ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical effect of internal fixation with closed reduction and hollow compression screws for the treatment of femoral neck fracture in young and middle-aged patients.</p><p><b>METHODS</b>From June 2013 to December 2016, 33 young and middle-aged patients with femoral neck fractures were treated with hollow compression screws fixation including 17 males and 16 females with an average age of 38.5 years old ranged from 19 to 59 years old; 20 cases were on the left side and 13 cases on the right side;the time from injury to operation ranged from 2 to 5 days with an average of 3 days. According to Garden classification, 1 case were type I, 11 cases were type II, 18 cases were type III, 3 cases were type IV. During regular follow-up after operation, through the hip joint X-ray, the healing situation of bone and osteonecrosis were observed. The Harris score was used to evaluate the hip function of the final follow-up.</p><p><b>RESULTS</b>The operation time was from 30 to 50 minutes, the blood loss during operation was 20 to 70 ml. All patients were followed up for 8 to 42 months with an average of 24 months. At the final follow-up, the Harris score of hip joint was excellent in 18 cases, good in 10 cases, fair in 2 cases and poor in 3 cases. Among them, the pain scores were 40.61±5.08, function scores were 38.94±6.78, malformation scores were 3.88±0.69, motion range scores were 3.70±0.64 and the total scores were 87.12±11.98. Thirty cases achieved bone healing, the healing time was 4 to 12 months with an average of 7.5 months, 2 patients occurred with nonunion (Garden type IV), 1 patient with femoral head necrosis (Garden type IV). All patients had no postoperative infection, internal fixation loosening, refracture and other complications.</p><p><b>CONCLUSIONS</b>In treating the young and middle-aged patients with femoral neck fracture, closed reduction and hollow compression screw fixation has advantages of simple, stable fixation, less trauma, high rate of fracture healing, osteonecrosis of the femoral head with low risk and satisfactory clinical effect.</p>
ABSTRACT
AIM To study the effects and action mechnism of Xiaoding Ointment (Pyrolusite,Catechu,Rhei Radix et Rhizoma,etc.) on rabbits' fracture healing in terms of cyclooxygenase-2 (COX-2),prostaglandin E2 (PGE2),cyclic adenosine monophosphate (cAMP) expressions at different time points.METHODS One hundred and twenty-eight New Zealand white rabbits were randomly divided into blank group,model group,Qingpeng Ointment (Oxytropis Falcatae Herba,Rhei lhasaense Radix et Rhizoma,Terminalia chebula Fructus,etc.) group and Xiaoding Ointment group.All the other groups,except the blank group,were made with ulna 3 mm bone defect,after which external fixation was applied to both the blank group and the model group.On the 3rd,7th,14th and 28th days after the medications,eight rabbits randomly selected from various groups had their callus morphopathology changes observed under optical microscope,their callus tissue COX-2 mRNA expression levels were detected by realtime fluorescence quantitative polymerase chain reaction (qRT-PCR),and their callus tissue PGE2 and cAMP protein expressions were determined by immunohistochemistry.RESULTS Compared with the model group and the Qingpeng Ointment group,the Xiaoding Ointment group exhibited significantly better formation of callus and collagen fibers.The mRNA expression of COX-2,and the protein expressions of PGE2 and cAMP in the Xiaoding Ointment group were remarkably enhanced as revealed on the 7th and 14th days' postoperative check (P ＜ 0.05),and the peak values arrived around the 14th day after the operation.CONCLUSION Xiaoding Ointment's obvious effect on promoting fracture healing may associate with its impact on COX-2/PGE2/cAMP signaling pathway.
ABSTRACT
<p><b>OBJECTIVE</b>To observe the clinical effects of miniaturized metacarpus steel plate for the treatment of child epiphysis injury, and to analyse its clinical advantages in the child epiphysis injury.</p><p><b>METHODS</b>From June 2004 to May 2009, 85 children with epiphysis injury treated with miniaturized metacarpus steel plate included 52 boys and 33 girls with an average age of 6.6 years old ranging from 1 to 14 years. All the children suffered from just one part injury. There were 68 cases of upper limb injury, 19 of which were humerus epicondyle injury, 16 humerus head injury, 12 olecranon injury, 14 distal radius injury and 7 head of radius injury. The other 17 cases were lower limb injury, 12 of which were femur epicondyle injury and 5 tibia epicondyle injury.</p><p><b>RESULTS</b>All children obtained good intention,and no postoperative complications occurrenced. Eighty-one children were followed up for 6 months to 5 years (averaged 2.6 years). The results were evaluated at 4 weeks after the operation and showed that there were excellent in 44 cases, good in 21 cases, fair in 11 cases and poor in 9 cases.</p><p><b>CONCLUSION</b>Treatment of child epiphysis injury with miniaturized metacarpus steel plate can achieve perfect anatomical reduction in the early stage, protect the biological environment of the recovery. This treatment makes the postoperative joint functions and movements recovery nice, barely cause any bone malformation, and worth further clinical applications.</p>