Loading...

Table of Content

    26 November 2014, Volume 18 Issue 48 Previous Issue    Next Issue
    For Selected: Toggle Thumbnails
    Dynamic hip screw, proximal femoral anti-rotation nail and artificial hip joint replacement in repair of intertrochanteric fractures in the elderly
    Qiu Ru-lai, Du Gui-xia, Wang Lai-jie, Zhang Fei
    2014, 18 (48):  7709-7713.  doi: 10.3969/j.issn.2095-4344.2014.48.001
    Abstract ( 452 )   PDF (806KB) ( 740 )   Save

    BACKGROUND: For patients with unstable intertrochanteric and severe osteoporosis who cannot tolerate arthroplasty, intramedullary fixation is the first choice. For patients with elderly unstable fracture and severe osteoporosis, who can walk before surgery, and tolerate a large surgery, artificial femoral head replacement is the first choice. For patients with stable fracture and good physical status, whose osteoporosis is not serious, dynamic hip screw extramedullary fixation can be used.
    OBJECTIVE: To compare and analyze clinical efficacy of dynamic hip screw, proximal femoral anti-rotation nail and hip replacement implants for treatment of intertrochanteric fractures in the elderly.
    METHODS: 120 elderly patients with intertrochanteric fractures were randomly divided into dynamic hip screw group, proximal femoral anti-rotation nail group and artificial hip joint group. There were 45 cases in the dynamic hip screw group, 40 cases in the proximal femoral anti-rotation nail group and 35 cases in the artificial 
    hip joint group. Intraoperative blood loss, time of surgery, length of hospital stay, complications during hospitalization and the excellent and good rate of treatment were compared and observed.
    RESULTS AND CONCLUSION: Operative time, intraoperative blood loss and the excellent and good rate of treatment were significantly better in the proximal femoral anti-rotation nail group than that in the other groups (P < 0.05). Moreover, the complications during hospitalization were significantly less in the proximal femoral anti-rotation nail group than those in the other groups (P < 0.05). Above data indicated that the clinical effects of proximal femoral anti-rotation nail were apparently better than dynamic hip screw and artificial hip joint in repair of elderly intertrochanteric fracture. Proximal femoral anti-rotation nail is characterized by less intraoperative blood loss, short operative time, and high surgical cure rate, and can evidently improve patient’s quality of life.


    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
    Rifampicin combined with levofloxacin for preventing infection after total hip arthroplasty
    Li Chao, Shang Xi-fu, Cao Xiao-fang, Gan Zi-yang, Dou Zheng-yu
    2014, 18 (48):  7714-7718.  doi: 10.3969/j.issn.2095-4344.2014.48.002
    Abstract ( 809 )   PDF (755KB) ( 626 )   Save

    BACKGROUND: Reasonable use of antibiotics postoperatively is widely recognized as one of the effective ways to prevent periprosthetic joint infection after total hip arthroplasty. However, at present there is no consensus in  the best kind of antibiotics, sole or collective use, the best dosage and course of treatment.
    OBJECTIVE: To explore the efficiency and safety of rifampicin combined levofloxacin for preventing periprosthetic joint infection after total hip arthroplasty.
    METHODS: 300 patients, who accepted primary total hip arthroplasty between January 2011 and June 2012, were randomly divided into experimental group (n=150) and control group (n=150). All patients accepted the same surgical procedure. Intravenous cephalosporins were used during hospitalization to prevent periprosthetic joint infection. After discharge, patients in experimental group were treated orally with rifampicin (0.15 g, three times/d) and levofloxacin (0.1 g, three times/d) for six weeks. Patients in the control group were orally given cephalosporins for six weeks. During the follow-up, the number of cases of periprosthetic joint infection was recorded and the adverse effects of drugs in experimental group were observed.
    RESULTS AND CONCLUSION: All patients were followed-up for 24-36 months. Four patients in experimental group and thirteen patients in control group suffered from periprosthetic joint infection at the last followed-up, and 
    the difference was significant between the two groups (P < 0.05). No patients in the experimental group had the side-effects of drugs such as skin allergies, nausea and vomiting, or joint pain. These findings indicate that after total hip arthroplasty, oral treatment with rifampicin and levofloxacin can effectively prevent periprosthetic joint infection. Combination of the two drugs does not increase the risk of the side-effects of drugs. However, large-scale randomized controlled trials were needed to verify the conclusion.


    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
    Anterior cervical decompression and fusion versus anterior cervical disc replacement for single-level cervical spondylosis: evaluation of mid-term outcomes
    Luo Hao, Wang Jian, Liang Wei-dong, Sheng Wei-bin
    2014, 18 (48):  7719-7725.  doi: 10.3969/j.issn.2095-4344.2014.48.003
    Abstract ( 352 )   PDF (949KB) ( 506 )   Save

    BACKGROUND: Spinal fusion is a classical surgical therapy for cervical spondylosis. The concept of non-fusion disc replacement added new vitality for cervical spondylosis. In short-term stable efficacy of anterior cervical disc replacement has been recognized by scholars. However, interim efficacy is inconclusive. What’s more, it is a worth exploring problem about the different adjacent segment degenerative changes between replacement and fusion. 
    OBJECTIVE: To compare mid-term curative effects of anterior cervical decompression and fusion and anterior cervical disc replacement for single-level cervical spondylosis.
    METHODS: A total of 114 cases of single-level cervical spondylosis, who were treated in the Department of Spinal Surgery, First Affiliated Hospital, Xinjiang Medical University from January 2008 to December 2010, were 
    retrospective reviewed. Of them, 86 cases underwent anterior cervical decompression and fusion fixation, and 28 cases received artificial cervical disc replacement. Operation time, blood loss, Japanese Orthopaedic Association score, neck and upper limb visual analog scale score, neck disability index and adjacent segment degenerative changes were compared. Odom criterion and improved excellent and good rate of Japanese Orthopaedic Association score were used to evaluate the clinical effect.
    RESULTS AND CONCLUSION: (1) Japanese Orthopaedic Association scores, visual analog scale score and neck disability index were significantly improved during final follow-up than before treatment in patients of both groups      (P < 0.05). There were no significant differences in operation time, blood loss, Japanese Orthopaedic Association score before treatment and during final follow-up, visual analog scale score and neck disability index between the two groups (P > 0.05). The excellent and good rate of Japanese Orthopaedic Association score was 86% in the anterior cervical decompression and fusion group and 89% in the anterior cervical disc replacement group. According to Odom criterion, the excellent and good rate was 83% in the anterior cervical decompression and fusion group and 93% in the anterior cervical disc replacement group, showing no significant difference (P > 0.05). (2) Adjacent segment affected degeneration in 22 cases in the anterior cervical decompression and fusion group during final follow-up. There were 15 cases of upper segment and 7 cases of lower segment. Of the 22 cases, 3 cases had clinical symptoms, and received secondary surgery. In the anterior cervical disc replacement group, two cases suffered from adjacent segment degeneration, including one case of upper segment and one case of lower segment. None of them received secondary surgery. Above results suggested that the mid-term curative effects are identical between anterior cervical decompression and fusion and anterior cervical disc replacement. The incidence of adjacent segment degeneration is low in anterior cervical disc replacement. The upper segment easily affected degeneration after anterior cervical decompression and 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
    Effects of horse chestnut seed extract on early hidden blood loss and limb circumference changes after total knee arthroplasty
    Gao Fu-qiang, Sun Wei, Ma Jin-hui, Li Zi-rong
    2014, 18 (48):  7726-7731.  doi: 10.3969/j.issn.2095-4344.2014.48.004
    Abstract ( 389 )   PDF (806KB) ( 508 )   Save

    BACKGROUND: The swelling of limbs after total joint arthroplasty is associated with the hidden blood loss. The main component of horse chestnut seed extract is Aescine, which can protect blood vessels, increase vascular tension, reduce capillary permeability, and exert anti-edema, anti-inflammation, and anti-exudation effect. This extract can prevent and treat post-traumatic swelling of the limbs.
    OBJECTIVE: To investigate the pathological mechanisms and effects of horse chestnut seed extract on early hidden blood loss and limb circumference changes after total knee arthroplasty.
    METHODS: A total of 150 patients undergoing total knee arthroplasty from January 2013 to September 2013 were retrospectively analyzed. The involved cases were divided into two groups. The test group of 85 cases received oral administration of 0.3 g horse chestnut seed extract, three administrations per day, from the first day after total knee arthroplasty. The administration was given for 14 days. Control group of 65 patients received no 
    detumescence drugs. There were no significant differences in patient’s age, body height and body mass index between two groups (P > 0.05). Blood routine examination was performed at 1-3 days after total knee arthroplasty. The amounts of intraoperative blood loss, postoperative blood loss, and postoperative blood transfusion were recorded. The hidden blood loss was calculated according to the Gross formula. Perioperative limb circumference above the knees was observed and measured. Two-independent-sample t-test was used to compare the difference between the two groups.
    RESULTS AND CONCLUSION: Hidden blood loss between the test group and control group was (590.6±214.2) and (821.2±457.30) mL, respectively, the difference was significant (t=3.238, P=0.021). The postoperative total blood loss and the thigh circumference changes above knee in test group were less significantly than that in control group within 2 and 3 days after surgery (P < 0.05). And there was no statistically significant difference in thigh circumference changes on postoperative 1 day and drainage between the two groups (P > 0.05). Experimental findings indicate that, early application of horse chestnut seed extract can significantly reduce hidden blood loss, significantly relieve postoperative limb swelling, and promote the recovery of limb function after primary total knee arthroplasty. The mechanism of detumescence might be due to the decrease of hidden blood loss and the promotion of venous return.


    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
    Comparison of perioperative blood loss in the same patient undergoing staged joint replacement
    Yuan Lei, Bao Ni-rong, Zhao Jian-ning
    2014, 18 (48):  7732-7738.  doi: 10.3969/j.issn.2095-4344.2014.48.005
    Abstract ( 262 )   PDF (757KB) ( 404 )   Save

    BACKGROUND: Perioperative blood loss is a common problem after orthopedic joint arthroplasty, however, anemia resulting from hidden blood loss has a strong impact on postoperative functional recovery. The related mechanism is still uncertain, numerous factors are complex, and the relevance is not clear.
    OBJECTIVE: To observe the changes in perioperative blood loss in staged bilateral joint replacement patients, to avoid the influence of the difference among patients on hidden blood loss, and to discuss the relationship between hidden blood loss and related factors.
    METHODS: A total of 19 patients, who received arthroplasty because of different diseases at different periods in Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA, were enrolled in this study. 
    Perioperative blood loss was analyzed in the same patient after staged bilateral joint replacement, including the correlation among dominant blood loss, hidden blood loss, staged surgery interval, disease type, kinds of surgery, length of operation, anticoagulant, regular blood detection after replacement and C-reactive protein.
    RESULTS AND CONCLUSION: Preoperative values of hemoglobin and hematocrit in 19 patients were in the normal range, and no significant difference was detectable. By means of statistical analysis, significant difference on dominant blood loss was detected in staged surgery (P < 0.05). Correlation between many variables was analyzed using rank correlation and multiple regression analysis. There was significant correlation between staged surgery interval and dominant blood loss (P < 0.05). No obvious correlation was found between replacement type, anticoagulant and dominant blood loss, hidden blood loss. Severe dominant blood loss and hidden blood loss after replacement were significantly correlated with preoperative and postoperative C-reactive protein levels (P < 0.05), but not associated with length of stay. Above data suggested that severe hidden blood loss existed after replacement, which was associated with the individual, but not directly correlated with other external variables. If we make a comparative study in the large sample and same type of patients by retrospective or prospective methods, it will make a contribution to exploring the mechanism of hidden blood loss.


    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
    Linoleic acid and acute red blood cells injury: mechanism of hidden blood loss after artificial joint replacement
    Yuan Tao, Cong Yu, Zhao Jian-ning, Zhou Li-wu, Chen Shuang-shuang, Bao Ni-rong
    2014, 18 (48):  7739-7744.  doi: 10.3969/j.issn.2095-4344.2014.48.006
    Abstract ( 272 )   PDF (757KB) ( 621 )   Save

    BACKGROUND: Hidden blood loss frequently occurs after artificial joint replacement surgery, the resulting anemia may cause serious impact on postoperative rehabilitation. There are many different theories about the hidden blood loss, but the mechanisms are not clear.
    OBJECTIVE: To study the effect of linoleic acid on red blood cells of rats and explore the pathogenesis of hidden blood loss after artificial joint replacement surgery.
    METHODS: Fifty Spraque-Dawley rats were randomly divided into five groups. Control group (n=10) was injected with alcohol solution via the tail veins. Four test groups (n=10) were injected with 15 mmol/L, 30 mmol/L,       
    60 mmol/L, 90 mmol/L linoleic acid via the tail veins, to establish high-level linoleic acid models in vivo. Blood samples collected from the orbital vein were determined before injection and at 24, 48, 72 hours after injection. Changes of hemoglobin, red blood cell count, glutathione peroxidase activity, total superoxide dismutase activity and hydrogen peroxide in the blood samples were observed.
    RESULTS AND CONCLUSION: Significant hidden blood loss occurred when the concentration was 60 mmol/L in the experimental group, with the hemoglobin and red blood cell count were sharply reduced in blood samples. The hemoglobin and red blood cell count were reduced in all the experimental groups and control group 24 hours after administration, while the experimental groups changed more obviously (P < 0.05); glutathione peroxidase activity, total superoxide dismutase activity and hydrogen peroxide were also significantly reduced in all groups, and the changes showed significant difference among them (P < 0.05). The hemoglobin and red blood cell count were relatively stable in control group and the experimental groups 48 hours after administration, while glutathione peroxidase activity, total superoxide dismutase activity and hydrogen peroxide were significantly decreased, and changes in the experimental groups were more notable (P < 0.05). Experimental findings show that elevated levels of linoleic acid in the blood cause acute oxidative damage of the red blood cells, which eventually lead to acute anemia and hidden blood loss.


    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
    Multilevel cage-assisted anterior decompression and fusion for cervical spondylosis: long-term outcomes in 20 cases
    Chen Xiao-ming, Ma Hua-song, Tan Rong, Tian Tian, Liu Tao, Cui Kai, Zhang Ye
    2014, 18 (48):  7745-7750.  doi: 10.3969/j.issn.2095-4344.2014.48.007
    Abstract ( 456 )   PDF (775KB) ( 449 )   Save

    BACKGROUND: Ideal method for spinal fusion is interbody fusion, which was firstly applied by Robinson and Smith in 1955 on the removal of herniated intervertebral discs through the anterior cervical approach, followed by interbody grafting. Subsequently the presumption of interbody contents emerges to promote spinal fusion. The spinal interbody fusion has achieved significant developments and is considered one of standard treatments for spinal degeneration.
    OBJECTIVE: To investigate the long-term efficacy of multilevel anterior cervical decompression and cage-assisted fusion for cervical spondylosis.
    METHODS: From October 2000 to October 2002, twenty cases with cervical spondylosis underwent three-level cage-assisted anterior cervical depression and fusion in the 306 Hospital of Chinese PLA (including 15 males and 5 females). The involved patients aged 48-65 years, with mean 56.4 years. The affected lesions were observed at the C4-7 level in 12 cases and at the C3-6 level in 8 cases. JOA scores were recorded before treatment and at final follow-up to evaluate the improvement rate. Clinical results were graded using the Odom criteria. Radiological results at the anterioposterior and lateral film positions were observed before and after treatment, as well as at final follow-up. Cervical spine curvature (Cobb angle) was measured before and after treatment. Adjacent segment degeneration and graft fusion rate were observed upon final follow-up.
    RESULTS AND CONCLUSION: All 20 patients were successfully operated. No neurological and fixation-related complications occurred. The follow-up period was arranged from 10 to 132 months. The JOA score was (9.85 ± 0.81) preoperatively and (14.40 ± 0.94) postoperatively, showing significant difference. The average JOA improvement rate was 81%. Odom grading at final follow-ups included 14 excellent cases, 4 good cases, and 2 fair cases. No adjacent segment lesions were observed, Cage sedimentation was visible in two cases, and cervical curve maintained good. Graft fusion rate was 100% at final follow-up. Radiograph analysis indicated that, Cobb angle of cervical lordosis was significantly higher at postoperative 1 year and at final follow-up compared with preoperative measurement (P < 0.01), and no difference was significant between postoperative 1 year and final follow-up (P > 0.05). Multilevel cage-assisted anterior cervical decompression and fusion is an effective and safe way for multilevel cervical spondylosis and the long-term outcomes are good.


    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
    Modified open-door laminoplasty for the repair of chronic compressive cervical myelopathy: follow-up of cervical stability
    Wang Jian, Luo Hao, Liang Wei-dong, Sheng Wei-bin, Sheng Jun
    2014, 18 (48):  7751-7756.  doi: 10.3969/j.issn.2095-4344.2014.48.008
    Abstract ( 393 )   PDF (865KB) ( 412 )   Save

    BACKGROUND: Cervical single door laminoplasty for chronic compressive cervical myelopathy has obtained exact effects. To reduce the occurrence of related complications, scholars have proposed various improvement programs, and have achieved a certain effect.
    OBJECTIVE: To discuss the clinical effects of modified open-door laminoplasty for chronic compressive cervical myelopathy.
    METHODS: From January 2010 to December 2013, we retrospectively analyzed the data of 87 cases of chronic compressive cervical myelopathy who underwent expensive open-door laminoplasty in the First Affiliated Hospital of Xinjiang Medical University. Among them, 41 cases in the modified group were treated by modified open-door laminoplasty. C7 spinous ligaments and muscle tissue attachment were retained. Door section was C3-C6. 46 cases in the control group were treated by traditional C3-C7 expensive open-door laminoplasty. Operative time and intraoperative blood loss were recorded. Japanese Orthopaedic Association (17-score method), cervical curvature Cobb angle, range of motion of cervical vertebra and axial symptom severity were compared and 
    analyzed before treatment and during follow-up after treatment.
    RESULTS AND CONCLUSION: A total of 87 cases were followed up. Operative time was (82.46±14.80) minutes, and blood loss was (196.3±141.4) mL in the modified group. The operative time was (78.41±15.43) minutes and blood loss was (220.91±128.21) mL in the control group. No significant difference was found between the two groups (P > 0.05). There were no significant differences in the recovery rate of Japanese Orthopaedic Association between the two groups (P > 0.05). The proportion of patients with apparent axial symptoms was 17% in the modified group and 46% in the control group, showing that the proportion was significantly higher in the control group than in the modified group      (P < 0.05). The degrees of cervical curvature loss and cervical activity loss were significantly less in the modified group than in the control group (P < 0.05). Door shaft side was healed and no door-reclose was noted during follow-up. Above findings showed that the modified expansive open-door cervical laminoplasty got a good nerve decompression, maintained the integrity of the posterior ligamentous complex structure and function to the most degree, reduced damage to the cervical spine stability mechanism, and retained cervical curvature, cervical activity, and diminished the occurrence of postoperative axial symptoms.


    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
    Zero-P implant versus traditional interbody fusion with titanium plate in the repair of nerve root cervical spondylosis: 2-year follow-up of efficacy and imaging
    Hu Wei, Li Lei, Liu Yan-lu, Wu Yan-sheng, Huang Yi-fei, Zhang Bin
    2014, 18 (48):  7757-7762.  doi: 10.3969/j.issn.2095-4344.2014.48.009
    Abstract ( 556 )   PDF (805KB) ( 599 )   Save

    BACKGROUND: Anterior interbody fusion has been used to treat cervical degenerative diseases for more than 50 years, but the standardization of its technique remains controversial. The major disadvantages of alone use of interbody fusion cage are instant poor stability and fusion subsidence. The main disadvantages of interbody fusion with anterior titanium plate are dysphagia in the plate region and heterotopic ossification around the operated intervertebral disc side.
    OBJECTIVE: To compare clinical and radiological efficacies of new implant Zero-P and traditional fusion with titanium plate for treatment of nerve root cervical spondylosis.  
    METHODS: We retrospectively analyzed clinical data of 56 patients with nerve root type cervical spondylosis undergoing anterior cervical decompression and fusion fixation. They were divided into two groups according to fixation scheme. Zero-P group contained 25 patients with 31 segments. Traditional group (traditional intervertebral fusion device + locking titanium plate) contained 31 patients with 40 segments. There were no significant differences in age, gender and operated regions between above two groups. Cervical dysfunction index, the incidence of dysphagia, Cobb C angle, Cobb S angle, vertebral height, vertebral stability and heterotopic ossification degree were compared between the two groups.
    RESULTS AND CONCLUSION: Cervical dysfunction index was significantly lower at 24 months after fixation than before fixation in both groups (P < 0.05). Patient’s symptoms were obviously improved after fixation. One patient affected dysphagia in early stage after fixation in the Zero-P group. Symptoms disappeared during 24-month follow-up. Two patients experienced dysphagia in the traditional group after fixation. No significant difference in the incidence of dysphagia was detected between the two groups (P > 0.05). No significant differences in Cobb C angle and vertebral height of surgical segment were detectable before and after fixation in the two groups (P > 0.05). Cobb S angle apparently increased in the Zero-P group from pre-fixation to post-fixation (i.e., surgical procedures). The maximum appeared in the first rechecking after fixation. In the traditional group, Cobb S angle slowly increased from pre-fixation to 6 weeks post-fixation, and peaked at 6 weeks post-fixation. Solid bony fusion was visible in the fusion segment in all cases of the Zero-P group, but solid body fusion was found in 30 cases of the traditional group, with a stable rate of 97%. In 24-month follow-up, the incidence of heterotopic ossification was 25% in the Zero-P group, but 44% in the traditional group. The rate of heterotopic ossification was significantly lower in the Zero-P group than that in the traditional group at 24 months after fixation (P < 0.05). These data suggested that compared with traditional pegboard system, Zero-P implant for treatment of nerve root cervical spondylosis has a certain advantage, and deserves to be used 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
    Posterior pedicle screw fixation for repair of multi-segmental thoracic fractures: restoration of vertebral height at follow-up
    Wang Yi-meng, Pi Bin, Zhu Xiao-yu, Qian Zhong-lai, Yang Hui-lin
    2014, 18 (48):  7763-7768.  doi: 10.3969/j.issn.2095-4344.2014.48.010
    Abstract ( 316 )   PDF (868KB) ( 367 )   Save

    BACKGROUND: The incidence of multi-segmental thoracic fractures gradually increased. How to restore normal vertebral morphology and neurological injury is the main direction of the present study.
    OBJECTIVE: To observe the clinical therapeutic effects of posterior pedicle screw fixation for repair of multi-segmental thoracic fractures in 24 cases.  
    METHODS: A total of 28 patients with multi-segmental thoracic fractures, who were treated from January 2009 to December 2013, were enrolled in this study. Of them, 24 were followed up, including 19 males and 5 females, with an age of 20-64 years old. They all had a history of trauma. The time taking for transporting to the hospital was between 1 hour and 4 days. All the patients had taken CT plain scan and coronal and sagittal reconstruction and whole-spine lateral X-ray examination in emergency. Whole-spine MRI examination was conducted within 4 days after hospitalization. There were 19 cases of 2-levels thoracic fractures, 3 cases of 3-levels thoracic fractures, 1 case of 4-levels thoracic fractures and 1 case of 6-levels thoracic fractures. There were 10 cases of Grade A, 9 cases of Grade B, 2 cases of Grade C, 2 cases of Grade D and 1 case of Grade E according to ASIA 
    system. Three cases combined with brain injury, four cases with rib fractures, three cases with hemopneumothorax, four cases of pulmonary contusion, two cases of rupture of spleen, and four cases of limb fractures. 
    RESULTS AND CONCLUSION: 24 patients were followed up for 9 to 37 months. No implant failure, nonunion, or neurological deterioration were noted during the follow up. No significant loss of vertebral height was found during the final follow-up, and the vertebrae were healed well. There were 10 cases of Grade A, 5 cases of Grade B, 2 cases of Grade C, 5 cases of Grade D and 2 cases of Grade E according to ASIA system at final follow-up. The Cobb angle improved from 26.8° preoperatively to 5.5° postoperatively, and 5.9° at final follow-up. These data suggested that it is very important to clarify the key injury site and the level of spinal cord during multi-segmental thoracic fractures. The pedicle screw fixation by posterior approach can restore the height of thoracic spine effectively, get full decompression and reliable fixation, finally obtained good curative effects.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Analgesic effect of ropivacaine complex liquid injection around the wound in lumbar fusion surgery
    Wang Shi-jun, Li Yu-ting, Li Chun-de, Liu Xian-yi, Sun Hao-lin, Wang Tian-long
    2014, 18 (48):  7769-7774.  doi: 10.3969/j.issn.2095-4344.2014.48.011
    Abstract ( 328 )   PDF (725KB) ( 772 )   Save

    BACKGROUND: Wound infusions with local anaesthesia have been used as postoperative multimode analgesia following surgery, but there is no clinical study to evaluate the effectiveness of local injection of ropivacaine complex liquid around the wound after lumbar fusion surgery.
    OBJECTIVE: To evaluate the analgesic effect of wound infiltration by ropivacaine on postoperative pain after lumbar fusion surgery.
    METHODS: 90 patients with lumbar spinal stenosis undergoing lumbar fusion surgery and pedicle screw
    internal fixation were randomly divided into two groups: experimental group and control group. The experimental group was treated with intravenous postoperative self-control analgesia and intraoperative infiltration with ropivacaine. The control group was only treated with intravenous postoperative self-control analgesia. The outcomes were evaluated with visual analog scale at 2, 4, 8, 12, 24, and 48 hours after surgery, the total frequency with which patients pushed the button of the patient-controlled analgesia system and the total fentanyl consumption were observed. In addition the incidences of postoperative nausea and vomiting after surgery were compared.
    RESULTS AND CONCLUSION: The visual analog scale score at 2, 4, 8, 12, 24 hours after surgery was significantly lower in the experimental group compared with the control group (P < 0.05). Total fentanyl consumption and the total frequency with which patients pushed the button were also significantly lower in the experimental group compared with the control group (P < 0.001). There was no statistically significant difference in the incidences of nausea and vomiting between the two groups (P > 0.05). Intraoperative infiltration with ropivacaine complex liquid during lumbar fusion surgery reduces the severity of postoperative pain and the consumption of opioid.


    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
    Injection of iohexol and methylthioninium chloride after spinal posterior late-onset infection and sinus tract formation: relationship with fixation
    Xue Hou-jun, Pan Lei, Huang Bi-liu, Liu Qing-hua, Li Jie, Chen Wei-xiong, Wang Shi-cheng
    2014, 18 (48):  7775-7779.  doi: 10.3969/j.issn.2095-4344.2014.48.012
    Abstract ( 497 )   PDF (657KB) ( 417 )   Save

    BACKGROUND: There was incidence of delayed infection after late-onset spinal posterior surgery, but reports are different, mainly showing the presence of implants. The incidence of above infection is low in patients without implants. When infection appears, whether infection is associated with fixation cannot be effectively judged by clinical symptoms before surgery. Imaging cannot give entire affirmation. Intraoperative commonly found method is to incise and to debride, and then to wash by inserting a catheter. 
    OBJECTIVE: To investigate the clinical application effects of iohexol and methylthioninium chloride in patients with posterior spinal late-onset infection and sinus tract formation, and to analyze its relationship with fixation.
    METHODS: A total of 30 patients with spinal posterior late-onset infection and sinus tract formation, who were treated in the Foshan Municipal Sixth People’s Hospital, were selected in this study. Onset time was 3 months after primary surgery. There were 21 cases with fixation and 9 cases without fixation. 30 patients were randomly assigned to two groups. Before the surgery, sinus tract of patients in the observation group was infused with iohexol. Contrast radiography was conducted to identify the depth of sinus tract and the base width. After guiding intraoperative anesthesia and extent of surgery and disinfection, 2 mL of methylthioninium chloride was injected into the injured site. Sinus wall was stained. Methylthioninium chloride-stained tissue was scavenged during the surgery. Drainage was performed, followed by stage I suture. In the control group, after cutting and debridement, the catheter was inserted for washing and draining. Operation time, blood loss, postoperative visual analog scale score and re-infection rate were compared between the two groups.
    RESULTS AND CONCLUSION: Operation time (45.26±7.66) minutes and the amount of blood loss (50.61±11.11) mL in the observation group were significantly lower than operation time (60.46±9.22) minutes and amount of blood loss (80.48±11.47) mL in the control group (all P < 0.05). The wounds were completely healed in both groups. At 1, 3, 6 and 12 months after surgery, re-infection did not occur in both groups. Postoperative visual analog scale score was significantly reduced over time in both groups (P < 0.05). No significant difference was detected at the same time points in both groups. These results confirmed that iohexol and methylthioniniun chloride can be effectively applied to patients with spinal posterior late-onset infection and sinus tract formation, which is helpful to assess preoperative anesthesia, to shorten the operation time and to reduce intraoperative blood loss with the presence or absence 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
    Metal implant intramedullary and extramedullary fixation in repair of intertrochanteric fractures in the elderly: comparison of perioperative hidden blood loss
    Li Hong-fei, Li Er-hu, Yan Feng-he, Zhao Peng, Ma Jun-jun
    2014, 18 (48):  7780-7785.  doi: 10.3969/j.issn.2095-4344.2014.48.013
    Abstract ( 256 )   PDF (684KB) ( 505 )   Save

    BACKGROUND: Intertrochanteric fracture refers to the fracture occurred outside hip capsule line to the region below the lesser trochanter, frequently in elder patients. At present, the main therapeutic manner of intertrochanteric fractures includes intramedullary fixation and extramedullary fixation.
    OBJECTIVE: To compare hidden blood loss in patients with elderly intertrochanteric fractures after intramedullary and extramedullary fixation, and to explore the related influential factors for perioperative blood loss.
    METHODS: We retrospectively analyzed 298 patients aged > 65 years with intertrochanteric fractures, including 138 males and 160 females. 153 cases underwent intramedullary fixation (81 cases of proximal femoral nail 
    anti-rotation, and 72 cases of Gamma nail). 145 cases received extramedullary fixation. According to Gross equation, perioperative pre-fixation hidden blood loss, post-fixation hidden blood loss, total hidden blood loss, total blood loss and total hidden blood loss proportion were calculated in patients with hip fracture. Perioperative blood loss was compared after intramedullary fixation and extramedullary fixation for intertrochanteric fractures. The effects of gender, operation time, injuries, surgical interval, diabetes and hypertension on above indexes were analyzed.
    RESULTS AND CONCLUSION: Post-fixation hidden blood loss, total hidden blood loss and total hidden blood loss proportion were significantly higher in the Gamma nail group and proximal femoral nail anti-rotation group than those in the dynamic hip screw group (P < 0.05). Dominant blood loss was significantly less in the Gamma nail group and proximal femoral nail anti-rotation group than those in the dynamic hip screw group (P < 0.05). No significant difference in hidden blood loss and total blood loss was detected before fixation in the three groups. Pre-fixation hidden blood loss was significantly lower in the group whose time from injury to surgery was < 48 hours compared with > 48 hours group  (P < 0.05). Post-fixation hidden blood loss and total hidden blood loss were significantly greater in the diabetes group than those in the non-diabetes group (P < 0.05). Post-fixation hidden blood loss and total hidden blood loss were significantly higher in the hypertension group than those in the non-hypertension group (P < 0.05). These data indicated that fixation mode, the time between injury and surgery, hypertension and diabetes are major influential factors for perioperative hidden blood loss in patients with elderly intertrochanteric fractures. We should pay attention to perioperative hidden blood loss in elderly intertrochanteric fracture patients combined with hypertension and diabetes.


    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
    Dynamic hip screw combined with antirotation screw in repair of unstable femoral intertrochanteric fractures
    Xin Feng, Zhu Guo-xing, Gu Yang-lin
    2014, 18 (48):  7786-7791.  doi: 10.3969/j.issn.2095-4344.2014.48.014
    Abstract ( 329 )   PDF (694KB) ( 595 )   Save

    BACKGROUND: For severe intertrochanteric fracture, the anti-rotation capability is poor, and single dynamic hip screw fixation easily became failure. For example, collapse of the femoral head, femoral neck shortening, unstable hip varus inside small rotor, head and neck rotating, head and neck cutting and nailing, steel nail out and broken steel appeared after fixation. For unstable intertrochanteric fractures, dynamic hip screw fixation has certain limitations.
    OBJECTIVE: To explore the effects of dynamic hip screw combined with antirotation screw in repair of unstable femoral intertrochanteric fractures.
    METHODS: A total of 96 cases of unstable femoral intertrochanteric fractures were separately subjected to fixation. There were 48 cases in the dynamic hip screw group and 48 cases in the dynamic hip screw combined with antirotation screw group. The surgical time, intraoperative blood loss, exposure time of X-ray, fracture healing time, postoperative Harris hip score and postoperative complications between the two groups were 
    compared and evaluated.
    RESULTS AND CONCLUSION: All the cases were followed up for 18-36 months. The surgical time, intraoperative blood loss, exposure time of X-ray and fracture healing time showed no significant difference between the dynamic hip screw group and dynamic hip screw combined with antirotation screw groups (P > 0.05). Postoperative Harris hip score was higher in the dynamic hip screw combined with antirotation screw group than in the dynamic hip screw group      (P < 0.05). The incidence of postoperative complications was significantly higher in the dynamic hip screw group (14%) than that in the dynamic hip screw combined with antirotation screw group (4%; P < 0.05). These data indicated that dynamic hip screw fixation for repair of unstable femoral intertrochanteric fractures showed many complications and high failure rate. However, dynamic hip screw combined with antirotation screw could reconstruct posterior medial femoral structure, make up the shortcomings and deficiencies of dynamic hip screw, and has an important value for the repair of unstable femoral intertrochanteric fracture.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation versus AO hollow compression screw fixation in the repair of femoral neck fracture in young and middle-aged patients  
    Zha Qing-lin, Zhang Hong-cheng, Lu Cheng-yun, Zhu Yu-ke
    2014, 18 (48):  7792-7796.  doi: 10.3969/j.issn.2095-4344.2014.48.015
    Abstract ( 252 )   PDF (637KB) ( 468 )   Save

    BACKGROUND: There is no unified treatment standard for femoral neck fracture in the clinic. Quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation and AO hollow compression screw fixation are common methods for treatment of femoral neck fracture, but both of them have their advantages and disadvantages.
    OBJECTIVE: To investigate the effects and complication rates of quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation and AO hollow compression screw fixation in young and middle-aged patients with Garden III and IV types of femoral neck fracture.
    METHODS: A total of 60 young and middle-aged patients with femoral neck fracture were divided into observation group and control group according to the different treatment methods. The observation group was treated with quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation. The control group was treated with AO hollow compression screw fixation. Fracture healing time, healing rate, excellent and good rate, the rate of avascular necrosis and late collapse rate were compared between the two groups.
    RESULTS AND CONCLUSION: (1) The fracture healing time of the observation group was less than that of the control group. The healing rate and the excellent and good rate were significantly higher in the observation group than those in the control group (P < 0.05). (2) Fracture healing time in patients of the observation group was less than that of the control group, but the healing rate and the excellent and good rate of fracture was significantly higher than those in the control group (P < 0.05). These data suggested that the quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation have good effects in the treatment of Garden III and IV types of femoral neck fracture in the young and middle-aged patients.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Combination therapy of external fixator, vacuum sealing drainage and pediculated latissimus dorsi myocutaneous flap transplantation for distal humeral traumatic osteomyelitis
    Shen Mei-hua, Aihemaitijiang•Yu-shu-fu, Ren Peng, Liu Ya-fei
    2014, 18 (48):  7797-7803.  doi: 10.3969/j.issn.2095-4344.2014.48.016
    Abstract ( 340 )   PDF (816KB) ( 449 )   Save

    BACKGROUND: The treatment of osteomyelitis is a worldwide problem, how to improve the cures rate of osteomyelitis is a current research emphasis.
    OBJECTIVE: To explore the effective treatment of traumatic osteomyelitis of the distal humerus by a combination therapy of external fixator, vacuum sealing drainage and pediculated latissimus dorsi myocutaneous flap transplantation.
    METHODS: During May 2006 to September 2013, 36 patients with distal humeral traumatic osteomyelitis were enrolled in this study, and were treated with a combined treatment, including external fixator, vacuum sealing drainage and the pedicle latissimus dorsi myocutaneous flap. Mayo elbow scoring system was applied to evaluate elbow joint function preoperatively and postoperatively. We adopted follow-up with outpatient service, telephone tracked and family visited.
    RESULTS AND CONCLUSION: All the involved 36 cases were followed up for 8 months to 6 years 8 months, average 4 years 3 months. The pedicle latissimus dorsi myocutaneous flaps were all survived, the biggest one was 40 cm × 13 cm and the least was 15 cm × 6 cm. 21 cases were treated using Orthofix external fixator, 11 cases with combined external fixator and 4 cases with Ilizarov circular external fixator. The fracture healing time was respectively 6-14 months, 10-16 months and 8-20 months. The average time of removing external fixator was 8 months. The postoperative elbow joint function was excellent in 3 cases, good in 19 cases, mild in 11 cases and poor in 3 cases. Among them, two cases recurred infection. At postoperative 3 months, 1 case appeared sinus again and was healed by debridement and iliac graft. One case with radial and median nerve injury had an elbow flexion of 100° and active extension active range of 20°, the wrist and fingers drop deformity was observed, fingers flexion contracted and stiffed, radial dorsal and flex sides of forearm were insensitive and subsided. Among the four cases, different degrees of tract exudation was visible in one or two pins, which cured after debridement and dressing. Small area skin defect in one case was healed after skin transplantation. Other cases were healed well, no iatrogenic nerve and vascular injury was observed. The combination therapy of external fixator, vacuum sealing drainage and pediculated latissimus dorsi myocutaneous flap transplantation is an effective treatment of traumatic osteomyelitis of the distal humerus.


    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
    Prevention and countermeasures of specific postoperative complications of clavicle hook plate
    Zou Wei, Xiao Jie, Long Hao, Wu Chen, Zhou Chang-jun
    2014, 18 (48):  7804-7809.  doi: 10.3969/j.issn.2095-4344.2014.48.017
    Abstract ( 1215 )   PDF (778KB) ( 671 )   Save

    BACKGROUND: Clavicle hook plate has been widely applied in the treatment of acromioclavicular joint dislocation and the distal fracture of clavicle and achieved satisfactory effects. The increasing application is associated with the emergency of some complications such as shoulder pain, subacromial impingement, subacromial osteolysis, hook-release, and stress fracture.
    OBJECTIVE: To analyze the complications and causes after the operations for the acromioclavicular joint dislocation and the distal fracture of clavicle with clavicle hook plate, and to summarize prevention and treatment measures.
    METHODS: From March 2006 to May 2014, 112 patients with acromioclavicular joint dislocation (64 cases) and the distal fracture of clavicle (48 cases) were cured by clavicle hook plate. Among them, 16 patients with distal fracture of clavicle of Neer type I, 32 patients of Neer type II; and 64 patients with acromioclavicular joint dislocation of Tossy type III. Four patients with superior shoulder suspensory complex double damage. The clinical results of hook plate internal fixation and the complications were retrospectively analyzed.
    RESULTS AND CONCLUSION: Finally 103 patients were involved in the follow-up analysis and other cases were excluded due to loss of follow-ups. 99 patients exhibited synostosis and no re-dislocation of acromioclavicular joint occurred. The incidence rate of postoperative complications was 30.1%. According to 
    Karlsson criteria, 79 patients got an excellent result, and 16 good. The excellent and good rate was 92.2%. Clavicle hook plate internal fixation is reasonable and effective for the treatment of the acromioclavicular joint dislocation and the distal clavicle fracture. Treatment should be based on the characteristics of individual, and wide concerns are needed to prevent complications.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Internal or external malleolus osteotomy using absorbable screw or absorbable stick for talar fracture: follow-up in 15 cases
    Li Gang-jian, Zhao Xin
    2014, 18 (48):  7810-7815.  doi: 10.3969/j.issn.2095-4344.2014.48.018
    Abstract ( 230 )   PDF (692KB) ( 592 )   Save

    BACKGROUND: Strict requirement of the reduction after talar fracture and susceptibility to blood supply dysfunction in talus are two main problems for the treatment of talar fracture, which is also called two balance points. On one hand, talar fracture needs precise reduction; one the other hand, blood supply in the talus should be protected.
    OBJECTIVE: To explore therapeutic effect of internal or external malleolus osteotomy using absorbable screw or absorbable stick for talar fracture.
    METHODS: From June 2008 to June 2011, 16 patients of talar fracture were treated with internal or external malleolus osteotomy. The talus was fixed using absorbable screw or absorbable stick, and refixed with steel plate or cannulated screws after reduction of internal or external malleolus. The blood supply should be protected during the operation. Internal incision was derived from the anterior border of medial malleolus to tubercle of scaphoid bone, between tibialis anterior and tibialis posterior muscle, avoiding the great saphenous vein. The rest blood supply of the talus which resided in the triangular ligament area should also be protected. When cleaning bone fragments, the drills and screws should not be close to subtalar joint, avoiding injury in the vascular network 
    of tarsal sinus and the artery in tarsal tunnel. Based on the patient’s chief complains, clinical efficacy was evaluated through detections of ankle joint appearance and function, X-ray and CT scanning. The therapeutic effect was assessed with Hawkings scoring system.
    RESULTS AND CONCLUSION: The involved 15 patients were followed up for 25-36 months. According to the modified Hawkings, 8 patients (53%) were rated as excellent, 5 patients (33%) good, 1 (7%) fair and 1 (7%) poor, the total rate of being excellent and good was 86%. Operation through approach of internal or external malleolus osteotomy using absorbable screw or absorbable stick is a good method for treatment of talar fracture.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Clinical efficacy of hyperbaric oxygen therapy combined with locking plate for intra-articular calcaneal fractures
    Xu Yun1, Shi Yong, Ouyang Lin-zhi, Tao Wei-jian, Jian Zheng-guang, Sun Xue-feng, Ma Chun-yan, Tang Tian-si
    2014, 18 (48):  7816-7821.  doi: 10.3969/j.issn.2095-4344.2014.48.019
    Abstract ( 336 )   PDF (790KB) ( 933 )   Save

    BACKGROUND: Wound infection, skin flap necrosis, local skin defects, and osteomyelitis are common complications following extensile lateral approach for calcaneal fracture, and these complications are very intractable. Hyperbaric oxygen therapy has been widely applied in treatment of severe crush injury, chronic osteomyelitis, chronic skin ulcers and defects, and other orthopedic diseases. Hyperbaric oxygen therapy may be a potential means to treat wound complications after calcaneal fracture fixation.
    OBJECTIVE: To assess the effectiveness of hyperbaric oxygen therapy in displaced intra-articular fractures after open reduction and internal fixation through an extensile lateral approach.
    METHODS: From January 2010 to September 2012, 80 patients with intra-articular calcaneal fractures after open reduction and internal fixation were randomized into two groups, receiving hyperbaric oxygen therapy (HBOT group) or hyperbaric air treatment (control group). Each group contained 40 patients.
    RESULTS AND CONCLUSION: Three cases in HBOT group and four cases in control group were excluded due to intolerance to hyperbaric oxygen therapy, and the remaining 73 patients were followed and assessed for a minimum of two years of follow-up. The demographic data showed no significant difference between the two groups (P > 0.05). The rates of infection were 3% (one case) in HBOT group and 8% (three cases) in control group. The overall complication rates for HBOT group and control group were 11% (four cases) and 33% (12 
    cases), respectively (P = 0.020). At 6 months after hyperbaric oxygen therapy, American Orthopaedic Foot and Ankle Society score, SF-36 score, VAS score were significantly better outcomes for HBOT group as compared with control group (P < 0.05). However, these outcome measures did not differ significantly between the two groups after 2 years of follow-up (P > 0.05). Adjunctive hyperbaric oxygen therapy would prevent and reduce the overall complication rate after open reduction and internal fixation through an extensile lateral approach. Hyperbaric oxygen therapy obviously improve clinical efficacy after treatment, but has no difference after 2 years.


    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
    Small incision reduction graft and percutaneous Kirschner wire fixation for calcaneal fractures: advantages and disadvantages
    Fan Ai-min, He Zhi, Zhang Li-liang, Feng Tie-cheng, Liu Fang-gang
    2014, 18 (48):  7822-7826.  doi: 10.3969/j.issn.2095-4344.2014.48.020
    Abstract ( 429 )   PDF (656KB) ( 488 )   Save

    BACKGROUND: The calcaneus is cancellous bone with thin cortical bone, and mostly prone to collapse compression fracture after injuries. Surgical reduction and fixation can basically restore joint integrity and calcaneus form, patients often need bone graft to fill the bone and receive Kirschner wire fixation to support bone graft and maintain reduction.
    OBJECTIVE: To explore the advantages and defects of small incision reduction graft and percutaneous Kirschner wire fixation in treatment of calcaneal fractures.
    METHODS: 26 patients with calcaneal fractures were treated with small incision reduction graft (autograft or allograft bone) plus percutaneous Kirschner wire fixation, and clinical data of the involved patients were retrospectively analyzed. Bohler and Gissane angles of calcaneal bone were observed after fixation. Maryland foot scoring system was applied to evaluate the clinical efficacy of bone graft and fixation, soft tissue complications after fixation were also observed.
    RESULTS AND CONCLUSION: All 26 patients were followed up for 6-12 months. Compared with before surgery, calcaneus Bohler and Gissane angles were significantly increased after treatment; according to the Maryland foot scores, excellent and good rate was 85%. Small incision reduction graft and percutaneous Kirschner wire fixation is reliable treatment method of intra-articular calcaneal fractures, with fewer complications.


    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程


    全文链接:

    Figures and Tables | References | Related Articles | Metrics
    Elastic intramedullary nail in the repair of long bone fractures in children: rigid fixation and jiggling at the fracture site promote fracture healing
    Wang Yao-wei, Wu Shu-hua, Wang Shu-jin, Li Yun-long, Zhu Dong-bo
    2014, 18 (48):  7827-7832.  doi: 10.3969/j.issn.2095-4344.2014.48.021
    Abstract ( 477 )   PDF (631KB) ( 641 )   Save

    BACKGROUND: Elastic intramedullary nail for children with specific elastic with bend round metal strip structure, is based on adult long bone fracture treatment using intramedullary needle through the development, evolution and improvement, and has become the minimally invasive treatment method in children with fractures. As a intramedullary fixation device, it has sufficient fixing strength for children long bone fractures, simultaneously can promote jiggling at the fracture site, finally contribute to fracture healing. At present, it has been a novel fixation material for treatment of children long bone fractures.
    OBJECTIVE: To retrospectively summarize and evaluate the clinical outcomes of elastic intramedullary nail internal fixation for the treatment of children with long bone shaft fracture using minimally invasive surgery.
    METHODS: From January 2010 to April 2014, 30 children with long bone shaft fractures were treated with elastic intramedullary nail fixation, including 4 cases of femur, 11 cases of tibia and fibula fractures, 4 cases of humerus, 7 cases of ulnar and radial fractures, 3 cases of ulnar fractures, and 1 case of radial fracture. All cases were fresh closed fracture. There were 21 males and 9 females. Their age at injury was from 5 to 16 years old, averagely 9.6 years. 23 cases received closed reduction, and 7 cases received limited small incision reset due to difficult closed reduction. Fracture reduction, operation time, healing time, functional recovery after fixation, curative effects of Flynn intramedullary nail, post-fixation complications and adverse events were observed in children. 
    RESULTS AND CONCLUSION: Operation time was between 25 and 65 minutes in 30 children, averagely 51 minutes. All fracture sites were reduced. All patients were followed up for 6-12 months. All fractures were healed, and the healing time ranged from 8 to 16 weeks, averagely 12 weeks. The excellent and good rate of Flynn intramedullary nail was 100%. The function of affected limbs recovered to normal. No complication occurred. The technology has the advantages of small incision, no need to strip periosteum, minor soft tissue injury, short operation time, low infection rate, biomechanical stability, quick functional recovery, fast healing, and less complications. Its design focuses on children fracture characteristics and growth rule of bone tissue, and is very suitable for long bone fracture 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
    Application value of deviation of screw placement in lower cervical pedicle by CT multiplane and three-dimensional reconstruction
    Chang Zhi-qiang, Zhang Pei, Wu Yi-min, Li Peng-fei
    2014, 18 (48):  7833-7837.  doi: 10.3969/j.issn.2095-4344.2014.48.022
    Abstract ( 232 )   PDF (644KB) ( 441 )   Save

    BACKGROUND: Cervical pedicle has large variations anatomical structure, which is adjacent to crucial blood vessels and nerves. Deviation of screw placement may increase the risk of damage in surrounding vessels and nerves. Therefore how to improve the accuracy of placing cervical pedicle screws is the key link of internal fixation.
    OBJECTIVE: To investigate clinical application value of deviation of screw placement in lower cervical pedicle by CT multiplane and three-dimensional reconstruction. 
    METHODS: Clinical data of 12 patients undergoing lower cervical pedicle screw due to cervical pedicle disease in the Second Affiliated Hospital of Inner Mongolian Medical University were retrospectively analyzed. The number of pedicle screws in all cases was 52. The involved cases were randomly divided into spiral CT group (CT multiplane and three-dimensional reconstruction) and X-ray fluoroscopy group (X-ray fluoroscopy assisted screw placement). The accuracy and deviation of screw placement between two groups were compared.
    RESULTS AND CONCLUSION: The number of first-class screws was 27, 96% of the total 28 pedicle screws in spiral CT group, and the number of second-class screws was 1. In the X-ray fluoroscopy group, the number of first-class screws was 21 (88%) and the number of second-class screws was 3. The accuracy of screw placement in spiral CT group was significantly higher than that of X-ray fluoroscopy group (P < 0.05). Screw placement in lower cervical pedicle by CT multiplane and three-dimensional reconstruction has great clinical application value, with high accuracy and strong three-dimensional sense.


    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
    Three-dimensional reconstruction by internal fixation under the assistance of digital technology: individual scheme for acetabulum fracture
    Guo Xiao-ze, Zhang Ying, Xia Yuan-jun, Huang Xian-hua, Yu Jie-feng
    2014, 18 (48):  7838-7843.  doi: 10.3969/j.issn.2095-4344.2014.48.023
    Abstract ( 420 )   PDF (751KB) ( 385 )   Save

    BACKGROUND: Acetabulum fracture is an intra-articular fracture. The acetabulum has a deep position, irregular shape and is adjacent to many important blood vessels and nerves. The purpose of treatment is to recover the anatomical contraposition of acetabulum joint surface accurately and to maximize the function of the hip retained. The digital technology has a guiding significance to the treatment of the acetabulum fracture.
    OBJECTIVE: To investigate clinical therapeutic effect of internal fixation with the assistance of digital technology on acetabulum fracture.
    METHODS: 50 patients with acetabulum fracture were recruited from Department of Orthopedic Trauma, Guangzhou General Hospital of Guangzhou Military Command of Chinese PLA between March 2009 and September 2011. The involved patients were divided into control group and study group randomly. 25 cases of  study group received preoperative plans through the digital technology and treated with open reduction and internal fixation according to the plans. 25 cases of control group were treated with operations only. The amount of bleeding during the operations, the duration of the operations, the duration of hospitalizations and the function evaluation after the operations were compared between the two groups.
    RESULTS AND CONCLUSION: 23 cases had been followed up from 13 to 24 months in the study group and 24 cases had been followed up from 12 to 26 months in the control group. The amount of bleeding during the operations and the duration of the operations in the study group were significantly lower than that in the control group (P < 0.05). The duration of hospitalizations and the healing time of the fracture after the operations were significantly shorter in the study group than in the control group (P < 0.05). The hip function scores after the operations in the study group were significantly higher than that in the control group (P < 0.05). Using the digital technology we reconstruct the three-dimensional models of acetabulum fracture before surgeries can help imitating the fracture reductions and formulating the individualized operation plans. It has satisfactory effect to treat the patients with open reduction and internal fixation surgeries according to the plans.


    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
    Application of three-dimensional models constructed using virtual simulation 
    technique in the vertebral metastatic tumor
    Liu Deng-jun, He Xiao-bing, Wang Ming-gui, Li Zheng-yan, Li Qi, Lin Li-jun
    2014, 18 (48):  7844-7848.  doi: 10.3969/j.issn.2095-4344.2014.48.024
    Abstract ( 352 )   PDF (471KB) ( 657 )   Save

    BACKGROUND: Vertebral metastatic tumor often damages vertebral body and the appendix, and causes severe pain in patients and high incidence of complications, such as paraplegia and spinal kyphosis. The principle of metastatic tumor treatment is early diagnosis, complete surgical resection, and postoperative chemotherapy. Imaging techniques such as CT can detect spinal metastases and accurately position the tumor before surgery. Currently visualized simulation and virtual reality techniques have been increasingly used in the field of orthopedics.
    OBJECTIVE: To find an anterior-posterior approach for the treatment of vertebral metastases using visual reality technique.
    METHODS: Based on the 64-layer spiral CT two-dimensional images of lumbar vertebra, we reconstructed the structure of normal vertebrae, affected vertebrae, abdominal aorta and bilateral kidney three-dimensionally using Mimics software. Then anterior debridement, titanium bone cement supporting, and posterior pedicle screw fixation were performed on three-dimensional models.
    RESULTS AND CONCLUSION: Three-dimensionally reconstructed models were clearly visible in Dicom format, and can reproduce the structure of affected vertebrae and adjacent organs. The virtual stimulation operation provided clarity with strong relief perception. Virtual simulation surgery accurately visualize three-dimensional structure of malignant tumor and adjacent structure, position the lesion site, and reconstruct spinal sequence via the posterior approach. This method provides an objective evidence for individualized treatment programs.


    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
    Atlantoaxial vertebral posterior fixation of short-segment graft: increased intensity has few impact on the rotation and flexion-extension movement
    Miao Jun, Xia Qun
    2014, 18 (48):  7849-7854.  doi: 10.3969/j.issn.2095-4344.2014.48.025
    Abstract ( 298 )   PDF (676KB) ( 367 )   Save

    BACKGROUND: Atlantoaxial vertebra is the central region of the life. Due to the unique anatomical structures, the operation in this region is difficult and has high risk. Posterior approach is a commonly used surgical reconstruction on the stability of the upper cervical spine. The best way to fix is short and strong internal fixation, which has strong fixation and causes less affect on the rotation and flexion-extension movement.
    OBJECTIVE: To review the technology of atlantoaxial vertebral posterior internal fixation.
    METHODS: The first author retrieved articles published until May 2014 on PubMed 
    (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang (http://med.wanfangdata.com.cn/) databases, with “upper cervical, internal fixation, atlas and axis, posterior approach” as the key words in English and Chinese. Using different combinations of the key words, a total of 267 articles in English and 189 in Chinese were retrieved. After reading the title and abstract for early screening, repeated and upper cervical unrelated reports in both English and Chinese literature are eliminated. Finally 48 articles were included in the reviews.
    RESULTS AND CONCLUSION: Due to the specific anatomy of atlantoaxial vertebra, atlantoaxial internal fixation technology is obviously different from the other cervical vertebra. Lamina depending internal fixation including Gallie technique, Brooks technique, Sonntag technique, lamina clamp, Locksley intersegmental tie bar technique and C2 crossing laminar screw technique. These techniques need the integrity of C1 and C2, and are not available for laminectomy decompression. Besides C2 crossing laminar screw, the rest of the methods require spinal canal invasion operation, and the ability to resist rotation are relatively poor. Lamina independing internal fixation is developed in recent years, including the lateral mass screws, transarticular screw, atlas pedicle screw, axial isthmus screw, and axial pedicle screws. Its characteristic is the application of screws, which greatly enhance biomechanical strength and increase fusion rate, without affecting the lamina decompression. Atlantoaxial area is very close to human body life central, being familiar with the regional anatomy and skilled internal fixation implant technique are essential for successful completion of the surgery in this area.


    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
    Posterolateral fusion and interbody fusion in repair of adult lumbar spondylolisthesis: a meta-analysis
    Arenbieke•Habulihan, Jin Ge-le, Li Zhong-wei, Nuerhanati•Shayilanbieke
    2014, 18 (48):  7855-7861.  doi: 10.3969/j.issn.2095-4344.2014.48.026
    Abstract ( 358 )   PDF (678KB) ( 401 )   Save

    BACKGROUND: Fusion treatment is an important part in lumbar spondylolisthesis surgery. The major aim of fusion is osseous junctions among intervertebral joint so as to establish and maintain strong spinal stability. The common fusion manner of lumbar spondylolisthesis is posterolateral fusion and interbody fusion. Although above two fusion manners have good clinical effects and their complications are less, it is still controversial on the optimal fusion manner of lumbar spondylolisthesis.
    OBJECTIVE: To assess the clinical outcome of adult lumbar spondylolisthesis treated by posterolateral fusion 
    and interbody fusion.
    METHODS: According to Cochrane systematic review method, Medline (from 2000 to March 2014), PubMed (from 2000 to March 2014), and Springerlink (from 2000 to March 2014) were retrieved by computer. Literatures were collected by hand. Only English literatures were included. All related randomized controlled trial and high quality cohort studies were collected. Meta-analysis was performed utilizing Revmen 5.2.0 software offered by Cochrane cooperative network. Thus, we attainted the literatures related to the clinical and imaging outcomes.
    RESULTS AND CONCLUSION: Through completely retrieving and screening, this study gained two randomized controlled trials and four high quality cohort studies. The results of meta-analysis showed that there were no significant differences between posterolateral and interbody fusion groups in last low back visual analogue scale [weighted mean difference (WMD)=0.32, 95% confidence interval (-0.89, 1.52), P=0.60], the last leg visual analogue scale [WMD=-0.24, 95% confidence interval (-0.49, 0.02), P=0.07], back pain ODI scores [WMD=4.18, 95% confidence interval (-0.30, 8.65), P=0.07], the postoperative satisfication degree [odd ratio (OR)=0.86, 95% confidence interval (0.46, 1.62), P=0.65] and postoperative early complication rate [OR=0.88, 95% confidence interval (0.44, 1.78), P=0.73]. The fusion rate of interbody fusion group was obviously higher than the posterolateral fusion group [OR=0.29, 95% confidence interval (0.15, 0.55), P=0.000 1]. Complication rate was higher in the posterolateral fusion group than interbody fusion group [OR=2.58, 95% confidence interval (1.12, 5.95), P=0.03]. Low back pain, leg pain and function recovery were better in both fusion groups after treatment compared with before treatment. These data indicated that fusion rate was obviously higher in the interbody fusion group than in the posterolateral fusion group. Posterolateral fusion group showed high incidence of long-term complications. There were no evident differences in other indexes between the two groups.


    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 | Related Articles | Metrics
    Progress in research and application of quality of life questionnaires dedicated to osteoporosis
    He Zao-peng, Yang De-hong
    2014, 18 (48):  7862-7866.  doi: 10.3969/j.issn.2095-4344.2014.48.027
    Abstract ( 588 )   PDF (568KB) ( 1305 )   Save

    BACKGROUND: During treatment of osteoporosis, assessment of quality of life is considered an important clinical progress. The assessment of quality of life can predict clinical disease progression and changes in physical and mental function, is helpful to select a favorable therapeutic condition for improving pathogenetic condition, can reverse bone loss and reduce the risk of fractures, which really improves the patient’s health status. Many outside-China studies designed and used osteoporosis dedicated scale to assess quality of life, which is considered a necessary measure of monitoring and evaluating the clinical efficacy. However, the scale development purposes and entry structure are different. When these scales were used in China, scholars feel unsure about scale choice, and questioned the accuracy of results.
    OBJECTIVE: To review design features and applications of quality of life scales dedicated to osteoporosis, and to explore scale development trend and best indications for clinical research.
    METHODS: Literature data were reviewed from January 1994 to July 2014. Medical subject headings were “osteoporosis, quality of life, spine fracture, questionnaire”. Database search was performed for representative scale. Data of related indicators were collected. Scale features were summarized and classified.
    RESULTS AND CONCLUSION: Questionnaires were categorized into classic ones with their short versions, new developed ones and domain-specific ones. The Quality of Life Questionnaire of the European Foundation for Osteoporosis is the osteoporosis-specific questionnaire most commonly used in the literature. In the present study on quality of life, these questionnaires should be selected based on the objectives of evaluation, severity of the patient’s condition and the domain of quality of life mainly involved. If used in the crowd with a different language, scale translation and content adaptation should be conducted by special procedures. Reliability and validity of the language should be tested. The scale should be selected in accordance with psychometric evaluation results. 
     


    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
    Prevalence and distribution of Schmorl’s nodes in cervical segment and its relationship with intervertebral disc degeneration
    Cao Sheng, Zhang Xue-li, Hu Wei, Zhu Ru-sen, Wan Jun, Liu Yan
    2014, 18 (48):  7867-7872.  doi: 10.3969/j.issn.2095-4344.2014.48.028
    Abstract ( 1035 )   PDF (782KB) ( 741 )   Save

    BACKGROUND: The distribution and characteristics of Schmorl’s nodes in lumbar spine have been described, but there are few studies focusing on Schmorl’s nodes in the cervical spine.
    OBJECTIVE: To evaluate the distribution of Schmorl’s nodes in patients suffered neck pain and analyze the factors responsible for Schmorl’s nodes. 
    METHODS: From January to December in 2012, 820 patients suffered neck pain were examined by magnetic resonance scan and plain film. There were 398 males and 422 females, with an average age of 52.2±11.5 years (range 30-80 years). The distribution features of Schmorl’s nodes in cervical endplate on age, sex, segment, head circumference, cervical curvature, and the type and grade of intervertebral disc degeneration were analyzed retrospectively.  
    RESULTS AND CONCLUSION: Among 4 920 cervical intervertebral segments of the 820 patients, 64 cases (7.8%) and 108 endplates (1.1%) were involved with Schmorl’s nodes, the incidence of Schmorl’s nodes in the cranial and the caudal endplates was not statistically significant (χ2=1.471, P=0.689 > 0.05). According to the prevalence per cervical segment, C5/6 was the most common level (2.4%), followed by C6/7 (1.5%) and C4/5 (1.3%). The incidence of Schmorl’s nodes was positively correlated with age, cervical curvature, the type and grade of intervertebral disc degeneration    (P < 0.05), but not with sex and head circumference (P > 0.05). The distributions of the grade of intervertebral disc degeneration were significantly different between groups with and without adjacent Schmorl’s nodes (χ2=424.26,      P < 0.05). Intervertebral discs with adjacent Schmorl’s nodes were more degenerated than those without adjacent Schmorl’s nodes (Z=58.80, P < 0.05). The distributions of the grade of intervertebral disc degeneration were significantly different between groups with both sides Schmorl’s nodes and one side Schmorl’s nodes (χ2=13.603, P=0.003 < 0.05). The both sides Schmorl’s nodes were more degenerated (Z=3.44, P < 0.05). The distributions of the grade of intervertebral disc degeneration were significantly different between groups with “acute Schmorl’s nodes” and “non-acute Schmorl’s nodes” (χ2=8.547, P=0.036 < 0.05). The “non-acute Schmorl’s nodes” were more degenerated (Z=2.40,      P < 0.05). Schmorl’s nodes distribution was correlated with disc degeneration, then age, and cervical curvature. Schmorl’s nodes occurred often in C5/6 segment in patients with neck pain. The incidence of Schmorl’s nodes in the cranial and the caudal endplates was not statistically significant. Schmorl’s nodes were correlated with age, cervical curvature, the type and grade of intervertebral disc degeneration, disc degeneration played the most important role.


    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 | Related Articles | Metrics