Modified Mclaughlin procedure combined with locking plate for posterior shoulder dislocation with fracture / 中国骨伤

OBJECTIVE@#To study clinical effects of modified Mclaughlin procedure combined with locking plate for posterior shoulder dislocation with proximal humeral fracture which area of femoral head injury less than 40%.@*METHODS@#From July 2012 to June 2017, 7 patients with posterior shoulder dislocation were treated, including 5 males and 2 females; aged from 37 to 53 years old. Three patients combined with split of humerus head and 4 patients combined with humerus surgical neck fracture. All patients treated with modified Mclaughlin procedure combined with locking plate. Motion of shoulder joint after operation was observed, postoperative UCLA score was used to evaluate clinical effects.@*RESULTS@#Seven patients were followed up from 10 to 33 months. The motion of anteflexion and up-lift ranged from 130° to 170°, the motion of extorsion ranged from 45° to 75°, the motion of abduction ranged fron 105° to 150°, and the internal rotation was between L₃ to buttock. UCLA score ranged from 29 to 34; and 1 patient reached excellent, and 6 patients good.@*CONCLUSIONS@#The modified Mclaughlin procedure combined with locking plate showed satisfying result for posterior shoulder dislocation combined with fractures. However, the internal rotation of shoulder could be compromised.

Analysis on the occult blood loss after unicompartment knee arthroplasty / 中国骨伤

<p><b>OBJECTIVE</b>To calculate the volume of occult blood loss after unicompartment knee arthroplasty(UKA), and analyze its influential factors by comparing with total knee arthroplasty.</p><p><b>METHODS</b>A retrospective study of 130 cases from July 2012 to July 2015 were enrolled, of which and 65 cases were UKA, and 65 cases were TKA. In UKA group there were 27 males and 38 females, and the mean age was (62.3±4.3) years old (ranged, 50 to 82 years old). There were 14 cases older than 70 years old, while 51 cases among 50 to 70 years old. The mean Body mass index (BMI) was (23.9±2.6) kg/m²(ranged, 18.3 to 30.1 kg/m²). In TKA group there were 23 males and 42 females, and the mean age was (67.4±4.9) years old (ranged, 57 to 81 years old). There were 34 cases older than 70 years old, while 31 cases among 50 to 70 years old. The mean BMI was (25.6±2.3) kg/m²(ranged, 20.6 to 33.1 kg/m²). Hidden blood loss was calculated according to Gross equation, and the differences between the two groups including different ages and genders were observed subsequently. The differences of red blood cell change between two groups were observed dynamically postoperatively.</p><p><b>RESULTS</b>Postoperative hidden blood loss was (375.25±168.09) ml, HSS score was 87.11±5.39 in UKA group. Hidden blood loss was (898.81±221.47) ml, HSS score was 82.23±3.08 in TKA group. The differences between the two groups were significant. There were no significant differences in ages and genders. There were no significant relationship between hidden blood loss and HSS score or BMI, while the differences of red blood cell change were significant on the second day, the 4th day and the 5th day. There was no allogenic blood transfusion in UKA group, while 3 patients with transfusion in TKA group.</p><p><b>CONCLUSIONS</b>Hidden blood loss is part of total blood loss after UKA, and the volume in UKA is less than that in TKA. It could be compensated by the body and rarely affect the knee function. The hidden blood is not a risk factor of transfusion.</p>

Distal fixation prosthesis for unstable intertrochanteric fractures in elderly patients: a mid-term follow-up study / 中国骨伤

<p><b>OBJECTIVE</b>To explore mid-term follow up results of distal fixation prosthesis in treating unstable intertrochanteric fractures in elderly patients.</p><p><b>METHODS</b>From May 2008 to March 2014,58 elderly patients with unstable intertrochanteric were treated with distal fixation prosthesis, among them, there were 15 males and 43 females aged from 75 to 87 years old with an average of 83.2 years old. Fracture were classified according to Evans classification, 39 cases were type I c and 19 cases were type I d. Surgical risk was evaluated before operation, 9 patients were performed total hip arthroplasty and 49 patients were performed prosthetic replacement hip joint function of patients with different age period, Evans classificaton, prothesis type, fixation method were evaluated respectively by using Harris score.</p><p><b>RESULTS</b>Fifty-six patients were followed up from 13 to 36 months with an average of 21.6 months. Harris score was 83.51 ± 6.40, 5 cases got excellent results, 38 cases good and 13 cases moderate. Harris score of patients aged from 75 to 80 years old was 88.64 ± 2.35, 81.64 ± 6.40 in patients aged more than 80 years old, and had significant differences between two groups; Harris score in patients with type Evans I c was 83.64 ± 6.53, and 83.11 ± 6.08 in type Evans I d, while there was no significant differences between two groups. There was no obvious meaning in Harris score between patients with tension band (83.63 ± 6.15) and without tension band (82.41 ± 6.57). There was no significant meaning in Harris score between patients with normal distal fixation prosthesis (83.34 ± 6.43) and femoral moment reconstruction distal fixation prosthesis (83.92 ± 6.51). There was 1 patient occurred hip joint dislocation on the operative side and re-dislocation after manual reduction, then received open reduction. Two patients occurred femoral osteolysis without clinical symptoms, and treated conservative treatment.</p><p><b>CONCLUSION</b>Artificial joint replacement for unstable intertrochanteric fractures in elderly patients, hip joint function in patients aged more than 80 years old is worse, while there was no obvious market effect in fracture classification, whether to use tension band and type of distal fixation prosthesis, moreover, proximal femoral osteolysis should be focused on.</p>

Arthroscopic treatment of tibial intercondylar eminence fracture in children / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical effects of extractable steel wire for the treatment of tibial intercondylar eminence fracture in children under arthroscopy.</p><p><b>METHODS</b>From October 2008 to December 2010,21 children with intercondyloid eminence fractures were treated with fixation by extractable steel wire under arthroscopy. Among the patients, 14 patients were male and 7 patients were female,ranging in age from 7 to 14 years old with a mean of 10 years old. The period from injury to operation ranged from 3 to 8 days, with an average of 4 days. Before operation, X-ray, CT and MRI were used to determine fracture and joint injury type. Lysholm criteria were used to evaluate clinical effects.</p><p><b>RESULTS</b>All fractures were healed. The Lysholm score improved from preoperative 30.2 +/- 4.2 to postoperative 92.8 +/- 9.1; 18 patients got an excellent result and 3 good.</p><p><b>CONCLUSION</b>The extractable steel wire in treatment of tibial intercondyloid eminence fractures in children under arthroscopy has advantage of economics, firm fixation, in favour of early functional exercise, decreasing the opportunity of bony avulsion of the anterior cruciate ligament and less iatrogenic injury of osteoepiphysis due to small diameter and slick steel wire.</p>

Serum levels of cartilage oligomeric matrix protein in the diagnosis of knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To select sub-clinical patients with symptoms of knee osteoarthritis (KOA) without X-ray changes by measuring the serum level of cartilage oligomeric matrix protein (COMP) with ELISA, so as to diagnose and treat patients with knee osteoarthritis at early stage.</p><p><b>METHODS</b>The 115 patients with KOA or with symptomatic primary KOA were enrolled from August 2007 to September 2009, which was OA group; and 35 healthy people in the control group. In OA group, there were 55 males and 60 females,ranging in age from 39 to 76 years, with an average of (55 +/- 13.32) years; the body mass index (BMI) ranged from 15.1 to 29.8; the disease course ranged from 6 to 60 months. In the control group, there were 16 males and 19 females, ranging in age from 36 to 77 years, with an average of (53 +/- 12.53) years; the BMI ranged from 14.8 to 29.2. Patients with symptomatic primary knee OA of Kellgren-Lawrence (K-L) grade I-IV were evaluated. Serum level of COMP and its correlation with OA grade were analyzed by ELISA method. The patients were treated with Celecoxib capsules. The patients in OA group were followed up, and the duration ranged from 24 to 38 months (averaged, 33.4 months), and the serum level of COMP were analyzed before and after treatment.</p><p><b>RESULTS</b>The serum level of COMP in the control group varied with age (t= 2.50, P=0.02). The serum level of COMP did not correlate with gender (control group: t=0.98, P=0.34; OA group: t=0.18, P= 0.86), BMI (control group: t=0.56, P=0.92; OA group: t=0.17, P=0.85) and smoking (control group: t=1.89, P=0.08; OA group: t=0.70, P=0.49). The serum level of COMP was higher in the patients with higher K-L grades than in the patients with lower K-L grades (F=15.56, P=0.001) . The sub-clinical KOA patients without X-ray changes can be detected significant higher COMP levels than sub-clinical patients with other diseases (t=2.55, P=0.03). Therefore, according to this method, subclinical OA patients can be detected from people with other sub-clinical diseases successfully.</p><p><b>CONCLUSION</b>The serum level of COMP can be used as a potential prognostic marker to diagnose KOA.</p>

Arthroscopic treatment of acute patellar dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate therapeutic effects of arthroscopic treatment for acute patellar dislocation.</p><p><b>METHODS</b>From May 2002 to March 2009, 36 patients with acute patellar dislocation were treated with arthroscopy, including taking out of the free cartilage chips, relaxing lateral retinaculum and tight suturing medial retinaculum. Among the patients, 6 patients were males and 30 patients were females, ranging in age from 12 to 30 years (averaged, 20.5 years). Fifteen patients had the dislocations on the left an 21 patients had the dislocations on the right. The development of condyles of femur and Q trianglel were detected by preoperative radiology. The Lysholm criteria system was used to evaluate the clinical effects.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 13 to 60 months (averaged, 42 months). All the patients had no complications such as infection, and the knee range of motion recovered to normal without pain. The Lysholm score improved from preoperative (28.9 +/- 2.5) to postoperative (95.1 +/- 8.4). All the patients had no redislocation.</p><p><b>CONCLUSION</b>Acute dislocation of the patella is an potential devastating injury. The arthroscopic treatment for acute patellar dislocation has advantages such as less trauma, faster recovery and more reliable.</p>

Improve on serological diagnosis method of nasopharyngeal carcinoma / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To improve the existing serological early diagnosis method of nasopharyngeal carcinoma by improve the detection sensitivity.</p><p><b>METHODS</b>The samples of 294 serum specimen from the prevention and treatment of nasopharyngeal cancer model base, involving 106 serum specimen from the patients suffering from nasopharyngeal cancer and 188 from the healthy testers. IgA/VCA antibody and IgA/EA antibody of the serums are tested by Streptavidin-biotin-antibody immunoenzymatic test and normal traditional enzyme methods, SPSS statistical software is used to analyse the test results with chi2 test and t test.</p><p><b>RESULTS</b>Referring to 106 patients, the sera antibody positive rate tested by Streptavidin-biotin-antibody immunoenzymatic test method is obviously higher than that tested by traditional method; and the t test result of the GMT has significant difference in the two method.</p><p><b>CONCLUSION</b>The modified method can improve the sensitivity of serology testing, ensure the specificity of test results, at the same time, improve the detection rate of nasopharyngeal carcinoma, so it can be applied to the early screen work of nasopharyngeal carcinoma.</p>