ABSTRACT
Objective To evaluate the effect of posteromedial combined with lateral surgical approach in treatment of trimalleolar factures.Methods The clinical data of 37 patients with trimalleolar factures underwent open reduction and internal fixation through posteromedial combined with lateral surgical approach were retrospectively ana-lyzed.There were 21 males and 16 females with average age of 55.0 years (ranged 35 -80).Complications such as infection,nonunion,fixation failures were observed.All patients were followed up at 6 months and 12 months after sur-gery and assessed functionally with American Orthopaedic Foot and Ankle Society Scores (AOFAS).After the 12 month follow up,the patients were also called for a radiological examination.Results Average follow -up time was 18.8 months (12 -27 months).All cases had no complications such as incision infection,skin necrosis,internal fixator loosening or rupture and bone nonunion.Using AOFAS,the scores were 82.9 and 89.7 respectively at the 6 month and 12 month follow up.The degree of arthrosis was grades Ⅰ in 2 ankles,Ⅱ in 1 ankle,and Ⅲ in 1 ankle according to Kellgren&Lawrence.Conclusion Posteromedial combined with lateral surgical approach for the treat-ment of trimalleolar factures has leaded to an satisfactory clinic outcomes.It is minimally invasive and has less compli-cations and cost.
ABSTRACT
BACKGROUND:Procolagen type 1 N-terminal propeptide (P1NP) and β-colagen special sequence(β-CrossLaps) are two bone metabolic markers that are closely related to osteoporosis. Combined detection of bone metabolic markers and bone mineral density is of clinical significance for the diagnosis of osteoporosis. Bone metabolic markers are ideal indicators to predict fractures, which can compensate for the lack of bone density test. OBJECTIVE:To introduce the application of bone metabolic markers in the monitoring of drug efficacy on the treatment of osteoporosis as wel as in the prediction of fracture risks in recent 20 years and to explore the clinical values of P1NP and β-CrossLaps to assess the therapeutic efficacy on osteoporosis and risks for osteoporotic fractures. METHODS:A computer-based search of CNKI and SCI databases were performed for relevant articles published from 2000 to 2014 using the keywords of “serum bone metabolic markers; osteoporosis; bone mineral density” in Chinese and English, respectively. Finaly, 44 articles meeting the inclusive criteria were reviewed. RESULTS AND CONCLUSION:This paper analyzes the source and detection mechanisms of P1NPand β-CrossLaps and then compares their advantages in the therapeutic effect assessment of osteoporosis. Serum bone metabolic markers cannot only reflect the dynamic changes of bone metabolism, but also have earlier changes than the bone mineral density. Both P1NPand β-CrossLaps are very important for assessing the early diagnosis of osteoporosis as wel as anti-osteoporosis drug efficacy.