ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical effects of surgical treatment for open dislocation of talus.</p><p><b>METHODS</b>From June 2001 to July 2008,the complete data of 11 patients with open dislocations of talus were retrospectively analyzed, including 8 males and 3 females with an average age of 39.5 years (ranged 19 to 52). According to Gustilo typing, type I was in 2 cases, type II in 6 cases, type III A in 2 cases, type III B in 1 case. Five cases were tibial astragaloid joint dislocation in which 3 cases associated with subtalar joint dislocation, 4 cases were subtalar joint dislocation and 2 cases were total dislocation of talus. Among them, 8 dislocations associated with talus fractures. All patients were treated with debridement, open reduction, internal fixation with K-wires or screws and external fixation with plaster or external fixator within 8 hours after injury. External fixations were removed at 6 weeks after operation. Partial weight bearing was permitted only when X-rays indicated bony healing. Clinical effects were evaluated according to AOFAS system and X-ray films during follow-up.</p><p><b>RESULTS</b>The mean time of follow-up was 13.8 months(ranged 10 to 15 months). Eight patients with fractures obtained bone healing in 4-7 months with an average of 4.3 months. No infection of wound or deep tissue was found. At final follow-up, talus necrosis was in 2 cases and traumatic arthritis was in 2 cases. The AOFAS score was 71.3 +/- 8.6, among the total, the pain, function, alignment was respectively (32.4 +/- 7.1), (31.0 +/- 15.7), (7.6 +/- 2.3) scores.</p><p><b>CONCLUSION</b>Complete debridement may avoid infection in treating open dislocation of talus, early reduction and fixation is a key point during treatment.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Follow-Up Studies , Joint Dislocations , Diagnostic Imaging , General Surgery , Talus , Wounds and Injuries , General Surgery , Tomography, X-Ray ComputedABSTRACT
Objective: To observe polyethylenimine-mediated BMP-7 gene transfection in promoting fracture healing in elderly rats. Methods: Male SD rats (20-month-old) were randomly divided into 3 groups: group A received BMP-7 gene therapy mediated by polyehtylenimine, group B was treated with normal saline and group C was treated with BMP-7 plasmid without polyethylenimine. Right femoral shaft fracture model was established in all rats. Animals in group A received transdermal injection of pcDNA3. 1-BMP-7/PET; those in group B and C received the same volume of normal saline and pcDNA3. 1-BMP-7, respectively. X-ray photography, histological observation (H-E staining), immunohistochemical staining of collagen type I, biomechanical and bone mineral density test were employed to assess the healing of fracture 2, 4, and 8 weeks after treatment. Results: The results of X ray and H-E staining showed no fracture healing in the 3 groups during the 8th week after fracture; however, the growth of coloboma in group A was better than that of the other 2 groups, with partial bone union between the fracture ends. Staining of collagen type I showed deeper, wider staining in group A compared with the other 2 group. Anti-bending intensity and bone mineral density tests showed that the parameters in group A were better than those of the other 2 groups (P<0.05 or 0.01). Conclusion: Polyethylenimine-mediated hBMP-7 gene transfer can effectively promote fracture healing in elderly rats.