ABSTRACT
PURPOSE: The purpose of this study is to evaluate the results of tension band wiring and additional circumferential wiring in treatment of comminuted patella fractures. MATERIALS AND METHODS: A retrospective study of 67 patients with follow-up period longer than six months who underwent tension band wiring and additional circumferential wiring for comminuted patellar fracture from January 2004 to December 2012 was conducted. Analysis was based on radiological evaluation of bony union and articular surface displacement, and clinically by evaluating the postoperative function of the knee joint using the Levack scoring system. RESULTS: Only one case out of 67 (1.5%) showed nonunion without metal breakage while good bone union was achieved in all other cases. Excluding the nonunion case, range of motion was 90 degrees minimum, 135 maximum, 129 on average. Average displacement was less than 2 mm, and 64 out of 67 cases showed satisfactory outcome with excellent functional score according to the Levack scoring system. CONCLUSION: Tension band wiring and additional circumferential wiring technique for treatment of comminuted patella fractures can be considered as an effective treatment for achievement of good bone union and restoration of normal knee function.
Subject(s)
Humans , Follow-Up Studies , Fractures, Comminuted , Knee , Knee Joint , Patella , Range of Motion, Articular , Retrospective StudiesABSTRACT
PURPOSE: This study was conducted in order to demonstrate the radiologic and clinical results of using the Asian type gamma 3 nail in treatment of trochanteric fractures. MATERIALS AND METHODS: Patients underwent operations with gamma 3 nails between August 2010 and August 2012. For the radiologic evaluation, we analyzed bone quality, fracture pattern, reduction quality, union period, and position of lag screw (tip-apex distance, Cleveland index). For the clinical evaluation, we analyzed mobility score of Palmer and Parker and Jensen's functional score. RESULTS: The mean union was taken at 17.4 weeks (14-25 weeks). Two cases (4.3%) underwent reoperation due to cutting out of the hip screws. The clinical outcomes of Parker and Palmer's average mobility score changed from 7.3 to 5.8 (79%), Jensen's functional score was 1.3 to 1.8 (72%). CONCLUSION: We achieved excellent clinical and radiological outcomes; therefore, Asian type gamma 3 nail is effective in treatment of trochanteric fractures of the femur in Korea.
Subject(s)
Humans , Asian People , Femur , Hip , Hip Fractures , Korea , ReoperationABSTRACT
Keratinocyte-derived factors are involved in regulating the proliferation, differentiation or melanogenesis of melanocytes. To investigate the effects of keratinocyte-derived factors on the skin pigmentation, human melanocytes and keratinocytes were cultivated in the forms of pure melanocyte or keratinocyte culture system, co-culture system (melanocytes and keratinocytes were cultivated together in a vessel but they were separated with semipermeable membrane) or mixed culture system (melanocytes and keratinocytes were cultivated together in a vessel in mixed form). The authors studied the cellular features (dendritogenesis and area) and the tyrosinase activities and observed the electron microscopic structures for melanosome transfer. Melanocyte in co-culture system increased in the area (p.0.05) but not in the dendritogenesis compared with the melanocyte in pure culture system. The tyrosinase activities of co-culture system on the 2nd and 4th day revealed higher compared with the ones of the pure and mixed culture system (p.0.05). In the co-culture system, the tyrosinase activities were gradually decreased with the lapse of time and vice versa in the pure and mixed culture system. On the 6th day culture, all of the three melanocyte culture systems showed the same tyrosinase activities. In spite of high tyrosinase activities in the medium, there were no tyrosinase activities in keratinocytes with the co-culture system. In transmission electron microscopic findings, there were scant of melanosomes in keratinocytes with the co-culture and mixed culture systems. In conclusion, keratinocyte-derived factors modulate the activities and melanogenesis of melanocytes but there were no effects on melanosome transfer to keratinocytes.
Subject(s)
Humans , Coculture Techniques , Keratinocytes , Melanins , Melanocytes , Melanosomes , Monophenol Monooxygenase , Skin PigmentationABSTRACT
Estrogen and progesterone are thought to be responsible for the pigmentary changes in pregnancy and also melasma. To investigate the action mechanism of estrogen and progesterone on the facultative skin pigmentation, Human melanocytes and keratinocytes were cultivated in the forms of pure melanocyte culture, co-culture (melanocytes and keratinocytes were cultivated together in a vessel but they were separated with membrane) or mixed culture (melanocytes and keratinocytes were cultivated together in a vessel in mixed form). After 2 days of cultivation in the presence of hormones (estrogen, progesterone and melanocyte stimulating hormone), the author studied the cell proliferation, the cellular features (the number of dendrites, perimeter and area), and the tyrosinase activity of melanocytes. Progesterone or melanocyte stimulating hormone increased in both the cell growth and the tyrosinase activity in pure melanocyte culture but estrogen did not. However, mixed culture treated with estrogen lead to increases in the tyrosinase activity. Pure melanocyte culture treated with estrogen or progesterone increased in the cell perimeter and the area but not in the number of dendrites. Co-cultured melanocytes without hormones revealed more increases in the perimeter (p.0.01) and the area (p.0.01) even in the number of dendrites (p.0.01) compared to the pure cultured melanocytes treated with the hormones. It was postulated with these results that estrogen, progesterone and keratinocyte possibly induced hyperpigmentation of the skin via the keratinocytes stimulated by estrogen, via the proliferation of melanocytes induced by progesterone, and via the cellular features altered by keratinocytes.