spinal and osteoporosis was selected from the Video Branch in the Second Affiliated Hospital of Inner Mongolia Medical College. It was used to establish the human integrity three-dimensional finite element model of the rib vertebral unit of the middle and lower thoracic vertebral and intervertebral discs. The data were extracted directly from CT image by the means of the medical image processing software Mimics, and the model was modified in the visual interface by the means of platform of reverse engineering technology Geomagic.  RESULTS AND CONCLUSION: The three-dimensional reconstruction of the rib vertebral unit of the middle and lower thoracic vertebral of human was performed through the reverse engineering software including Mimics and Geomagic, and combined with the technology of CT scan. This way reproduced the characters of the appearance and anatomy accurately, and achieved fine distinguish of the internal vertebral structure. There were 132 649 tetrahedral elements in every rib vertebral unit of the middle and lower thoracic vertebra. It suggests that this method can improve the efficiency and maneuverability of the modeling, and can successfully establish the finite element model conforming to the experimental requirements. Related Articles | Metrics

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Finite element analysis of prophylactic reinforcement in adjacent vertebral bodies after kyphoplasty with bone cement leakage into the intervertebral discs  Liu Shi-you1, Lu Qing-lin1, Zheng Wei2, Peng Da-yong1, Zhang Wen-qiang1, Shan Shi-ying1 2012, 16 (22):  4001-4005.  doi: 10.3969/j.issn.1673-8225.2012.22.003 Abstract ( 296 )   PDF (391KB) ( 399 )   Save BACKGROUND: Adjacent vertebral fracture after percutaneous kyphoplasty (PKP) has been reported. Many scholars have analyzed that cement leakage into the intervertebral discs is one of the major reasons for subsequent fracture of the adjacent vertebral bodies. OBJECTIVE: To explore the biomechanical changes of the adjacent vertebral bodies after PKP with bone cement leakage into the intervertebral discs using finite element analysis; to further analyze the causes of adjacent vertebral fractures and to seek for the remedial measures. METHODS: A three-dimensional finite element model of thoracolumbar spine (T11-L2) was constructed using MIMICS, ABAQUS and other software. Simulation of PKP treatment for L1 vertebral osteoporotic compression fractures was performed to observe whether the cement leakage into the T12-L1 discs has biomechanical effects on the adjacent vertebral bodies of the fractures; a further simulation of prophylactic reinforcement of 2, 3 and 4 mL cement in the vertebral body T12 was performed to observe the Von Mises stress of the ensemble and each of different models under different loads. RESULTS AND CONCLUSION: The relevant three-dimensional finite element models were successfully established. The maximum Von Mises stress of the adjacent vertebral bodies (T12) and the inferior endplate in the group with cement leakage into the disc(T12-L1) was significantly higher than that in the group without cement leakage. The maximum Von Mises stress of the adjacent vertebral body (T12) decreased to some extent after the prophylactic reinforcement of different doses of bone cement. The prophylactic reinforcement of low dose of bone cement (2-4 mL) did not obviously affect the biomechanical behaviors of the other vertebral bodies and intervertebral discs. These findings indicate that kyphoplasty with bone cement leakage into the intervertebral discs may lead to secondary fractures in the adjacent vertebral bodies; the prophylactic reinforcement of the adjacent vertebral bodies may reduce the occurrence of secondary fractures.   Related Articles | Metrics

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The thickness distribution characteristics of cortical bone around acetabulum measured by three-dimensional image Sun Jian-wei1, Yin Wang-ping1, Zhang Chun-cai2, Ren Ke3, Xu Zheng-feng1, Wang Ming-xin1, Zhi Xiao-cheng1 2012, 16 (22):  4006-4009.  doi: 10.3969/j.issn.1673-8225.2012.22.004 Abstract ( 425 )   PDF (331KB) ( 354 )   Save BACKGROUND: Preliminary studies have established the method to research the spatial distribution of cortical bone thickness through the three-dimensional model based on the CT data of the normal body.  OBJECTIVE: To make division of the thickness of cortical bone around the acetabulum according to the three-dimensional thickness distribution of the hip cortical bone. METHODS: The cortical bone was extracted and the geometric model was established through the segmentation of eight healthy volunteers CT image by Mimics. The new algorithm of cortical thickness measurement was determined by Patran Command Language provided by PATRAN platform. After the thickness data were obtained, we made a division of the thickness area by cluster analysis method according to the distribution size of the cortical bone.    RESULTS AND CONCLUSION: The cortical thickness of acetabulum was between 0.44 mm and 4.00 mm. Cluster analysis showed that it could be divided into 0.44-1.133 mm group, 1.133-1.826 mm group and 1.826-4.00 mm group. According to the thickness of the three groups, the model was rendered, and then we found that the thicker parts of the cortical bone could be divided into three cortical bone beams. The first group was extended from the arcuate line to the pubic symphysis. The second group was extended from the acetabular roof to iliac nodules .The third group was around the ischium notch. There were three thickest positions throughout the thicker parts of the cortical bone around acetabulum. The positions were consistent with the high stress points.   Related Articles | Metrics

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Multi-objective optimization design of the institutions of the prosthetic knee joint Sun Bai-yang 2012, 16 (22):  4010-4014.  doi: 10.3969/j.issn.1673-8225.2012.22.005 Abstract ( 460 )   PDF (341KB) ( 479 )   Save BACKGROUND: Nowadays, how to achieve the comfortableness and flexibility is the focus of the studies on artificial knee joint. OBJECTIVE: To analyze the law of the instantaneous center of the knee during exercise and to construct a suitable evaluation function to make it better meet the requirements of the wearer comfort and natural, then get the prosthetic knee joint structural parameters. METHODS: This paper focused on the four-bar linkage mechanism of artificial knee joint, the kinematics of mechanism model was constructed and the centrode of connecting rod was deduced on the basis of three centrosomes theorem. Regarding the comfortableness, the marking system model was established as the evaluation function; further regarding the flexibility, the multi-objective optimization model was established based on the dual optimization objective gained from the minimum total departure of actual and ideal instantaneous center in the process of bending knee and on the maximum value of evaluation function, as well as on the restriction of artificial knee joint mechanism bionics and the restriction of the double rocker linkage size. RESULTS AND CONCLUSION: Utilizing primary target method and MATLAB program, the parameter of optimal artificial knee joint mechanism was gained. The designed four-bar mechanism can well realize the coordination of the comfortableness and flexibility. Related Articles | Metrics

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Establishment of a three-dimensional finite element digital model for ankle joint Guo Guo-xin1, Li Wei2, Guo Ji-tao1, Ren Guo-shan2 2012, 16 (22):  4015-4018.  doi: 10.3969/j.issn.1673-8225.2012.22.006 Abstract ( 371 )   PDF (330KB) ( 311 )   Save BACKGROUND: Biomechanics research of ankle joint increasingly becomes a hot spot. Research method in previous studies is traditional biomechanical research that has developed to finite element mechanical analysis OBJECTIVE: To establish a three-dimensional finite element digital model of ankle joint and to discuss the stress distribution of various components in the ankle joint. METHODS: An adult woman was selected to treat with spiral CT scanning on ankle. The obtained images were processed by Mimics and Geomagic for the establishment of three-dimensional finite element digital model. RESULTS AND CONCLUSION: The three-dimensional finite element digital model was established, including distal tibiofibular shaft and talus. With realistic appearance and excellent geometry-comparability, the rotatable model of ankle is available to be observed from different perspectives, to be collected three-dimensional data and is valid for biomechanical study. Related Articles | Metrics

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Digital speckle measurement of the displacement under internal fixation for fracture of femoral shaft****◆ Wang Zhi-hua1, Zhao Yun-wei2, Li Jing-hua3, Chen Ying-jie4, Ye Hong4, Zhou Yi-ping5, Li Zhong-ming4 2012, 16 (22):  4019-4022.  doi: 10.3969/j.issn.1673-8225.2012.22.007 Abstract ( 287 )   PDF (309KB) ( 358 )   Save BACKGROUND: The biomechanical features of the plate internal fixation for the fractures are commonly analyzed utilizing direct contact and low accuracy sensor. However, it has some limitations such as direct contact and low accuracy. The digital speckle method used in the biomechanics of fractures is more accurate to analyze the characteristics of the screw breakage. OBJECTIVE: To measure the displacement of screws under different tensile force conditions after the internal fixation surgery of compression plate for adult thighbone using digital speckle method. METHODS: A total of six femur samples from adults were used to prepare model of midshaft humerus fractures. Each of two ends of fractured samples was fixed with five screws, and the pull test was conducted under the load of 200 and 300 N by electronic versatile machine to measure the displacement of the screws under 10 conditions. RESULTS AND CONCLUSION: The displacement distance of the screw was significantly longer under 300 N loading force compared with 200 N (P < 0.01). Except screws 1 and 10, 2 and 9, 3 and 8, 4 and 7, and 5 and 6, there were significant differences in the displacement between any two screws (P < 0.05). Results showed that the displacement of the screws increased with increasing pulling force, and the displacement near the fracture line significantly changed with pulling force. Related Articles | Metrics

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Three anaesthetic drugs in dynamic hip replacement of double hip joint Lian Ke-jian, Shen Jia-zuo, Lin Da-sheng, Li Da-kun, Li Qiang, Zhang Dong, Li Lin 2012, 16 (22):  4023-4026.  doi: 10.3969/j.issn.1673-8225.2012.22.008 Abstract ( 336 )   PDF (246KB) ( 382 )   Save BACKGROUND: Literatures and reports about floret pigs’ anesthesia are rare and the effects of these anaesthetic drugs are not perfect. OBJECTIVE: To compare the effect of single anaesthetic drug and compounded anaesthetic drugs for floret pig during dynamic hip replacement of double hip joint. METHODS: Research group brought 18 floret pigs, which were randomly divided into three groups. In the Xylazine group,     0.2 mL/kg Xylazine was injected into musculi colli of floret pig. In Xylazine+Pentobarbital group, 0.2 mL/kg Xylazine compounded with 15 mg/kg Pentobarbital were injected into both musculi colli of floret pig. In Xylazine+Ketamine group, 0.2 mL/kg Xylazine mixed with 10 mg/kg Ketamine were injected into one of musculi colli of floret pig. After the anaesthetic took effects, we had the dynamic replacement of double hip. RESULTS AND CONCLUSION: Induction period of Xylazine group was longer than that of the other two groups (P < 0.05); anaesthesia period of Xylazine group was shorter than that of the other two groups (P < 0.05); there was no significant difference of recovery period among these three groups (P < 0.05). The respiratory rate of Xylazine+Ketamine group was faster than that of the other two groups (P < 0.05); the heart rate of the Xylazine+Pentobarbital group was faster than that of the other two groups  (P < 0.05); the systolic pressure of Xylazine group and Xylazine+Ketamine group was higher than that of Xylazine+Pentobarbital group (P < 0.05); the shock index of Xylazine+Pentobarbital group was higher than that of the other two groups (P < 0.05). We draw a conclusion that combination anesthesia is better than single-agent anesthesia and recommend that Xylazine mixed with Ketamine is better than Xylazine mixed with Pentobarbital as it has shorter time of anesthesia induction, better effect during maintaining and higher security and waking up quickly, and that is the ideal anaesthetic method. Related Articles | Metrics

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Total hip arthroplasty for the treatment of old femoral neck fractures with lower limb length discrepancy Wei Ren-qian, Cao Xing-hai, Tu Da-hua 2012, 16 (22):  4027-4030.  doi: 10.3969/j.issn.1673-8225.2012.22.009 Abstract ( 325 )   PDF (252KB) ( 357 )   Save BACKGROUND: Most femoral neck fracture patients with lower limb length discrepancy have experienced long-term traction or failure internal fixation, the hip has severe osteoporosis, soft tissues around the hip joint and joint capsules contracture or avascular necrosis as well as the lower limb length discrepancy, so the clinical treatment is difficult. OBJECTIVE: To explore the clinical effect of total hip arthroplasty for treatment of old femoral neck fracture complicated with limp length discrepancy. METHODS: Thirty-five cases of old femoral neck fractures with lower limb length discrepancy were treated with total hip arthroplasty. Skeletal traction on the femoral condyle and the X-ray measurement of both lower extremities and pelvis were prepared preoperatively, it was done to anticipate for the level of femoral neck osteotomy and the level of loosing up tissue around hip joint, as well as to adjust the length of the prosthesis head and neck in order to maintain the length of the limbs during surgery. RESULTS AND CONCLUSION: Results of the 6 patients with shortened limb ranging 3.0-4.0 cm preoperartively, only 1 case had limb length discrepancy in 1 cm after surgery, as for the rest 5 cases and 29 patients with shortened limb ranging 1 to 2 cm preoperatively, none limb had been shortened postoperatively compared with its contralateral limb. According to Harris score system, the mean preoperative Harris score was significantly improved after 1 year postoperatively (P < 0.05). Total hip replacement can recover hip function rapidly and steady with a high good rate and satisfactory short term effect. Therefore, total hip arthroplasty is a very important and an effective treatment method for old femoral neck fracture with limp length discrepancy． Related Articles | Metrics

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Clinical application of spiral-type acetabulum and press-fit acetabulum Zhang Mei, Bai Peng-cheng, Jiang Jian-ping, Wang Hui, Feng Xiao-zhi, Jin Shao-lin, Tong Xu-jun, Zhang Chang-yi, Li Yong 2012, 16 (22):  4031-4034.  doi: 10.3969/j.issn.1673-8225.2012.22.010 Abstract ( 297 )   PDF (338KB) ( 365 )   Save BACKGROUND: Most studies suggest that the spiral-type acetabulum of total hip arthroplasty (THA) could provide better stability than the press-fit acetabulum. OBJECTIVE: To compare the effects of press-fit acetabulum and spiral-type acetabulum in THA. METHODS: The retrospective analysis on the clinical data of 39 THA patients with press-fit acetabulum and spiral-type acetabulum was preformed.  RESULTS AND CONCLUSION: ①All cases were followed-up for 4-51 months, the average time was 32.6 months. ②Harris scores: Postoperative Harris scores were significantly improved than preoperative in the final follow-up (P < 0.05), and the score of the spiral-type acetabular group was slightly higher than that of press-fit acetabular group, but the difference was not significant. ③Adverse reactions: The postoperative complications of the press-fit acetabular arthroplasty group included looseness of hip prosthesis 1 case after 1 year, ambulation pain 3 cases, osteogenesis around acetabular prosthesis 6 cases, translucent around acetabular prosthesis 3 cases, osteosclerosis around acetabular prosthesis 1 case and bone resorption around acetabular prosthesis 1 case; the spiral-type acetabular group included osteogenesis around acetabular prosthesis 3 cases, translucent around acetabular prosthesis 1 cases and bone resorption around acetabular prosthesis 1 case. Therefore, the initial stability of the spiral-type acetabular prosthesis was better than that of the press-fit acetabular prosthesis. Related Articles | Metrics

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Measurement of lumbar disc related to artificial nucleus pulposus replacement in Chinese  Wang Zi-xuan1, Shan Tao2 2012, 16 (22):  4035-4038.  doi: 10.3969/j.issn.1673-8225.2012.22.011 Abstract ( 258 )   PDF (250KB) ( 264 )   Save BACKGROUND: Surgeons usually predict the size and number of nucleus pulposus (NP) prosthesis before operation according to the diameters of lumbar intervertebral disc measured on medical images. OBJECTIVE: To measure and analyze height of lumbar intervertebral space, lumbar disc and NP diameters in normal for obtaining basic data of intervertebral disc related to artificial prosthetic nucleus. METHODS: Totally 157 lumbar spine X-ray films (Lateral views) of normal adult were randomly selected. Anterior, middle and posterior heights of lumbar intervertebral space were measured on X-ray films. A total of 106 lumbar Magnatic Resonance Imaging (MRI) images of normal adult were randomly selected for measuring transverse diameter and antero-posterior diameter (A-P diameter) of NP and lumbar disc. RESULTS AND CONCLUSION: ① X-ray film: from upper to lower, the height of intervertebral space increased gradually. Posterior height of lumbar intervertebral space was low. It ranged between 7 mm and 9 mm, approximately 50% at L2/3, L3/4, and L4/5, about 39.5% at L5/S1. ② MRI images: from L2/3 to L5/S1, the transverse diameter and A-P diameter of lumbar disc enlarged in turn. About 46.7% A-P diameter of lumbar discs were more than 37 mm. However, only 49.0% were proved that the A-P diameters of NP were more than 24 mm. In this study, the average transverse diameter of NP was 33.5 mm, the average A-P diameter was 23.4 mm. The A-P diameters of NP were all more than 12 mm. Among these, about 22.9% were more than 24 mm. The results indicated that single prosthetic disc nucleus (PDN) is suitable for most Chinese patients, and the height of 7 mm of PDN is commonly chosen. The A-P diameter of lumbar disc ranging from 37 mm is demonstrated unreliable to predict double PDN replacement before operation in Chinese. Related Articles | Metrics

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Three-dimensional gait analysis of temporal and spatial parameters and the action of the pelvic during gait in children with spastic diplegic cerebral palsy  Wang Yu-xia1, Yu Tao2, Chu Qin2, Wang Yu2, Yu Ling-yun2, Zhang Jin-hua1, Zhao Peng1 2012, 16 (22):  4039-4043.  doi: 10.3969/j.issn.1673-8225.2012.22.012 Abstract ( 353 )   PDF (250KB) ( 517 )   Save BACKGROUND: The gait abnormalities in the children with spastic cerebral palsy are common, and how to improve the gait has become the focus of the rehabilitation. OBJECTIVE: To investigate the temporal and spatial parameters and the action of the pelvic during gait in children of 4-6 years old with spastic diplegic cerebral palsy.  METHODS: Three-dimensional gait analysis was used to get the temporal and spatial parameters and the action date of the pelvic during gait. Sixty children were involved: 20 children who can walk more than three meters by themself as independent walking group; 20 children who cannot walk by themself or walk the distance less than 3 meters, but in the help of one hand may walk more than 3 meters as assist walking group; at the same time to select the match age of 20 healthy children as normal control group. RESULTS AND CONCLUSION: ①As for the temporal and spatial parameters, the step length and stride length of stance phase and double support phase in the normal control group was shorter than those in the independent walking group and assist walking group (P < 0.05); and the step length and stride length in the assist walking group were more longer than those in the independent walking group (P < 0.05); no significant differences were observed in step width between three groups (P > 0.05). ②As for the action of the pelvic, the total excursion of pelvic obliquity in the independent walking group and assist walking group was larger than that in the normal control group (P < 0.05) and the total excursion of pelvic obliquity in the assist walking group was larger than that in the independent walking group (P < 0.05); the anterior tilt of each phase of the walk cycle in the independent walking group and assist walking group was obvious than that in the normal control group (P < 0.05) and the assist walking group was more obvious than independent walking group (P < 0.05); the total excursion of pelvic rotation in the independent walking group and assist walking group was significantly larger than that in the normal control group (P < 0.05) and the assist walking group was more larger than independent walking group (P < 0.05). The temporal and spatial parameters and the action of the pelvic during gait in children of 4-6 years old with spastic diplegic cerebral palsy are different from healthy children. The poorer the walking ability, the more obvious the abnormality was. The excessive anteversion of pelvic may be the most important factor for walking ability. Related Articles | Metrics

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Clinical efficacy of minimal incision and conventional incision for total hip arthroplasty: A systematic Meta-analysis Liu Yun, Xiao Zeng-ming, Liao Shi-jie, Liu Hui-jiang 2012, 16 (22):  4044-4048.  doi: 10.3969/j.issn.1673-8225.2012.22.013 Abstract ( 286 )   PDF (210KB) ( 395 )   Save BACKGROUND: At present, the controversy on minimally incision total hip arthroplasty is mainly on the wild limitation of small incision, the occurrence of femoral neck fracture, nerve injury and poor prosthetic position as well as the impact of surgery long-term efficacy. OBJECTIVE: To compare the efficacy and safety of minimal incision and conventional incision for total hip arthroplasty. METHODS: We searched and collected the randomized controlled trials of minimal incision and conventional incision for total hip arthroplasty. The quality of the included studies was critically assessed and the relative data were extracted. Meta analysis was performed with the statistical software Revman 5.1. RESULTS AND CONCLUSION: Ten randomized controlled trials and 1 001 hips were included. The results of system evaluation showed that there was no statistically significant difference in the rate of iatrogenic nerve injury, the cup abduction angle, the stem alignment (varus/valgus), the rate of hip dislocation and the rate of reoperation between minimally incision and conventional exposure for total hip arthroplasty. Subgroup analysis showed that there was no significant difference in the rate of cup abduction angle, the rate of hip dislocation and the rate of reoperation, and there was no significant difference of hip dislocation rate between posterolateral approach minimally incision and conventional exposure for total hip arthroplasty. The curative effect of the minimal incision and conventional exposure for total hip arthroplasty is equivalent. Related Articles | Metrics

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Broken stick after orthopedic surgery for adult scoliosis Lu Ming, Ma Hua-song, Tan Rong, Ren Dong-yun, Bai Ke-wen, Wang Xiao-ping, Ma Xiao-ming, Zhang Mo, Zheng Rui, Zhang Jing 2012, 16 (22):  4049-4052.  doi: 10.3969/j.issn.1673-8225.2012.22.014 Abstract ( 408 )   PDF (363KB) ( 411 )   Save BACKGROUND: The efficacy of spinal orthopedic fixation has relationship with the fatigue properties and fatigue life of the materials used in fusion and fixation technology. OBJECTIVE: To analyze the related factors of broken stick after orthopedic surgery for adult scoliosis and the clinical significance. METHODS: The time for broken rods, activity, implant location, fusion rate, rate of orthopedic surgery and other data of 9 broken stick patients with orthopedic surgery for adult scoliosis were analyzed. RESULTS AND CONCLUSION: Among the 9 patients, 6 cases with the phenomenon of un-sufficient in laminectomy, and there were obvious blank area and formation of false bone island. The analysis showed that the fatigue life had positive correlation with metal fusion rate and correction rate (P < 0.01). Orthopedic surgery in patients with adult scoliosis fusion in good laminectomy condition can ensure the metal fixation devices applied in the treatment stay in a relatively stable state of fatigue strength to meet the fixation conditions required for the process, and can ensure the fixation of the metal rod to obtain intrinsic fatigue threshold below the point of fatigue, in order to achieve effective and sustained orthopedic fixed purpose, and to avoid the occurrence of broken rods. Related Articles | Metrics

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Iatrogenic factors for knee extensor device adhesion after middle and lower femoral fracture repair  Li Peng1, Zhang Chao-chun2 2012, 16 (22):  4053-4056.  doi: 10.3969/j.issn.1673-8225.2012.22.015 Abstract ( 272 )   PDF (236KB) ( 243 )   Save BACKGROUND: Knee extensor device adhesion is one for the common postoperative complications in the femoral lower-middle section fracture. OBJECTIVE: To investigate the iatrogenic factors for knee extensor device adhesion after the femoral lower-middle section fracture repair. METHODS: A total of 90 cases that operated on the femoral lower-middle section fracture with internal fixation and diagnosed as knee extensor device adhesion were selected. Effect of different surgical approaches, internal fixation methods, postoperative gesso externally fixation time and postoperative functional exercise on the occurrence of knee extensor device adhesion were statistically analyzed. RESULTS AND CONCLUSION: All the 90 cases were followed up for an average time of 18.7 months. Surgical approaches, internal fixation methods, postoperative gesso external fixation time and postoperative functional exercise were the iatrogenic factors which had statistically significant correlation with the knee extensor device adhesion (P < 0.05). The treatment of the femoral lower-middle section fracture with open reduction and internal fixation through posterolateral surgical approach, fixed using intramedullary nail, postoperative gesso external fixation time were shortened and the incidence of knee extensor device adhesion can be reduced by using continuous passive motion functional exercise. Related Articles | Metrics

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Necessity of hook plate removal in surgical treatment of Rockwood type Ⅲ acromioclavicular dislocation  Zhang Wei, Xin Wei-wei, Han Xiao-feng, Zhu Ying-hua 2012, 16 (22):  4057-4061.  doi: 10.3969/j.issn.1673-8225.2012.22.016 Abstract ( 348 )   PDF (236KB) ( 305 )   Save BACKGROUND: It is still controversial in clinical practice whether the hook plate should be removed or not timely after surgical treatment on acromioclavicular joint dislocation. OBJECTIVE:To evaluate the necessity of early hook plate removal after surgery on Rockwood type Ⅲ acromioclavicular joint dislocation by follow-up with shoulder functional assessment and radiographic measurement. METHODS: Seventy-four cases of acute traumatic acromioclavicular dislocation (Rockwood type Ⅲ) treated with hook plate internal fixation were followed up. All patients were divided into either removal group with plate removal and retaining group without removal. RESULTS AND CONCLUSION: There were no significant differences of each indicator in the removal group before internal fixation and retaining group after half one year. Constant score, activities of daily living, range of motion and Oxford Shoulder Score (OSS) scores after removal were significantly higher than those of before removal (P < 0.05), However, pain and strength scores showed no significant difference. At 1 year after internal fixation, compared with the retaining group, constant score, activities of daily living, range of motion and OSS score were increased in the removal group (P < 0.05), and pain, strength, coracoclavicular distance and acromioclavicular width were not significantly changed. There were no postoperative infection and complications of re-fracture and plate breakage in all the cases, and significant systemic and local reactions were also not found. It is indicated that shoulder function rehabilitation can be reached by improving Constant and OSS score after exercise if hook plate can be early removed after internal fixation in the treatment of acromioclavicular dislocation. Meanwhile, the anatomy of acromioclavicular joint remains the same and further complications can be reduced. Related Articles | Metrics

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Relationship between the second metatarsal shaft axis and the center of the ankle in healthy southern Han Chinese adults: Evaluated by laser aiming reproducible standard lower limb radiography Zhu Qi, Xu Dong-liang, He Pei-heng, Deng Bing-feng 2012, 16 (22):  4062-4066.  doi: 10.3969/j.issn.1673-8225.2012.22.017 Abstract ( 224 )   PDF (425KB) ( 363 )   Save BACKGROUND: During total knee arthroplasty surgery, second metatarsal shaft axis is consider as a reference, but its position through the ankle joint is unclear. OBJECTIVE: To establish a new laser aiming reproducible standard full-length lower limb radiography, to use the method to evaluate the relationship between the second metatarsal shaft axis and the center of the ankle in healthy southern Han Chinese adults. METHODS: All subjects were divided into 3 groups: ① The new method was adopted to mark skin by same tester who guided the filming position of patients. ② The new method was adopted to mark skin by different testers. ③ Routine radiography was used as control without mark. Twice radiography was done for each subject. RESULTS AND CONCLUSION: There was no difference of the testers in the group 1 and group 2 (P=0.729), but had difference in the group 1 and group 3 (P=0.017). Absolute value in two radiography of the groups 1 and 2 was lower than that of the group 3,  repeatability in the groups 1 and 2 was higher than the group 3. Using the new method, the ratio of the distance from the second metatarsal shaft axis to the medial and lateral ends of the transverse axis of the ankle was 1.06±0.882. The view that the second metatarsal shaft axis passes the center of the ankle is acceptable clinically.   Related Articles | Metrics

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Biomechanical analysis of double-column internal fixation on acetabular transverse fracture Wu Shu-qin 2012, 16 (22):  4067-4070.  doi: 10.3969/j.issn.1673-8225.2012.22.018 Abstract ( 308 )   PDF (358KB) ( 351 )   Save BACKGROUND: The key of pelvic and acetabular fracture treatment is accurate fracture reduction and stable internal fixation. OBJECTIVE: To analyze the biomechanical characteritics of three kinds of double-column internal fixation operation for acetabular transverse fracture in order to find the most stable method. METHODS: Anisotropic pelvic fracture model was established, and based on the maximum displacement, the maximum equivalent stress and other comprehensive evaluation indexes, the biomechanics of double-column screw, anterior-column screw and posterior-column plate, double-column plate on the standing position were analyzed. RESULTS AND CONCLUSION: Finite element analysis showed that the maximum displacement of double-column screw was 1.827 mm，maximum equivalent stress was 26.589 MPa; the maximum displacement of screw and posterior-column plate was 2.080 mm, maximum equivalent stress was 106.04 MPa; the maximum displacement of double-column plate was 2.987 mm, maximum equivalent stress was 200.37 MPa. The most stable method is double-column screw and the last one is double-column plate. Related Articles | Metrics

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Sectional anatomy and CT scanning of the sphenoid sinus and its clinical significance Wu Zhi-bing1, Guo Xing2, Li Fu-de1, Li He-ping1, Li Jian-bin1, Liu Xue-min1 2012, 16 (22):  4071-4074.  doi: 10.3969/j.issn.1673-8225.2012.22.019 Abstract ( 345 )   PDF (293KB) ( 341 )   Save BACKGROUND: To properly grasp the sectional anatomy of the sphenoid sinus is the key to clinical trans-sphenoidal approach. OBJECTIVE: To provide an anatomic basis for trans-sphenoidal approach surgery by observing sectional anatomy of sphenoid sinus. METHODS: CT scanning and sectional anatomy were used for observing 60 cases with CT scanning head and 20 cases head specimens. RESULTS AND CONCLUSION: ① Optic nerve and cavernous sinus were clearly displayed on coronal section, average distances were (16.02±3.47) mm and (17.23±3.64) mm of two sides optic nerves and internal carotid artery. ② Average distances from the ostia of the sphenoidal sinus to the anterior cranial fossa base, the lowest point of the bottom of the sphenoidal sinus, the posterior wall of sphenoidal sinus and the anterior nasal spina were (9.57±2.51) mm, (12.75±3.64) mm, (23.42±4.36) mm and (57.82±3.94) mm, from the anterior nasal spina to the center of the sellar base was (71.98±6.12) mm on median sagittal plane. ③ Three and four antrums were found by CT scanning of the sphenoidal sinus. It is indicated that sectional anatomy of sphenoid sinus can provide a guide for surgeons. Related Articles | Metrics

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Reliability of three-dimensional CT reconstruction and X-ray image for intertrochanteric fracture classification Yu Qing-wen, Zhang Li-cheng, Mao Zhi, Wang Hao, Zhang Li-hai 2012, 16 (22):  4075-4079.  doi: 10.3969/j.issn.1673-8225.2012.22.020 Abstract ( 336 )   PDF (353KB) ( 500 )   Save BACKGROUND: Three-dimensional CT reconstruction has been widely used in the classification of intertrochangeric fractures. OBJECTIVE: To compare the reliability of currently used classification systems with three-dimensional CT and X-ray image for intertrochanteric fractures of the proximal femur.  METHODS: Sixty-eight cases with intertrochanteric fractures of the proximal femur were subjected to CT and X-ray examination, and then the CT data were imported into the mimics10.0 software with dicom format to do the three-dimensional reconstruction. The three-dimensional data were classified independently by three experienced observers using the AO and Evans classification systems. The kappa value of AO and Evans classification groups of three observers was calculated when using the X-ray and three-dimensional CT image, as well as the kappa value of AO and Evans classification group between the observers when using the X-ray and three-dimensional CT image. Then the consistency among the three groups based on the kappa values was evaluated. RESULTS AND CONCLUSION: Excluding 18 cases with unclear image, 50 cases obtained the satisfactory image. As for the typing based on the X-ray image and three-dimensional CT image, the kappa value in the three-dimensional CT image group was larger than that in the X-ray image group no matter which method we used; the the kappa value in the AO typing group was larger than that in the AO subgroup and Evans typing group no matter which method we used. Results indicate that the three-dimensional CT can be used more reliably to measure intertrochanteric fractures of the proximal femur than X-ray, and the reliability of the AO classification was more satisfactory than Evans. Related Articles | Metrics

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Acute-stage microcirculation changes of lumbar spine vertebral bone marrow after radiotherapy with magnetic resonance perfusion-weighted imaging Xie Feng, Pan Shi-nong, Wang Feng-zhe, Fu Xi-hu, Liu Nan, Guo Qi-yong 2012, 16 (22):  4080-4083.  doi: 10.3969/j.issn.1673-8225.2012.22.021 Abstract ( 330 )   PDF (349KB) ( 431 )   Save BACKGROUND: The study of the shortly change of microcirculation after lumbar radiotherapy using magnetic resonance perfusion-weighted imaging is significant to research lumbar micro-cycle characteristics, the development of radiation treatment planning, as well as to determine the disease prognosis. OBJECTIVE: To investigate the acute-stage microcirculation changes of lumbar spine vertebral bone marrow in rabbit after radiotherapy with magnetic resonance perfusion-weighted imaging. METHODS: Fifteen rabbits were divided into 3 groups and underwent dynamic contrast enhanced magnetic resonance imaging of the lumbar spine. After 24 hours, local radiotherapy of the lumbar spine was performed, each rabbit underwent radiotherapy on lumbar spine by different X-ray doses (500 cGy, 1 000 cGy, 1 500 cGy). Seven days after the radiotherapy, each subject re-underwent dynamic contrast enhanced magnetic resonance imaging of the lumbar spine. The changes of the maximum enhancement value, peak enhancement rate and the wash-in rate were analyzed with the time-intensity curve. RESULTS AND CONCLUSION: The maximum enhancement value in the group with 500 cGy was increased after radiotherapy  (P < 0.05). The maximum enhancement value and the wash-in rate in the group with 1 000 cGy were increased after radiotherapy (P < 0.05). The maximum enhancement value, peak enhancement rate and the wash-in rate in the group with 1 500 cGy were increased after radiotherapy (P < 0.05). It can be observed using dynamic contrast-enhanced magnetic resonance perfusion imaging that the acute-stage changes of the microcirculation of rabbit lumbar spine vertebral bone marrow is ascended after radiotherapy, and in a dose-dependent manner. Related Articles | Metrics

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Application of three-dimensional CT angiography of cervical part in posterior atlas fixation Zhang Zhi, Wang Ting, Zhang Jin-feng, Li Shu-zhong 2012, 16 (22):  4084-4087.  doi: 10.3969/j.issn.1673-8225.2012.22.022 Abstract ( 418 )   PDF (305KB) ( 267 )   Save BACKGROUND: Posterior atlantoaxial fusion with internal fixation is a common treatment method for the treatment of upper cervical lesions. Some cases of vertebral artery injuries have been reported since complex and variable anatomical structure here. OBJECTIVE: To observe normal three-dimensional CT angiograph images of the upper cervical spine and to study the anatomy of atlantal posterior arch and the accompanying vertebral artery journey in order to provide the basis of microvascular anatomy for clinical treatment. METHODS: Four hundred cases without pathological lesions of atlantoaxial joint were selected. All the three-dimensional CT images were formed with volume rendering together with the techniques of separating, fusing, opacifying and false-coloring, On the three-dimensional CT images, the courses and variations of vertebral artery were observed, and the posterior screw-related data of the atlantal posterior arch were measured. RESULTS AND CONCLUSION: All the three-dimensional CT angiography images of head and neck were in high quality and up to our requirements. The courses of vertebral artery accompanied with the atlas were curved. There were 385 cases with typical itinerary. Variations were found in 15 cases, a total of 18 sides. There were 11 sides of persistent first intersegmental artery, 6 sides of fenestrated vertebral artery, 1 side of abnormal posterior inferior cerebellar artery respectively. 48 cases of posterior ponticulus were found, and 10 cases were bilateral, a total of 58 sides. The bottom of the vertebral artery’s groove was the weakest part of the posterior arch, and there was no significant difference between left and right (P > 0.05). The shape of the atlantal posterior arch and the vicinal vertebral artery are polytropic which bright the uncertain factors for the atlas posterior screw. Therefore, the three-dimensional CT angiography image clearly shows the anatomical structures. Full understanding of these data before operation can help to identify the precise surgical programs in order to improve the security of the operation.   Related Articles | Metrics

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Educational value of virtual reality skill in the surgical anatomy of petrous bone Zhao Ya-qun, Tang Ke, Zhou Jing-an 2012, 16 (22):  4088-4091.  doi: 10.3969/j.issn.1673-8225.2012.22.023 Abstract ( 370 )   PDF (229KB) ( 285 )   Save BACKGROUND: Surgical education assignment of petrous bone is difficult for the complexity of anatomic morphology and stereo architecture relationship. Merits including efficient, objective, and interactive exist in computed virtual reality technology, of which the development potential is enormous for the surgical education of prtrous bone. OBJECTIVE: To evaluate the application value of virtual reality technique in the surgical education of petrous bone. METHODS: The Dicom data of CT scan performed for one case without skull base disease was transferred to the virtual reality system to reconstruct three-dimensional image, and then, the images of structures in the osseous tubes and impressions of petrous bone were extracted to build three-dimensional anatomy model by using the software of image process. Forty volunteers were divided randomly into two groups with 20 members in each group respectively. The examined group had assignment of both textbook reading and image model observation. The control group had only task of textbook reading. Scoring about accuracy for written test of anatomy knowledge and marking of anatomic illustration was employed after 1 week and 2 weeks of study to evaluate the educational effect. RESULTS AND CONCLUSION: Effect of three-dimensional visualization was well for petrous bone model. Testing was performed after 1 week study, the scores of written test and illustration marking in the examined group were higher than those in the control group. Significant difference existed in the score of written test and illustration marking between two groups (P < 0.05). After 2 weeks study, there was no significant difference in the score of written test between two groups (P > 0.05). However, the illustration marking score of examined group was significantly higher than that of control group, and there was significant difference of illustration marking score between two groups (P < 0.05). The virtual reality three-dimensional model has good advantages in the surgical education of petrous bone. Related Articles | Metrics

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Inhibition of Xianlinggubao on bone loss in tail-suspended rats Pi Jun-jie1, Lü Zhi-wei2,Yan Zhi-rong1, Rong Jian-min3 2012, 16 (22):  4092-4095.  doi: 10.3969/j.issn.1673-8225.2012.22.024 Abstract ( 295 )   PDF (293KB) ( 349 )   Save BACKGROUND: Chinese herbal preparation Xianlinggubao whose main ingredient is icariin can promote bone formation. OBJECTIVE: To investigate the effect and related mechanism of Xianlinggubao on bone loss in tail-suspended rats. METHODS: Sprague-Dawley rats were divided into 3 groups: control group (A), simulated weightlessness group (B) and Xianlinggubao group (C). Rats in the group B and group C underwent tail-suspension, and in the group C was administered Xianlinggubao by gavage with dosage of 250 mg/(kg•d) at the same time while in the group B was administered double distilled water as control. Bone mineral density (BMD), biomechanical three-point bending and bone morphology of the right femurs were detected after 4 weeks removing the right femurs. RESULTS AND CONCLUSION: BMD, trabecular bone volume, bone trabecular thickness, trabecular number and biomechanics maximum load in the group A were markedly higher than those in groups B and C (P < 0.05), BMD of tibia distal 1/4, trabecular bone volume of proximal tibia in group C were higher as compared to group B (P < 0.05). Biomechanics maximum load in the group C was also higher than that of the group B, but there was no significant difference. Xianlinggubao inhibition by gavage can promote bone formation and partially prevent bone loss in tail-suspended rats. Related Articles | Metrics

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Effect of intra-articular injection with paeonol and acupuncture at Zusanli on serum interleukin 1-beta and tumor necrosis factor alpha contents in a rabbit model of knee osteoarthritis Zhou Jian-zhong1, Wang Chang-feng1, Ma Yong2, Hu Yu-hua1 2012, 16 (22):  4096-4099.  doi: 10.3969/j.issn.1673-8225.2012.22.025 Abstract ( 392 )   PDF (404KB) ( 382 )   Save BACKGROUND: Acupuncture or intra-articular injection with western medicine both can effectively treat osteoarthritis, but the therapeutic effect of acupuncture and intra-articular injection with traditional Chinese drug treating osteoarthritis is rarely reported. OBJECTIVE: To explore the effect of intra-articular injection with paeonol and acupuncture at Zusanli (ST36) on interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) in serum of rabbit’s knee osteoarthritis model. METHODS: Rabbit models of knee osteoarthritis were randomly divided into five groups: normal group (without treatment), model group, paeonol group, acupuncture group and paeonol+acupuncture group. The last four groups were made by intra-articular injection with papain. The model group was without treatment. The paeonol group was treated with the intra-articular injection with paeonol, once a week, a total of 5 times. The acupuncture group was treated with acupuncture of rabbit bilateral Zusanli, once a day and a total of 29 times. The paeonol+acupuncture group was treated with the intra-articular injection with paeonol, once time a week, a total of 5 times, and the acupuncture Zusanli was performed at the same time, once a day and a total of 29 times. The content of IL-1β and TNF-α in serum were measured after treatment. RESULTS AND CONCLUSION: The contents of IL-1β and TNF-α in paeonol group, acupuncture group and paeonol+acupuncture group were lower than those in model group (P < 0.05) but higher than those in normal group (P < 0.05). However, the contents of IL-1β and TNF-α in paeonol+acupuncture group were lower than those in paeonol group and acupuncture group (P < 0.05). It was considered that intra-articular injection with paeonol and acupuncture Zusanli could significantly degrade the content of IL-1β and TNF-α in serum and inhibit the damage effect of IL-1β and TNF-α on articular cartilage which could potentially delay the degeneration of joint cartilage. Related Articles | Metrics

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Curative effect of radiofrequency thermocoagulation combined with ozone injection for lumbar disc herniation evaluated by far-infrared thermography Liang Xue-liang, Huang Guo-zhi, Wu Wen, Fan Tao, Lu Peng-cheng 2012, 16 (22):  4100-4104.  doi: 10.3969/j.issn.1673-8225.2012.22.026 Abstract ( 267 )   PDF (400KB) ( 379 )   Save BACKGROUND: To data, the determination of the curative effect on the patients with lumbar disc herniation mainly depends on the subjective symptom and physical examination, there still lacks a subjective evaluation method. OBJECTIVE: To evaluate the curative effect of the radiofrequency thermocoagulation combined with ozone injection for lumbar disc herniation evaluated by far-infrared thermography. METHODS: Forty-six patients who got lumbar disc herniation and matched all the conditions for our clinical research were selected. The patients were randomly divided into the radiofrequency treatment group and conservative treatment group. Each group had 23 cases and was treated with radiofrequency thermocoagulation combined with ozone injection treatment and conservative treatment respectively. Thermography was taken before and after treatment to detect the difference of lower limbs’ temperature and compared with the effects assessed by visual analogue scale. RESULTS AND CONCLUSION: The remarkable effective rates of radiofrequency treatment group and conservative treatment group were 52% and 17% respectively, and the effective rates were 96% and 65%. There was statistical difference of curative effect between the two groups (P < 0.05); the difference of temperature in thermograph was obviously decreased in radiofrequency treatment group after treatment compared to conservative treatment group (P = 0.00); the change in temperature before and after the treatment was significantly increased in radiofrequency treatment group compared to conservative treatment group (P = 0.00). Far-infrared thermography can be used as an objective indicator to evaluate the curative effect of radiofrequency thermocoagulation combined with ozone injection for lumbar disc herniation. Related Articles | Metrics

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Effectiveness of manipulative reduction on osteoporotic thoracolumbar compression fracture  Deng Xuan-geng, Xiong Xiao-ming, Wan Dun, Shi Hua-gang, Cao Wan-jin, Song Cai-mao 2012, 16 (22):  4105-4108.  doi: 10.3969/j.issn.1673-8225.2012.22.027 Abstract ( 278 )   PDF (218KB) ( 375 )   Save BACKGROUND: Manipulative reduction is an important conventional non-surgical means for the treatment of osteoporotic thoracolumbar compression fracture (OTLCF). Its main function is to restore vertebral height and correct kyphosis, but its effectiveness is controversial. At present, the clinical assessment and clinical significance of the manipulative reduction are usually an empirical judgment, so there still lacks an objective study. OBJECTIVE: To research the effect of manipulative reduction on the treatment of OTLCF. METHODS: A random and control study was employed. The cases should be osteoporotic patients with thoracolumbar compression fracture in the ages of 60-75 years old (compression degree: 1/3-1/2, kyphosis angle≤30°). Patients with OTLCF were randomly divided into manipulative group and control group. Manipulative group received manipulative reduction in pronate stretch station, and the control group did not receive manipulative reduction. The other treatments were same between the two groups. The height ratio and kyphosis angle of fracture vertebra were compared between the two groups, measured from the X-ray films at the time of admission, after reduction, standing and follow-up. RESULTS AND CONCLUSION: Sixty-seven patients were enrolled, 36 cases in manipulatine group (13 males and 23 females, mean age: 65.4±10.8 years old) and 31 cases in control group (11 males and 20 females, mean age: 67.2±9.7 years old). There was no significant difference about sex, age, the height ratio and kyphosis angle of fracture vertebra. Compared with control group, manipulative group gained obvious improvement on the height ratio after reduction (P=0.016), and no statistic difference was found between two groups about kyphosis angle at any time point (P=0.089). However, it failed to show any additional significance at the time of standing and follow-up (P > 0.05) and similar to that at the time of admission (P > 0.05). Manipulative reduction has a temporary effect on improvement of the compressed vertebral height in the period of bed-rest, and shows no obvious improvement on kyphosis angle in a short course of treatment. And so, manipulative reduction has little value in treating OTLCF. Related Articles | Metrics

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Medical image edge detection based on the improved SUSAN algorithm Wang Min1, Gong Xiao-feng1, Zeng Jun2 2012, 16 (22):  4109-4111.  doi: 10.3969/j.issn.1673-8225.2012.22.028 Abstract ( 233 )   PDF (216KB) ( 278 )   Save BACKGROUND: Medical image edge detection is an important technology of medical image process, which is also the foundation of the deeper medical image process. OBJECTIVE: To use improved SUSAN algorithm to detect the medical image edge, so that richer medical image edge will be get and which is benefit for the deeper process of medical images. METHODS: Sobel operator was used to improve the SUSAN algorithm and the C++ programming language was adopted. The improved algorithm was realized based on the VC++6.0 development platform. RESULTS AND CONCLUSION: Experimental results showed that our algorithm could realize the threshold adaptive selection and had a better detection result in low contrast image edge of medical images. Related Articles | Metrics

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Study and implementation of co-operation for dual referral based on integrating healthcare enterprise cross-enterprise document sharing technique Xu Qing1, Zhou Yi2, 3, Zhou Ling-hong1, Geng Qing-shan1, 4 2012, 16 (22):  4112-4116.  doi: 10.3969/j.issn.1673-8225.2012.22.029 Abstract ( 241 )   PDF (498KB) ( 580 )   Save BACKGROUND: Dual referral system has a positive significance in improving resource utilization, increasing the social benefit of the health service. It has become an important procedure in territorial health platform. OBJECTIVE: To solve the problem of sharing medical information and health care resources between different medical institutions, establish the dual referral system and promote regional health information constructions. METHODS: Started with the character and importance of information exchange and interoperability, the roles and transactions under integrating healthcare enterprise cross-enterprise document sharing technical frame were analyzed, the share flow and implementation scheme of health information exchange was formulated, also the implementation strategy of document repository and data storage were put forward; based on which, technologies were realized to support medial institutions to the construction of the dual referral system. RESULTS AND CONCLUSION: Based on integrating healthcare enterprise cross-enterprise document sharing framework, we realized the construction of dual referral system and the system was tested in different systems and institutions. This system can share the patient information effectively and quickly. Related Articles | Metrics

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Application of finite element analysis in lumbar spine biomechanics  Yan Guang-kui, Ye Jun-jian 2012, 16 (22):  4117-4120.  doi: 10.3969/j.issn.1673-8225.2012.22.030 Abstract ( 243 )   PDF (346KB) ( 286 )   Save BACKGROUND: Finite element analysis is one of the spine biomechanics research methods that can commonly be used now. With the progress of imaging and image processing, the continuous development and application of finite element analysis software, spine biomechanics researches are further developed. OBJECTIVE: To introduce the differences of concept, principle between finite element and the other biomechanical study methods. METHODS: Chinese journal full-text, Chinese science and technology periodical and PubMed databases were retrieved by computer for articles published from January 1979 to January 2011 about the finite element analysis of lumbar spine biomechanics in the title and abstract with the key words of “lumbar, finite element, biomechanics” in Chinese or “lumbar, finite element, biomechanics” in English. Articles related to lumbar finite element analysis were selected. The articles which published in recently literatures or the authoritative magazines were selected in the same field. A total of 591 articles were selected, finally 20 articles were involved for summarization according to inclusion criteria. RESULTS AND CONCLUSION: In recent years, application of the finite element analysis in biomechanics analysis of physiological and pathological conditions in lumbar spine: different operative methods, fixation devices and artificial implant on the influence of lumbar biomechanics are different. Related Articles | Metrics

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Biological internal fixation of the fracture and performance analysis of the internal fixation materials Cheng Xiang-yu, Ji Bin, Pang Jin-hui 2012, 16 (22):  4121-4124.  doi: 10.3969/j.issn.1673-8225.2012.22.031 Abstract ( 296 )   PDF (359KB) ( 287 )   Save BACKGROUND: In recent years, the focus of internal fixation for the fracture has developed from rigidity, stability and anatomic reduction to biological fixation which can preserve soft tissue blood supply, relatively stable and had anatomical axis arrangement. OBJECTIVE: To summarize the clinical characteristics of various materials for fracture fixation, and to analyze the biocompatibility after fixation device implantation. METHODS: A computer-based online retrieval of CNKI database and VIP database from January 1990 to November 2011 was conducted for articles addressing fracture internal fixation materials, by screening the key words of “fracture, internal fixation, plates, screws” in title and “loose, breakage, compatibility” in abstract. Documents related with fracture fixation treatment were involved, and those published in recent years or in authorized journals were preferred in the same field. After preliminary retrieval, 178 literatures were screened out and 24 of them were involved in the retrospective analysis according to inclusion criteria. RESULTS AND CONCLUSION: With the advanced progress on raw materials industry and biomedicine, internal fixation devices are rapidly developing. The vast majority of current orthopedic internal fixation plates and screws used in medical institutions show very good biocompatibility and stiffness. However, fixation materials in different parts and different types of fracture alter, thus resulting in different bending resistance, axial, lateral and anti-rotational stability, as well as complications and compatibility after fixation. Biological fixation for the fracture can greatly reduce the injury at soft tissue and rate of bone graft, thereby shortening fracture healing time and significantly reducing the incidence of fracture non-union, second fracture and infection. Related Articles | Metrics

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Application of CT virtual endoscope technique on examination of chest diseases Wang Wei, Liu Guo-hua, Wang Hai-yong 2012, 16 (22):  4125-4128.  doi: 10.3969/j.issn.1673-8225.2012.22.032 Abstract ( 275 )   PDF (384KB) ( 282 )   Save BACKGROUND: As a kind of invasive examinations, conventional endoscopy is difficult to be accepted by patients because it not only can cause some damage to patients but also has some risks. CT virtual endoscope technique, as a new examination method, has been widely used in clinic due to the advantages of non-invasive, painless, and security. OBJECTIVE: To summarize the research progress of CT virtual endoscope on the clinical application of chest airway, blood vessel, and esophageal diseases. METHODS: A computer-based search of China Journal Full-text Database and Pubmed was performed for related articles published from January 2000 to December 2010 with the key words of “Virtual Endoscope, airway, blood vessel, esophagus” in Chinese and English. Repetitive articles with poor quality were excluded. Finally, 42 literatures were included. RESULTS AND CONCLUSION: The examination of CT virtual endoscope combined with three-dimensional reconstruction technology provides accurate image information for clinical diagnosis. Although there are some limitations, the examination has still important clinical value on the noninvasive diagnosis and preoperative assessment. With the development of CT virtual endoscopy technique, it will have a broad prospect in the clinical application. Related Articles | Metrics

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The bacterial culture of prosthesis infection Wang Yue-ni, Zhao Xiu-li 2012, 16 (22):  4129-4132.  doi: 10.3969/j.issn.1673-8225.2012.22.033 Abstract ( 235 )   PDF (328KB) ( 360 )   Save BACKGROUND: The prosthesis infection was a serious complication after joint replacement, which could lead to surgical failure. OBJECTIVE: To multivariately analyze the literature on the study of the bacterial culture of prosthesis infection through China National Knowledge Infrastructure (CNKI) and its analysis tool, which aimed at enriching the knowledge and reference for other inspectors. DESIGN: Bibliometric analysis. DATA RETRIEVAL: A retrieval was performed for the literature of the study of the bacterial culture of prosthesis infection, including prosthetic joint, infection, bacterial culture, synovial fluid, soft tissue during 2001-01 and 2010-12 in CNKI. Summary of Chinese health workers at all levels to domestic authors and units was on the research of the bacterial culture of prosthesis infection. The retrieval results were analyzed, and the trends were described in words and graphics. SELECTIVE CRITERIA: (1)Articles on the study of the bacterial culture of prosthesis infection. Exclusive criteria were included (1)Articles unrelated to the study of the bacterial culture of prosthesis infection. (2)Duplication of research articles. (3)Materials and methods undetailed or the results of the disputed article. MAIN OUTCOME MEASUREMENTS: The literatures were analyzed by publication year, discipline distribution, journal distribution, institutional information, authors and the fund. RESULTS: A total of 947 literatures on the study of the bacterial culture of prosthesis infection in CNKI database. The overall number of literature had an upward trend from 2001 to 2010. CONCLUSION: This paper provides a valuable reference for researchers to understand the overview and present situation of this field in order to set further research.   Related Articles | Metrics

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Complications after hip arthroplasty: A literature data analysis based on the Science Citation Index database Gao Hui, He Cheng, Huang Wei-min, Wen Xu, Zhu Wen-qing 2012, 16 (22):  4133-4142.  doi: 10.3969/j.issn.1673-8225.2012.22.034 Abstract ( 397 )   PDF (405KB) ( 387 )   Save BACKGROUND: The total hip arthroplasty after 30 years of clinical practice, has been fully affirmed and has developed into a reliable means of treatment. OBJECTIVE: To multivariately analyze the literature on the complications after hip replacement through Science Citation Index (SCI) database and its analysis tool. DESIGN: Bibliometric analysis.  DATA RETRIEVAL: A retrieval was performed for the literature of the complications after hip arthroplasty, including hip arthroplasty, loosening, infection, fracture, dislocation during 2001-01 and 2010-12 in SCI database. The retrieval results were analyzed, and the trends were described in words and graphics. SELECTIVE CRITERIA: Articles on the complications after hip arthroplasty including the following types: (1)Peer-reviewed original paper; (2)Proceedings paper; (3)Reviews; (4)Letters; (5)Editorial materials; (6)Conference abstrcts; (7)Reprint; (8) Corrections. Exclusive criteria were included (1)Articles unrelated to the study of the complications after hip replacement. (2)Articles published before 2001. (3)Articles which were not published on journals. MAIN OUTCOME MEASUREMENTS: The literatures were analyzed by publication year, national distribution, institutional information, journal distribution, discipline distribution, fund agents, citation frequency and authors. RESULTS: A total of 5 602 literatures on the complications after hip arthroplasty were retrieved in SCI database from 2001 to 2010, in which most of paper were published as original articles. Eight articles were identified as classic literature. The overall number of literature had an upward trend from 2001 to 2010. Journal of Arthroplasty published most papers in this field (n=747, 13.34%). CONCLUSION: This paper provides a valuable reference for researchers to understand the overview and present situation of this field in order to set further research. Related Articles | Metrics

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The research of screws, intramedullary nails and the plate for treating the ankle injury    Chen Jian-bo 2012, 16 (22):  4143-4150.  doi: 10.3969/j.issn.1673-8225.2012.22.035 Abstract ( 221 )   PDF (355KB) ( 422 )   Save BACKGROUND: The ankle fracture is a common trauma, which the incidence rate is in the first intra-articular fracture with the aging population and complex transport. OBJECTIVE: To multivariately analyze the literature on the ankle injury through Scopus database and its analysis tool. DESIGN: Bibliometric analysis. DATA RETRIEVAL: A retrieval was performed for the literature of the ankle injury, including ankle joint or ankle, injury or defect or trauma, fracture, screw, intramedullary nail or nail, plate or steel plate or steel sheet during 2007-01 and 2011-12 in Scopus database. The retrieval results were analyzed, and the trends were described in words and graphics. SELECTIVE CRITERIA: Articles on the ankle injury including the following types: (1)Peer-reviewed original paper; (2)Reviews; (3)Conference papers; (4)Notes; (5)Letters; (6)Short survey; (7)Articles in press; (8)Editorials. Exclusive criteria were included (1)Articles unrelated to the study of the ankle injury. (2)Articles published before 2007. (3)Articles which were not published on journals. (4)Articles which need to be retrieved by phone or manually. MAIN OUTCOME MEASUREMENTS: The literatures were analyzed by type of articles, publication year, national distribution, institutional information, journal distribution, citation frequency and authors. RESULTS: A total of 600 literatures on the ankle injury were retrieved in Scopus database, in which most of paper were published as original articles. The overall number of literature had an upward trend from 2007 to 2011. Foot and Ankle International published most papers in this field (n=85, 14.17%). CONCLUSION: This paper provides a valuable reference for researchers to understand the overview and present situation of this field in order to set further research. Related Articles | Metrics

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The 10-year international development trends of intertrochanteric fracture of femur    He Jian-jun, Ge Jian-zhong 2012, 16 (22):  4151-4158.  doi: 10.3969/j.issn.1673-8225.2012.22.036 Abstract ( 342 )   PDF (362KB) ( 422 )   Save BACKGROUND: With the gradual aging of the society and the number of osteoporosis increasing, the rate of intertrochanteric fracture of femur is also on the rise. OBJECTIVE: To multivariately analyze the literature on the intertrochanteric fracture of femur through Science Citation Index (SCI) database and its analysis tool. DESIGN: Bibliometric analysis. DATA RETRIEVAL: A retrieval was performed for the literature of the intertrochanteric fracture of femur, including intertrochanteric fracture of femur or intertrochanteric fracture or femoral intertrochanteric fracture, intramedullary nail or nail, dynamic hip screws, femoral head replacement or femoral head arthroplasty or femur head prosthesis replacement during 2001-01 and 2010-12 in SCI database. The retrieval results were analyzed, and the trends were described in words and graphics. SELECTIVE CRITERIA: Articles on the intertrochanteric fracture of femur including the following types: (1)Peer-reviewed original papers; (2)Proceedings paper; (3)Letters; (4)Conference abstrcts; (5)Reviews; (6)Editorial materials; (7)Corrections. Exclusive criteria were included proofreading, essays, short messaging and unpublished articles. MAIN OUTCOME MEASUREMENTS: The literatures were analyzed by publication year, national distribution, institutional information, journal distribution, discipline distribution and citation frequency. RESULTS: A total of 584 literatures on the intertrochanteric fracture of femur were retrieved in SCI database from 2001 to 2010, in which most of paper were published as original articles. Five articles were identified as classic literature. The overall number of literature had an upward trend from 2001 to 2010. Injury -International Journal of the Care of the Injured published most papers in this field (n=59, 10.10%). CONCLUSION: This paper provides a valuable reference for researchers to understand the overview and present situation of this field in order to set further research.   Related Articles | Metrics

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The digital design used in spinal disease Chen Xuan-huang, Lin Hai-bin 2012, 16 (22):  4159-4168.  doi: 10.3969/j.issn.1673-8225.2012.22.037 Abstract ( 270 )   PDF (419KB) ( 421 )   Save BACKGROUND: With the development of medical imaging equipment and computer technology, three-dimensional medical image processing technology and 3D visualization technologies are widely used in clinical field. At present, the quantitative diagnosis, surgical simulation and surgical prediction, provide a strong support for medical diagnosis and treatment. OBJECTIVE: To multivariately analyze the literature on the digital design used in spinal disease through Science Citation Index (SCI ) database and its analysis tool. DESIGN: Bibliometric analysis. DATA RETRIEVAL: A retrieval was performed for the literature of the digital design used in spinal disease, including three-dimensional reconstruction, three-dimensional measurement, finite element model, spinal disease, spine, lumbar vertebrae during 2001-01 and 2010-12 in SCI database. The retrieval results were analyzed, and the trends were described in words and graphics. SELECTIVE CRITERIA: Articles on the digital design used in spinal disease including the following types: (1)Peer-reviewed original paper; (2)Proceedings paper; (3)Reviews; (4)Conference abstrcts; (5)Editorial materials; (6)Letters. Exclusive criteria were included (1)Articles unrelated to the study of the digital design used in spinal disease. (2)Articles published before 2001. (3)Articles which were not published on journals. MAIN OUTCOME MEASUREMENTS: The literatures were analyzed by publication year, national distribution, institutional information, type of literature, journal distribution, discipline distribution, fund agents, citation frequency and authors. RESULTS: A total of 598 literatures on the digital design used in spinal disease were retrieved in SCI database, in which most of papers were published as original articles. Seven articles were identified as classic literature. The overall number of literature had an upward trend from 2001 to 2010. Spine published most papers in this field (n=81, 13.55%). CONCLUSION: This paper provides a valuable reference for researchers to understand the overview and present situation of this field in order to set further research. Related Articles | Metrics

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Biomechanics of artificial intervertebral disk and nucleus prosthesis Li Yu-cheng, Xing Xing, Sun Wen-cai 2012, 16 (22):  4169-4172.  doi: 10.3969/j.issn.1673-8225.2012.22.038 Abstract ( 201 )   PDF (433KB) ( 329 )   Save BACKGROUND: Whether total intervertebral disk or nucleus prosthesis accorded with anatomical characteristics and biomechanics of human intervertebral disk was a focus of recent studies. OBJECTIVE: To summarize the types and biomechanical characteristics of artificial intervertebral disk and nucleus prosthesis. METHODS: The first author retrieved Wanfang Database, China National Knowledge Infrastructure and PubMed Database for literatures published from 1989 to 2011. The key words were “intervertebral diac, nucleus pulposus, artificial prosthesis, biomechanics”. Articles regarding types and biomechanical characteristics of artificial intervertebral disk and nucleus prosthesis were included, and repetitive studies were excluded. Totally 72 articles were retrieved. In accordance with inclusion and exclusion criteria, 26 articles were included. RESULTS AND CONCLUSION: At present, materials for artificial intervertebral disk included cobalt-chromium alloy, titanium alloy, stainless steel, ceramics and ultrahigh molecular weight polyethylene. Bryan prosthesis was widely used in clinic. In vitro study, three dimensional finite element analysis and clinical study have confirmed good biomechanical characteristics and high success replacement rate. Artificial nucleus pulposus prosthesis contained prefabricated type and in situ polymerization type. It could obtain small surgery injury, and was a focus of recent studies. However, it is difficult to reach biomechanical function of human nucleus pulposus. To discover novel materials and to design individual prosthesis are future development directions. Related Articles | Metrics

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Orthopedic implant prepared by shape memory alloy in treatment of violence-induced bone injury and fracture healing Yuan Li-jun 2012, 16 (22):  4173-4176.  doi: 10.3969/j.issn.1673-8225.2012.22.039 Abstract ( 312 )   PDF (362KB) ( 409 )   Save BACKGROUND: With the elevation of opposability and intensity of athletic competition, participants were affected by varied internal and external violence. Shape memory alloy, as a novel internal fixation material in the department of orthopedics, has obtained good outcomes in clinical therapy. OBJECTIVE: To introduce therapeutic mechanisms of shape memory alloy, and to analyze the fracture-related outcomes. METHODS: The author retrieved China National Knowledge Infrastructure from 1980 to 2011 and PubMed from 1980 to 2011. The key words were “memory alloy, bone, internal fixation, treatment”. The mechanism and outcomes of shape memory alloy on fracture were summarized. RESULTS AND CONCLUSION: A total of 138 articles were retrieved, and 29 articles were included in accordance with inclusion criteria and exclusion criteria. The therapeutic mechanisms of shape memory alloy were summarized, including material feature, working principle and clinical application of different instruments, clinical therapeutic measures and outcomes of fracture at different sites. Results indicated that shape memory alloy has many advantages of bone internal fixation materials, is a novel perfect material, but still has a certain operation risk. It is important to choose specialized internal fixation material for therapeutic outcomes in accordance with the anatomic morphological features of fracture site, requirement of special functions, shape, size and metal property of internal fixation material. Related Articles | Metrics

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Application of multislice spiral CT combined with three-dimensional reconstructed post-processing techniques for the diagnosis of bone tumo Wang Tie-cai1, Zhang Hao2, Wang Yao1 2012, 16 (22):  4177-4180.  doi: 10.3969/j.issn.1673-8225.2012.22.040 Abstract ( 349 )   PDF (461KB) ( 380 )   Save BACKGROUND: Multislice spiral CT has become an effective tool for imaging diagnosis of bone tumors, the advantages of fast scanning speed, clear image and less radiation make it possible of the large-scale three-dimensional scanning. OBJECTIVE: To investigate the application value of multislice spiral CT combined with three-dimensional reconstructed post-processing techniques for the diagnosis of bone tumors. METHODS: Wanfang database was searched by the first author for the articles on multislice spiral CT and post-processing techniques for the diagnosis of bone tumors from 1995 to 2011. Key words were “image processing, bone tumors, tomography, three-dimensional post-processing, X-ray computer” in Chinese. According to the inclusion criteria, the articles on the three-dimensional reconstruction of bone tumors with highly direction and correlation were included, as well as the articles on the application of maximum intensity projection, surface shaded three-dimensional reformatted images and volume rendering technique in the diagnosis of bone tumors. Repetitive studies, published earlier, review and Meta analysis were eliminated. Finally, a total of 20 articles were included to review according to the inclusion criteria after the primary search. RESULTS AND CONCLUSION: Each reconstructed image can display the bone tumors; the multi-planar reconstructed image can accurately display the bone destruction, periosteal changes, the scope of bone destruction and violation of tumor to the surrounding soft tissue. Maximum intensity projection, surface shaded three-dimensional reformatted images and volume rendering technique can volumetric display the changes of the bone; enhanced surface shaded three-dimensional reformatted images and volume rendering technique can show the tumor feeding arteries, vein and tumor vessels. Post-processing combined with cross-sectional images can accurately show the bone destruction, periosteal reaction type, the extent of the tumor and violation of tumor to the surrounding soft tissue from different directions.       Related Articles | Metrics