Comparison of the efficacy between elastic intramedullary injection and autologous bone marrow blood injection in the treatment of bone cyst in children / 中国骨伤

OBJECTIVE@#To evaluate the efficacy of autogenous bone marrow injection and elastic intramedullary injection in the treatment of bone cyst in children.@*METHODS@#From January 2012 to December 2016, 56 children with simple bone cyst were divided into two groups: autogenous bone marrow blood injection group and elastic intramedullary needle group. There were 28 cases in the autogenous bone marrow blood injection group, 16 boys and 12 girls, aged (7.7±1.9) years old, 10 cases of proximal humerus, 8 cases of proximal femur, 6 cases of proximal tibia and 4 cases of femoral shaft. In the elastic intramedullary needle group, there were 28 cases, 18 boys and 10 girls, aged(7.5±2.2) years old, 11 cases of proximal humerus, 7 cases of proximal femur, 5 cases of proximal tibia, 4 cases of femoral shaft and 1 case of distal femur. The treatment effect was evaluated by Capanna standard.@*RESULTS@#All the patients were followed up, including 17 to 35(25.6±4.2) months in the elastic intramedullary needle group and 19 to 35(27.4±4.8) months in the autogenous marrow blood injection group. According to Capanna's evaluation standard of bone cyst, 27 patients in the elastic intramedullary needle group were treated effectively(25 patients cured, 2 patients healed but some remained lesions), 1 patients recurred, 0 patient had no response to treatment; 18 patients in the autogenous bone marrow blood injection group were treated effectively(13 patients cured, 5 patients healed but some remained lesions), 8 patients of cyst recurred, 2 patients had no response to treatment; the difference between the two groups was statistically significant(<0.01). The overall cure time was calculated by the follow-up of 25 cases in the elastic intramedullary injection group and 13 cases in the autogenous marrow blood injection group. The cure time was(20.2±3.5) months in the elastic intramedullary injection group and(27.7±4.9) months in the autogenous marrow blood injection group. The difference was statistically significant(<0.05).@*CONCLUSIONS@#For the treatment of bone cyst in children, the therapeutic effect of elastic intramedullary needle is better than that of autogenous bone marrow blood injection, and the cure time is shorter.

Treatment of long bone cyst in children by autologous bone marrow blood injection and elastic intramedullary needle / 中国骨伤

OBJECTIVE@#To observe the clinical effect of autologous bone marrow blood injection combined with elastic intramedullary needle implantation in the treatment of long bone cyst in children.@*METHODS@#From January 2010 to December 2015, 29 children with long bone cyst were treated with autologous bone marrow blood injection combined with elastic intramedullary nail implantation, including 22 males and 7 females, aged 2 to 12 years old with an average age of 7.7 years old, and the course of disease was 12 to 84 months. Among them, 17 cases were proximal humerus, 9 cases were proximal femur, 2 cases were distal femur and 1 case was proximal ulna. All children with bone cyst underwent preoperative X-ray examination and CT or MRI examination if necessary. After definite diagnosis, bone marrow blood injection combined with elastic intramedullary needle support and drainage were used as treatment methods. After operation, multiple X-ray examination and follow-up were carried out. The curative effect was evaluated with Capanna bone cyst treatment evaluation criteria.@*RESULTS@#Twenty-seven of 29 children were followed up for 12 to 60 months with an average of 31.8 months. According to the evaluation criteria of Capanna bone cyst, 26 cases were cured and 1 case was partially healed with residual lesions.@*CONCLUSIONS@#Autologous bone marrow blood injection combined with elastic intramedullary needle has the characteristics of definite curative effect, high cure rate, fewer complications and objectively controllable treatment process for simple long bone cyst in children.

Treatment of clavicular fractures using intramedullary nailing or K-wire versus plating fixation: a meta-analysis / 中国骨伤

<p><b>OBJECTIVE</b>TFo compare the efficacy and complications rate of intramedullary (IM) nailing or K-wire versus plating fixation for clavicular fractures.</p><p><b>METHODS</b>Pubmed, Embase, Cochrane Library databases, CNKI, VIP and Wangfang databases were searched to find all randomized or quasi-randomized controlled trials of clavicle fractures using plating versus IM nailing or K-wire. The methodologic quality of the studies was assessed. After independent study selection by 2 authors ,data were collected and extracted independently. Outcomes of postoperative shoulder functional measurement, the efficacy and information of the operation and complications rate were meta-analyzed using RevMan 5 software.</p><p><b>RESULTS</b>Nine hundreds and seventy-six patients in 10 randomized controlled trials (RCTs) and 3 quasi-RCTs were involved in the meta-analysis,of which 5 studies compared the K-wire and the plating fixations and 8 studies compared the IM nailing and the plating fixations. The overall odds ratio(OR) (with 95% CI) of the operation efficacy for K-wire versus the plating was 3.79 (1.93, 7.46). The overall weighted mean difference (with 95% CI) of Constant Shoulder score for plating versus IM fixation was -1.39 (-3.43, 0.65) in 6 studies. The overall OR of the plating versus IM nailing was 9.34(2.70, 32.32) for the overall major complications in 5 studies and 5.04 (1.52,16.77) for the revision rate in 5 studies.</p><p><b>CONCLUSION</b>The current limited evidences suggested that the IM fixation could reduce the incidences of the overall major complications and the revision surgery, while the post-operative efficacy of the plating was superior to the K-wire. More high quality RCTs are still needed in the future.</p>