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OBJECTIVE@#To explore the efficacy of a novel sternoclavicular hook-plate for treatment of proximal clavicle fracture with dislocation of sternoclavicular joint.@*METHODS@#Retrospective analysis of 13 cases of proximal clavicle fracture with dislocation of sternoclavicular joint treated with sternoclavicular hook-plate from June 2011 to January 2019 in our department. There were 9 males and 4 females, aged 26 to 78 years old, with an average age of (54.08±13.91) years old. All the patients had closed injuries without damage of blood vessels and nerves. The patient's operation time, intraoperative blood loss, hospital stay time, and postoperative complications were recorded. Fracture healing and reduction were evaluated according to X-ray and CT after operation. Constant-Murley score and Rockwood sternoclavicular joint score were used to evaluate limb function at 12 months after operation.@*RESULTS@#All the patients were treated with sternoclavicular hook-plate. The operation time ranged from 50 to 76 min, with a mean of (54.08±13.91) min. The intraoperative blood loss ranged from 20 to 56 ml, with a mean of (46.08±11.15) ml. The hospital stay time ranged from 6 to 14 d, with a mean of (8.31±2.32) d. X-ray and CT examination on the second day after operation showed that all fractures and dislocations were anatomically reduced, and shoulder joint function exercise was performed early. All patients were followed up, and the duration ranged from 12 to 24 months, with a mean of (16.77±4.63) months. The healing time ranged from 9 to 13 d, with a mean of (11.00±1.75) d;and the bone healing time ranged from 3 to 4 months, with a mean of (3.65±0.46) months. There were no complications such as infection, internal fixation failure and nerve injury. At 12 months follow-up, the constant Murley score ranged from 78 to 100, with a mean of 87.83± 11.26; and Rockwood score ranged from 9 to 15, with a mean of 13.70±1.85. Among them, 11 cases were excellent, 1 case was good, and 1 case was general.@*CONCLUSION@#The use of the novel sternoclavicular hook-plate for treatment of proximal clavicle fracture with dislocation of sternoclavicular joint is an effectively internal fixation with high safety, allowing early functional exercise for patients.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Bone Plates , Clavicle , Fracture Fixation, Internal , Fractures, Bone , Joint Dislocations , Retrospective Studies , Sternoclavicular Joint , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of a new type sternoclavicular hook plate fixation in treating unstable sternoclavicular joint dislocation and fracture.</p><p><b>METHODS</b>From June 2011 to December 2013, 32 patients with sternoclavicular joint dislocation and fracture were treated with a new type sternoclavicular hook plate fixation, including 24 males and 8 females with an average age of 42 years ranging from 25 to 76 years;12 patients were anterior dislocation, 5 pations were posterior dislocation, 10 patients were internal extremity of clavicle fracture and 5 patients were sternoclavicular joint dislocation combined with fracture. The anterior fracture dislocation of the sternoclavicular joint adopted standard sternoclavicular joint hook plate, and the posterior dislocation was at the distal end of the hook of the steel plate, that is, the front part of the handle of the breast was added with a nut and a gasket to prevent the re-dislocation after operation. The results were evaluated according to Rockwood score.</p><p><b>RESULTS</b>No complication happened in all patients. X-ray and CT showed that the dislocation and fracture of the sternoclavicular joint was well reduced and the plate was on right position. All patients were followed up for 6 to 24 months with an average of 10 months. At 6 to 3 months after operation, the fracture was healing without re-dislocation of the sternoclavicular joint, the medial end of the clavicle anatomical structure were restored, functional satisfaction, in which 9 patients with the swelling around sternoclavicular joint, but no pain and other symptoms. The total Rockwood score was 12.78±1.43; the results were excellent in 24 cases, good in 8 cases.</p><p><b>CONCLUSIONS</b>The use of the new type of locking hook plate for the treatment of unstable fracture of the sternoclavicular joint, internal fixation is reliable, high security, easy to operate, to provide a reliable method for the treatment of such trauma.</p>
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Objective To investigate the toxicities of methotrexate in the treatment of the children with acute lymphoblastic leukemia Method 28 children with acute lymphoblastic leukemia were randomly divided into two groups(A and B), they were treated with methotrexate 3.0 g/m 2 (n=16) and 5.0 g/m 2(n=12). The toxicities of two doses of methotrexate were observed. Results The main toxicities of methotrexate were marrow suppression,gastrointestinal reaction and liver damage. They were mostly mild.No statistically significant difference was found between group A and group B .Conclusion The toxicities of methotrexate are common and can be tolerated.
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<p><b>OBJECTIVE</b>To explore the causes of delayed diagnosis of the vertical unstable pelvic fractures in patients with multiple trauma so in order to minimize these incidence.</p><p><b>METHODS</b>A retrospective study was conducted in 176 patients with the vertical unstable pelvic fractures from January 2003 to December 2008. The classification of vertical unstable pelvic fractures was recorded. Medical data were compared and statistically analyzed to identify the incidence, and the contributing factors of the delayed diagnosis of the vertical unstable pelvic fractures. Of the 176 patients, 46 (26.1%) had delayed diagnosis of the vertical unstable pelvic fractures. There were 29 males and 17 females with an average age of 34 years old.</p><p><b>RESULTS</b>Of the factors contributing to 46 cases of delayed diagnosis, 41.3% (19/46) closely related to the evaluation by the doctors and were potentially avoidable, and 58.7% (27/46) were associated with the severity of the injuries.</p><p><b>CONCLUSION</b>The patients with multiple trauma had high incidence of delayed diagnosis of the vertical unstable pelvic fractures. The recognition of pelvic fractures, careful clinical assessments, and the awareness of the orthopedic doctors, emergency doctors and ICU doctors. Most of the delayed diagnosis of the vertical unstable pelvic fractures in patients with multiple trauma are potentially avoidable.</p>
Subject(s)
Adult , Female , Humans , Male , Delayed Diagnosis , Classification , Fractures, Bone , Diagnosis , Pelvic Bones , Wounds and Injuries , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To analyze the fenestration operation for treatment of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome.</p><p><b>METHODS</b>From July 2005 to February 2007, 52 cases of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome were treated by two methods. Among them, 24 cases were treated by fenestration operation for articular facet reduction, bone grafing, anatomical reconstruction of the acetabular parastyle with internal fixation, included 17 males and 7 females with an average age of (35.2 +/- 6.4) years old; the other 28 cases were treated only anatomical reconstruction of the acetabular parastyle with internal fixation, included 19 males and 9 females with an average age of (36.4 +/- 4.8) years old. All the patients were evaluated with modified d'Aubigne-Postel clinical evaluation standard.</p><p><b>RESULTS</b>All patients gained bone healing. There were only 1 patient occurenced femoral nerve injury and recovered 2 months later. There were no other complications. All patients were followed up from 12 to 51 months (averaged in 31.5 months). According to modified d'Aubigne-Postel clinical evaluation standard, there were statistic difference between the two groups of patients in pain, walking, range of motion and total score. In fenestration operation group, the results were excellent in 13 patients, good in 9, fair in 1, poor in 1; in parastyle reduction group,the results were excellent in 9 patients, good in 11, fair in 6, poor in 2 (u=0.613, P<0.05).</p><p><b>CONCLUSION</b>Fenestration operation for treatment of acetabular parastyle fracture combined with articular facet compression and collapse of acetabular top involving weight-bearing dome is a feasible method for the recovery of hip joint function.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Acetabulum , Wounds and Injuries , General Surgery , Fractures, Compression , General Surgery , Joints , Wounds and Injuries , General Surgery , Treatment Outcome , Weight-BearingABSTRACT
Objective To investigate the clinical outcomes of sternoclavicular hook plate in treatment of the anterior sternoclavicular joint dislocation. Methods A new device named sternoclavicular hook plate was devised by our team. Between May 2002 and Octorber 2009, 66 patients with sternoclavicular joint anterior dislocation were treated with the new device, among whom there were 47 males and 19 females,aged 21-68 years old (average, 32.6 years old). Twenty-one cases were caused by crush injury, 5 cases by falling and 40 cases by traffic accident. Anterior fracture-dislocation was found in 41 cases. According to the Allman system, there were 35 cases of type Ⅱ and 31 cases of type Ⅲ. Patients were evaluated with serial clinical and radiographic examinations. Rockwood score were used after the operation to assess the curative effect. Results The average operative time was 33 min (range, 20-48 min). The mean blood loss was 60 ml (range, 20-90 ml). There were no vascular or peripheral nerve injuries in the patients. All incisions healed smoothly. The X-ray and CT showed that the reduction of sternoclavicular joint and the location of internal fixation were satisfactory. All the 66 patients were followed up for 12-37 months (average, 17 months). There was no internal fixation failure, redislocation or other complications. The sternoclavicular hook plate was removed 12 months after operation. The mean Rockwood's score was 13.2 (8 to 15). There were excellent in 50cases, good in 15 cases, and fair in 1 case. Conclusion The sternoclavicular hook plate is a new, safe and liable technique for sternoclavicular fracture-dislocation. This new technique is helpful for early functional exercises.
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A 33-year-old male patient complained of presenting goiter on the low back area for 2 months. Pathological examinations of resected goiter suggested non-Hodgkin lymphoma and showed that T cells, immunoblasts, and hemogram were roughly normal, and 2% sarcoma cells could be found in bone marrow. Stage Ⅳ T-cell non-Hodgkin's lymphoma was diagnosed. Following 4 months of chemotherapy using CHOP protocol (cyclophosphamide, adriamycin, vincristine, and prednisone included), the patient underwent bone marrow activation and autologous peripheral blood stem cell transplantation in combination with recombinant interleukin-2 application in April 1998. The preprocessing was performed under MACC protocol (L-sarcolysinum, cytarabine, cyclophosphamide, and Iomustine included). Ten days after autologous stem cell transplantation, neutrophil concentration was > 0.5×109/L and sixteen days after transplantation, blood platelet concentration was > 50×109/L. Six days after transplantation, the patient exhibited fever, and E. Coli infection was confirmed through blood culture. After antibiotic treatment, body temperature recovered to normal, and fever disappeared. The patient had been followed-up for 10 years and 10 months. During the follow-up period, he lived a normal life and work.
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Objective: To study the effect of new photosensitizer Chlorophyl-derivative (CPD4) combined with Adriamycin on cell cycle and cell proliferation of MCF-7 breast cancer cell line and to investigate the mechanism of combination therapy. Methods: A new type of photosensitizer and traditional chemotherapy drug Adriamycin (ADM) were used to treat breast cancer cell line MCF-7. Flow cytometry was employed to detect apoptosis rate and cell cycle distribution in ADM group, group with photodynamic effect and the combined group. The influence of ADM on the mean fluorescence intensity and the changes in the mean fluorescence intensity after CPO4 (1.5μg/mL) treatment were analyzed. Results: The apoptosis rate of the combination group was higher than that in the other two groups, with statistical significance (P＜0.01). Photodynamic effect caused G_0/G_1 phase arrest in MCF-7 cells. Low concentration of ADM increased the number of G_2/M phase cells. The percentage of G_2/M phase cells was increased in the combination group. No significant difference was found in the mean fluorescence intensity between ADM pretreated MCF-7 cells for 24 hours and 48 hours and the control group (P＞0.05). Pretreatment of MCF-7 cells with ADM increased the volume of photosensitizer CPD4 into the cells. The mean fluorescence intensity at 2 hours after CPD4 incubation was the highest. Conclusion: ADM can increase the amount of CPD4 into the MCF-7 cells. Photodynamic therapy com-bined with Adriamycin has a synergistic effect on MCF-7 cells.
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<p><b>OBJECTIVE</b>To explore the different therapeutic effects of comminuted clavicular fracture with acromioclavicular external fixtatior and DCP internal fixation.</p><p><b>METHODS</b>There were 768 cases of comminuted clavicular fracture involved in the study. Among them, 528 patients (321 male and 207 female, aged from 15 to 82 years) treated with acromioclavicular external fixator, in which there were 165 cases of three parts fracture and 363 cases of more than three parts fracture; 240 patients (152 males and 88 females, aged from 17 to 64 years) treated with the internal fixation, in which there were 178 cases of three parts fracture and 62 cases of more than three parts fracture. The time between injury and treatment was 1.3 days (range, 2 h to 8 days). The results were evaluated according to Neer scoring system.</p><p><b>RESULTS</b>All the cases were followed up from 8 to 24 months. For treatment of fracture more than three parts, there was significant difference between acromioclavicular external fixation group and internal fixation group in nonunion rate (chi2=44.17, P<0.05) and in Neer scores (t=5.284, P<0.05).</p><p><b>CONCLUSION</b>Treatment with DCP internal fixation which matching the AO principles can obtain anatomic reduction, firm fixation and early functional exercise; however, treatment with self-designed acromioclavicular external fixator is an ideal therapeutic method as it has, early union of the fracture and good functional outcome with seldom complications.</p>