ABSTRACT
Objective To investigate the potential predictors and treatment for secondary sexual dysfunction following pelvic fracture. Methods 184 patients were included in this study from multiple centers in Guangzhou city, to find the potential predictors for secondary sexual dysfunction following pelvic fracture. 76 patients were identified to be secondary sexual dysfunction, which were randomized into three treatment groups, who were given continuous low dose of tadalafil (5 mg/time)combined with oral sildenafil (50 mg/time), tadalafil (5 mg/time) only and sildenafil (50 mg/time) only respectively, and followed by evaluation of therapeutic effect according to IIEF-5 questionnaire and Sexual Encounter Profile (SEP) diaries to evaluate the effect. Results Risk factors including age and the type of pelvic fractures but not urethral injury was associated with the complication of secondary sexual dysfunction . After treatment for twelve weeks, the IIEF-5 score in A groups (18.1 ± 4.2) was significantly higher than that in B (16.4 ± 3.4) or C (16.6 ± 4.0) group (P<0.05). The positive rate of response to SEP2 and SEP3 in A group were 73.0% and 79.4% respectively, both of which were remarkably higher than those in B or C group (P < 0.05). Conclusion Secondary sexual dysfunction following pelvic fracture is associated with age and type of pelvic fractures. Continuous low dose of tadalafil (5 mg/time) combined with sildenafil (50 mg/time) provides superior effective treatment for secondary sexual dysfunction following pelvic fracture.
ABSTRACT
Objective To compare the stability effect of the fixation segment using the new test system based robotics to simulate the complex human movement at natural state about the three-level fixa-tion by using four, five or six pedicle screws in treatment of thoracolumbar burst fractures. Methods Six human cadaveric spines were dissected from T_(11)-L_3. The inferior half part of L_1 vertebral bodies and L_1-L_2 dises were resected to mimie an unstable L_1 burst fracture with loss of anterior column support. Specimens were tested in accordance with the following order:intact, 4,5 and 6 pedicle screws fixation at the three-level fixation. The range of motion (ROM) of the fixation segment (T_(11)-L_3) was measured with the six-freedom degree robotics system controlled by mixed force and displacement during flexion, exten-sion, lateral bending and axial torsion, when the stiffness was calculated. One-way statistieal analysis was used for analyzing the collected data. Results With increased number of screws, the ROM of the fixa-tion segment (T_(11)-L_3) was gradually decreased and the stiffness gradually increased. The ROM under ax-ial rotation of six and five screws group became smaller than four screws group (P < 0.05). The stiffness under axial rotation of six screws group was higher than four screws group (P < 0.05). There was no sta-tistical difference between five screws group and four screws group in regard of the stiffness in axial rota-tion (P > 0.05). There were no significant differences in ROM and stiffness under six different loading directions between six screws group and five screws group (P > 0.05). No statistical difference was observed for three fixation modes in aspects of ROMs and stiffness under flexion-extension or lateral ben-ding (P > 0.05). Conclusions Three-level fixation of burst fractures with five or six screws offers im-proved biomechanical stability compared with traditional four screws fixation. But the difference is insig-nificant between six and five screws fixations.