Progress on diagnosis and treatment of the terrible triad of elbow joint / 中国骨伤

The terrible triad of elbow is a kind of complex elbow fracture dislocation, after reduction, it should get a concentric circles joint reduction and elbow stability, if radial and coronoid process fractures is less piece, the conservative treatment can be performed, but regularly follow up is mandatory. If surgical treatment was chosen, radial head fractures and the lateral collateral ligament complex must be repaired. Single lateral approach can be used and also can be combined with anteromedial approach in surgery. Some problems are still controversial in the treatment of coronoid process fracture with Morry type I and type II, such as fixation or not, whether additional external fixation and repair of the medial collateral ligament injury at the same time.

Clinical effect of one-stage arthroscopically assisted repair and reconstruction for posterolateral dislocation of knee joint with multiple ligament injuries / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy and repair of the injured posteromedial complex structure of the knee joint in the treatment of posterolateral knee dislocation with multiple ligament injuries.</p><p><b>METHODS</b>From March 2008 to August 2012,22 patients (16 males and 6 females, ranging in age from 20 to 53 years old, with an average of 30.5 years old) with posterolateral dislocation of the knee were treated with primary reconstruction of ACL and PCL, combined with the repair of injuries in the posteromedial complex and soft-tissue. Eight patients had injuries caused by sports,5 patients road accidents and 9 patients falling down. The ACL was reconstructed using the gracilis and semitendinosus tendons. The PCL was reconstructed using LARS artificial ligaments (14 cases), or gracilis and semitendinosus tendons (8 cases). Suture repair was performed in 17 patients with posteromedial ligament injuries,and self-semitendinosus strengthening operations were performed in 5 patients. Continuouspassive montion (CPM) and active exercises were executed after operation at early stage. The IKDC and Lysholm system were used to evaluate therapeutic effects.</p><p><b>RESULTS</b>All the patients were regularly followed up, and the duration ranged from 11 to 56 months (averaged, 39 months). According to the IKDC scale,9 patients got a grade A result, 10 got a grade B result, and 3 got a grade C result. The IKDC subject score was 89.6±3.1 and the Lysholm scores was 90.7±1.8 at the latest follow-up, which were both better than those before operation.</p><p><b>CONCLUSION</b>Reconstructing the ACL and PCL and repairing injured posteromedial complex of the knee followed by an active rehabilitation is an effective method to treat posterolateral knee dislocation.</p>

Effect of extracellular ATP on the expression of MAP-2 and the recovery of motor function after spinal cord injury in rats / 中华创伤杂志

Objective To investigate the effects of extracellular ATP on the expression of(Mi- crotubule associated proteins MAP-2)and the recovery of motor function after spinal cord injury in rats. Methods Six rats were selected randomly from 66 adult healthy Wistar rats as the normal control group,the rest animals were divided into two groups after contusion injury was performed by drop weight method with Allen impactor:Group A(ATP group)and Group B(control group),each group contained thirty rats.At days 1,3,7,14,and 28 after injury,the rats were killed,the expression of MAP-2 was detected with immunohistochemistry.The expression of MAP-2 in the adjacent area was quantitatively an- alyzed with a computer image analysis system.The recovery of motor function after spinal cord injury was assessed with improved Tarlov scores.Results The expression of MAP-2 was higher in Group A than in Group B after spinal cord injury in rats.Significant difference was revealed by the expression of MAP- 2 between the two groups at days 14 and 28 after injury(P

Effect of the intraperitoneal injection of ATP on denervated skeletal muscle atrophy and neurotrophic factor-3 in spinal cord motor neuron after brachial plexus injuries / 中华显微外科杂志

Objective To observe the influence of ATP protection after brachial plexus injuries. Methods A total of 80 female Wistar rats,weighting 280～300 g,were randomly divided into ATP and con- trol groups.The right C_5～T_1 nerve roots were transected and then the intraperitoneal injection of 4m[ of ATP or normal saline was given immediately and once daily to the rats,respectively.The rats were sacrificed on postoperative days 14,28 and 42 respectively.The C_5-T_1 segments of the spinal cord were harvested.NT-3 activity was measured by enzymo-histochemistry method.Four weeks and 6 weeks postoperatively,ultrastruc- ture of the denervated skeletal muscles was observed.Results Compared to the control group,the expres- sions of NT-3 was increased in the treated groups with ATP injection (P