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BACKGROUND:Screw fixation of the fractured vertebral body can share the stress of implant, increase fixing strength, and help to maintain the stability of late fracture. However, whether it can assist reduction using fracture vertebral screw, but no relevant clinical reports were found at present. OBJECTIVE:To explore the effectiveness of self-designed screw-assisted reduction of fractured vertebrae. METHODS:161 cases of thoracolumbar fracture who had been hospitalized between June 2001 and June 2009 were enrol ed in this study, including 101 males and 60 females, at the age of 22-67 years, averagely 36 years. By Denis classification, 64 cases affected burst fractures and 97 flexion-compression fractures. Fracture levels involved T11 (9 cases), T12 (63 cases), L1 (74 cases) and L2 (15 cases). The self-designed method of reduction assisted with screw insertion was used. The efficacy of this reduction method was evaluated by operation time, intraoperative bleeding, fracture union time, height ratio of anterior borders of injured and normal vertebrae, sagittal Cobb’s angle, and reduction of fragments. RESULTS AND CONCLUSION:The operation time ranged from 60 to 150 minutes, averaging 80 minutes. The intraoperative bleeding ranged from 67 to 750 mL, averaging 98 mL. The fol ow-up time ranged from 16 to 42 months in 161 patients. Fracture union time ranged from 10 to 18 weeks, averaging 12.6 weeks. The ratio of anterior heights and sagittal Cobb’s angle of fractured vertebrae were significantly improved from (54.39±9.60)%and (22.55±7.90)° respectively preoperati on to (82.80±6.63)%and (8.91°±5.85)° 12 months postoperation (P<0.05). The size of spinal canal was increased by (46.5±2.6)%postoperatively. CT scan revealed satisfactory fragment reduction and no deep infection appeared. These findings suggest that our self-designed screw-assisted reduction of the fractured vertebrae can improve the reduction quality in the treatment of thoracolumbar fractures.
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Objective To explore clinical and radiographic outcomes of unstable distal clavicle fractures (Neer ⅡB) fixed with lateral clavicle anatomic locking compression plate (LCP).Methods Between January 2009 and October 2010,eleven consecutive patients with unstable fractures of the distal clavicle (Neer ⅡB) were treated using lateral clavicle anatomic LCP.There were 9 men and 2 women,with the mean age of 37.2 years (range,23-43 years).The right shoulder was involved in 6 patients and the left in 5 patients.The interval between injuries to operation was 24-72 h (mean,48 h).After fracture reduction,the plate was place on superior of the distal clavicle.According to the distal fragment length,3 to 6 locking screws were carefully inserted,3 locking screws were used to fix proximal fractures.Coracoclavicular ligament was not repaired.Functional recovery of the shoulder joint was assessed using the American Shoulder and Elbow Surgeons (ASES) rating scale score.Plain radiographs of clavicles were used to assess bony union.Results All the patients were followed up for 9 to 12 months (mean,10.3 months).Solid bony union was eventually achieved in all patients.The mean ASES scores were 89.1 (range,84-91) on the injured side versus 96.2 (range,94-100) on the contralateral side.No implant-related fracture,fixation failure and rotator cuff injury occurred.Conclusion Lateral clavicle anatomic LCP fixation in the treatment of distal clavicular fractures is a reliable and simple technique.
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Objective To study the effects of persistent atrial fibrillation (AF) on the expression of k1 opioid receptor and change of ultrastructure in heart atrium.Methods The mRNA and protein expressions of κ1 receptor in atrial tissue were detected with RT-PCR and immunochemistry,respectively,in 24 patients with AF and 24 patients with sinus rhythm (SR).Mitochondria were analyzed in the atrial tissue by electron microscopy in 4 patients with AF and 4cases with SR.Results The κ1 receptor mRNA in patients with AF was lower than in patients with SR (262±20 vs.196± 11,P＜0.05),and amount of protein expression was also deduced (1261±90vs.2325± 131,P＜0.05).Mitochondria size was decreased in persistent AF compared with SR[(1.0±0.2) μm vs.(0.8±0.2) μm,P＜0.05].Conclusions The decrease of k1 receptor expression suggests reduction of atrial protective capacity in persistent AF,combining with remodeling of ultrastructure.
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[Objective]To study the effects of Cable-Pin system used as a treatment alternative for patellar fractures.[Method]Thirty-five cases of patellar fracture were operated with the Cable-Pin system from October 2005 to May 2007.Their diagnosis were 19 transverse close ractures and 16 comminuted of patella.There were 21 males and 14 females.Their ages ranged from 21 to 75 years old.After open reduction,the author used a drill bit vertically through the patella in a superior direction,drilled the threaded portion of the pin across the fracture site,inserted a second Cable Pin through the second hole in a similar manner.A horizontally directed drill hole anterior to the pins was created in the superior pole of the patella.The two cables were crossed in a fighre eight over the an-terior surface of the patella.The Crimper Tensioning Handle was,the cable carefully,the handles of the crimper were squeezed until the crimp was fully crimped.[Result]The 35 patients were followed up for 12 to 18 months(mean 13.2 m).Fractures healed in all the cases without such complications as loosening of screw and cable loop,loss of reduction or irritation to soft tissue.Restoration of the knee joint motion was excellent in 32 cases and good in 3 cases according to Bostman score system.[Conclusion]Cable-Pin system as a new option for the treatment of patella fracture,can result in reliable fixation and low rate of complications.
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[Objective]To investigation the relavant genes to the pathogenesis and metastasis of osteosarcoma,and to discuss the significance of gene expression in the pathogenesis and metastasis of osteosarcoma. [Method]Two well-known ATCC osteosarcoma cell lines and an osteoblastic cell line were collected.After the total RNA was extracted,the finally synthesized biotinylated cRNAs were hybridized to SBC arrays.After the design and synthethesis of the primers,four of the differentially expressed genes were then chosen at random to further confirm the array results using the SYBR Green real-time RT-PCR method in freshly collected osteosarcoma specimens and the cell lines.The data analysis depended on the ABI Prism 7300 system.[Result]By an entrance limit of ≥2.0 or ≤0.5,189 up-regulated and 84 dowm-regulated genes which were considerable differentially expressed in the two osteosarcoma cell lines compared with the osteoblastic cell line hfob1.19 were finally detected.Many of the genes were first reported to be related to the pathogenesis of osteosarcoma.The array results were further confirmed by the real-time RT-PCR.[Conclusion]Many genes are involved in the pathogenesis and metastasis of osteosarcoma.It is helpful to apply gene array to find the laws of gene expression and to study the gene-gene interactional relationships in this tumor.
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[Objective]To analyze the result of mini-type T plate for treatment of Mason type-III radial head fracture.[Method]Seven cases of Mason type-Ⅲ radial head fractures,6 male and 1 female,including 2 cases with radial neck fractures,were treated by open reduction and mini-type T plate fixation associated with Kirscher wires.If necessary,bone graft was placed between radial head and neck.[Result]The patients were followed up for an average of 20.3 months(ranged from 14 to 39 months).All fractured radial heads were heal and no case appeared ischemic necrosis.According to the Brobrg and Morrey functional elbow index,the averaged score was 87 points and the outcome was excellent in 2 patients,good in 4,the excellent and good rate was 85.7%.[Conclusion]Treatment of Mason type-Ⅲ radial head fractures by open reduction,mini type T plate fixation assocated with Kerscher's wire and autogenous bone graft showed a high union rate of fracture and satisfactory joint function but no ischemic necrosis with the advantages of reservation of radial head and decreasing the rate of re-section and prosthesis replacement.Further observation should be taken to get more clinical cases number.