ABSTRACT
BACKGROUND: Different pretreatments of the tendon allograft for repairing hand tendon defect due to traumatic injuries have received much attention in the study of tissue engineering for hand surgeries.OBJECTIVE:To explore the characteristics of deep-frozen glutaraldehyde-treated tendon allograft for repairing hand tendon defect.DESIGN: A self-controlled study.SETTING:Ward of Orthopedic Department, Huizhou People's Central Hospital.PARTICIPANTS:Fifteen patients (aged 20-35 years) with 17 defected tendons were hospitalized in the Department of Orthopedics of Huizhou People's Central Hospital between January 1997 and August 2001. Among the 17 defected tendons, 8 were extensor tendons and 9 flexor tendons,with the length of defects varying from 2 to 9 cm.METHODS:The allogenic tendon grafts were obtained from young donors died in accidents or non-replantable amputated limbs due to traumatic injuries with informed consent obtained from the donors or their family members. These grafts were stored at -80 ℃ and immersed in 3.5 g/L glutaraldehyde solution before transplantation. Surgical operation was conducted following standard microsurgical procedures. According to the assessment criteria for total rang of motion (ROM) recommended by International Hand Surgery Association, the outcome of the surgically repaired hands was graded as excellent, good, acceptable and poor.MAIN OUTCOME MEASURES:Total ROM of the digits and graft rejection.RESULTS:None of the 15 patients was lost for analysis. The follow-up lasted for 8 months, during which 4 transplanted tendons had excellent, 6good, 4 acceptable and 3 poor functions, with a total effective rate of 82.36% (14/17). Neither cortical hormone nor immunosuppressants were used in these cases and no acute graft rejection or rupture of the tendons occurred.CONCLUSION: The antigenicity of the tendon allografts can be lowered after deep freezing of the grafts at -80 ℃ with preoperative glutaraldehyde treatment, which also increases the strength and tenacity of the tendons and decreases the risk for infection. The treated grafts provide a good alternative for autologous tendon graft but the complication of tendon adhesion still awaits to be tackled.
ABSTRACT
Objective To verify the significance the Atlas Fixation (AF) for thoracolumbar vertebrae.Methods 61 patients with fracture of thoracolumbar spine were operated by AF internal fixation. And to evaluate the effectiveness of the AF by X ray and CT scans. Results The patients of Frankel's B～D were improved by 1～2 scroe after operation. There were no iatrogenic nerve root injury and broken screws. There no earlier period infection. 2 had peri-screws abscess after 6 months by operation. Conclusion Compared with other spinal posterior internal fixation, AF has better results in effectiveness and simplification.
ABSTRACT
【Objective】To compare different approaches and their effectiveness on the treatment of the femoral neck fracture in children,in order to provide a reliable and effective way for the treatment of the disease.【Methods】Clinical data of 21 cases with femoral neck fracture from 1983 to 1993 were analyzed retrospectively.【Results】21 cases were divided into three groups:① group Ⅰ:14 cases underwent closed reduction and internal fixation with multiple Kirscher′s pins or cannulate compression screws under C-arm X-ray monitor.Of the 14 cases,11 cases were healed,3 cases developed ischemic necrosis of femoral head;② group Ⅱ:4 cases was treated with skin traction and hip spica cast plaster fixation,3 cases was healed,1 case developed ischemic necrosis of femoral head;③ group Ⅲ:3 cases underwent opened reduction and internal fixation with multiple pins or cannulate compression screws,1 case was healed,2 cases developed ischemic necrosis of femoral head.【Conclusion】Closed reduction and multiple pins internal fixation under C-arm X-ray monitor may be the best choice of treatment of femoral neck fracture in children.