ABSTRACT
The first metacarpal fracture is very common in forensic identification process,it often affects the function of the thumb,and how to correctly assess the degree of loss of thumb function become a focus in the fields of forensic medicine.We review the existing problems in the forensic identification of the first metacarpal fracture.
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<p><b>OBJECTIVE</b>T o summarize the clinical effects of the repairing methods for skin and soft tissue defection of heel.</p><p><b>METHODS</b>From June 1998 to June 2009,42 patients with skin and soft tissue defection of heel underwent the repairing treatment,including 23 males and 19 females, with an average age of 37 years old ranging from 18 to 65. The causes of injuries included mangled injury in 22 cases, high fall injury in 10 cases, cut injury in 5 cases,melanoma in 3 cases, decubital ulcer in 2 cases. Of the 42 cases, 27 were on left side and 15 on right side. The defect area of skin ranged from 3 cm x 2 cm to 18 cm x 16 cm. The time between the injury and surgery ranged from 8 hours to 10 years. The wounds were repaired separately by medial plantar flap in 13 cases, lesser saphenous sural nerve vascular island flap in 18 cases, saphenous neurocutaneous vascular flap in 11 cases. The patients' outcome were evaluated with appearance,blood supply, texture, resilience and two points discrimination of the flaps.</p><p><b>RESULTS</b>All of the 42 flaps were survived. The distal skin necrosis occurred in 2 flaps, but healing occurred after debridement and intermediate thickness skin grafting. Three patients with sinus formation healed after 5 to 12 months of dressing change. All patients were follow-up for 8 months to 6 years. The flaps of all patients gained a satisfied shape after operation. The patients had a normal gait, the flaps had a good sense and a resistance to wearing,and no ulcer occurred. The two point discrimination of the flap was 4 to 12 mm.</p><p><b>CONCLUSION</b>It is convenient and effective to repair the heel skin and soft tissue defects using medial plantar island skin flap when the defects is less then 8 cmx6 cm. As reliable blood supply,major artery preservation and high survival, the lesser saphenous sural nerve vascular island flap and saphenous neurocutaneous vascular flap can be transferred to repair the large soft tissue defect of heel.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Foot Injuries , General Surgery , Heel , Congenital Abnormalities , General Surgery , Plastic Surgery Procedures , Soft Tissue Injuries , General Surgery , Surgical FlapsABSTRACT
@#ObjectiveTo investigate the effect of nickel-titanium(Ni-Ti) shape memory alloy embracing internal fixer on oblique or spiral fracture.Methods23 cases with spiral or oblique fracture accepted internal fixation with Ni-Ti shape memory alloy embracing.The time of bone healing,articular function,the appearance and function of the wound extremity were evaluated after 9～34 months follow-up.ResultsAll fractures healed in 4～16 weeks after operation.None infection,nonunion,embracing emersion or break had been found. The fine rate was 91.3%.ConclusionThe effect of Ni-Ti shape memory alloy embracing internal fixer on long spiral or long oblique fracture is satisfactory.
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<p><b>AIM</b>To study the long-term effects of 17 beta-estradiol (E2) on cell proliferation, 45Ca up-take, and mineralized bone-like tissue formation in human osteoblast-like cell line TE85.</p><p><b>METHODS</b>Human osteoblast-like cell line TE85 was used as osteoblast cell model. Using methods of 3H-thymidine incorporation for cell proliferation and 45Ca deposit for calcium uptake, and Alizarin red S dye for mineralized bone-like tissue.</p><p><b>RESULTS</b>Compared with the cells of control group, 3H-thymidine incorporation into TE85 cells was significantly increased (85.65%, 93.42% and 106.58%, respectively) and 45Ca uptake was increased (101.35%, 130.9% and 169.5% respectively), after treated with E2 (0.1, 1.0, 10 nmol.L-1) for 14 days. The stained area of Alizarin red S in E2 treated cells was also increased obviously. ICI182,780, a specific antagonist of estrogen receptor, was shown to partly inhibit E2 induced actions with the inhibition ratio of 19.6% or 37.28% in both experiments of 3H-TdR and 45Ca uptake on the condition of E2 (1.0 nmol.L-1).</p><p><b>CONCLUSION</b>E2 was found to increase the mineralized bone-like tissue by enhancement of cell proliferation and promotion of calcium uptake, which were in favor of bone formation. These actions may be partly mediated by estrogen receptor.</p>