ABSTRACT
Objective:To evaluate the clinical efficacy of fixation with TightRope plate combined with hollow screw in the minimally invasive surgery for fresh Neer type Ⅱ B distal clavicle fracture.Methods:From January 2014 to December 2018, 27 patients with fresh Neer type Ⅱ B distal clavicle fractures underwent minimally invasive surgery using TightRope plate and hollow screw for fixation. The distal clavicle fracture was repositioned, and then the medial and lateral margins of coracoid base were located by Kirschner wires. A 0.8 cm incision was made on the skin above the undamaged clavicle more than 1.0 cm from the innermost side of fracture line. Under the guidance of X-ray, after drilling needle and reaming on the clavicle and the coracoid base, the medial side of clavicle fracture was fixed by TightRope plate. After drilling needle obliquely from the anterior lateral margin to the posterior medial one at the distal clavicle, a hollow screw of 3.0 mm in diameter was used to fix the clavicle fracture.Results:All operations were successful. Patients were followed up from 12 to 24 months and bone union was achieved from 8 to 20 weeks. The range of motion of shoulder joint was nearly normal at about 8 weeks after operation. At the last follow-up, the curative effect was excellent in 25 cases and good in 2 cases according to Constant-Murley standard.Conclusion:The minimally invasive surgery with TightRope plate and hollow screw is effective for Neer type Ⅱ B distal clavicle fracture, with simple manipulation, less cosmetic defect, rapid function rehabilitation, and short hospital stay.
ABSTRACT
BACKGROUND:Osteoarthritis, a degenerative joint disease, is not only a result from the breakdown of joint cartilage and underlying bone, but also an imbalance of bone remodeling and crosstalk among tissues in the joints. OBJECTIVE: To review the effect of bone-cartilage crosstalk in the progression of osteoarthritis and its new treatment strategy. METHODS: A computer-based search of PubMed and CNKI databases was performed for relevant literatures about the relationship between the progress of osteoarthritis and the bone-cartilage crosstalk published from 2007 to 2017. The keywords were cartilage, interaction, osteoarthritis, pathogenesis, cytokines, signaling pathway in English and Chinese, respectively. The relationship between the progress of osteoarthritis and the bone-cartilage crosstalk was summarized in views of cytokines, signaling pathway, and new treatment strategy. RESULTS AND CONCLUSION: Totally 169 articles were retrieved, and finally 54 eligible papers were enrolled based on the inclusion and exclusion criteria. There is a close physical association between subchondral bone and cartilage, and the bone-cartilage interface is a functioning synergistic unit. Increased vascularization, micro-crack formation and abnormal bone remodeling may accelerate the molecules transporting from cartilage to bone in osteoarthritis. Therefore, the bone-cartilage crosstalk plays a pivotal role in the occurrence and development of osteoarthritis.