ABSTRACT
BACKGROUND: Internal fixation with cannulated screws is the most commonly used treatment for femoral neck fracture, but some patients may have the phenomenon of femoral neck shortening after surgery, and even cause the occurrence of postoperative dysfunction of the hip joint. OBJECTIVE: To investigate the incidence, clinical features, prognosis and influencing factors of femoral neck shortening after internal fixation of femoral neck fracture. METHODS: One hundred and eleven cases of femoral neck fracture treated by cannulated screw internal fixation at three orthopedic hospitals in Chengdu from January 2012 to March 2017 were retrospectively analyzed. All patients signed the informed consents and the study was approved by the ethics committee of the hospital. Femoral neck shortening was as the prognostic indicator. The incidence, occurrence time and main clinical characteristics of femoral neck shortening after surgery were recorded. Univariate chi-square test was used to analyze the correlation between sex, age, Garden type, Garden index, bone mineral density T value, Singh index, time from injury to operation, weight-bearing time and the femoral neck shortening after surgery. Statistically significant factors were included in the multivariate Logistic regression model. RESULTS AND CONCLUSION: (1) The incidence of femoral neck shortening was 48.6% (54/111), with 31.5% (35/111) of 10-19 mm shortening and 5.4% (6/111) of ≥ 20 mm shortening. (2) The occurrence time of femoral neck shortening was mainly within 6 months after surgery, accounting for 76%. (3) The clinical manifestations of the femoral neck shortening mainly included pain during weight-bearing, dysfunction of hip movement and claudication. The analysis results showed that the moderate pain (67%) was dominant in the shortening group, and no pain/mild pain (86%) was dominant in the non-shortening group; the incidence of hip motion limitation in the shortening group was higher than that in the non-shortening group (68% vs. 21%); and the incidence of claudication in the shortening group was higher than that in the non-shortening group (61% vs. 18%); the differences were significant (all P < 0.05). (4) Univariate and multivariate Logistic regression analysis showed that Garden classification of fracture was type III and IV, Garden index was grade III and IV, bone mineral density T value ≤ -2.5, weight-bearing time ≤ 2 months were independent risk factors for femoral neck shortening after reduction and internal fixation of femoral neck fracture. Therefore, there is a high risk of femoral neck shortening after internal fixation with cannulated nails for femoral neck fractures, which mainly occurs within 6 months after surgery.
ABSTRACT
Objective The mechanism of inhibition of the proliferation and migration of osteosarcoma cells by miR-646 was investigated.Methods The effects of miR-646 on the proliferation of U2OS cells were detected by MTT assay.The effects of miR-646 on U2OS cell migration were analyzed by Tmnswell assay.MIRDB was used to predict the binding sites of miR-646 and epidermal growth factor receptor (EGFR),which were confirmed in a luciferase reporter assay.Western blotting was conducted to detect the effect of miR-646 on the EGFR pathway.Results The MTT test showed that transfection of miR-646 significantly inhibited U2OS cell proliferation;the 24 h inhibition rate was 21.76％± 1.05％.In contrast,the 24 h promotion was 18.89％± 0.81％.Transwell experiments showed that miR-646 inhibited the migration of osteosarcoma U2OS cells.MIRDB predicted that miR-646 bound in the 3'-untranslated region of EGFR,and luciferase reporter gene experiments showed that miR-646 directly acted on EGFR.Western blotting experiments demonstrated that miR-646 inhibited the proliferation and migration of U2OS cells to some extent by inhibiting the EGFR pathway.Conclusion miR-646 can inhibit the proliferation and migration of osteosarcoma cells by inhibiting the EGFR pathway.