ABSTRACT
Objective To investigate the therapeutic effects of nano-hydroxyapatite/polyamide 66/platelet-rich plasma com-pound(n-HA/PA66/PRP)on the recovery of rabbit femur bone defect.Methods 40 New Zealand rabbits were artificially made to be bone defect by resecting the 1 cm substantia ossea with periosteum of femur,and were divided into two groups averagely depen-ding on implanted materials:experimental group(n-HA/PA66/PRP),control group (n-HA/PA66).Every five rabbits were sacri-ficed on week 2,4,8,12,and the femur healing status was observed by X ray,histology,and immunohistochemistry.Results No rabbit was infected or died,no implantation objects dropped.Gross observation,X-ray result and histology results demonstrated that the experimental group began to have a new bone tissue at 2 weeks after the operation,with the extension of time,the experimental group new bone growth speed and the quantity was better than the control group.The Lane-Sandhu method X-ray score showed that the experimental group (6.80±2.05)points and the control group(4.20±1.30)points at 12 weeks after the operation,and there were significant differences between two groups(P 0.05).Conclusion PRP combined with n-HA/PA66 artificial bone could accel-erate the healing of bone defect,and the effect of repair of bone defect is better than that of n-HA/PA66 artificial bone in the early.
ABSTRACT
Objective To compare the clinical outcomes of transforaminal lumbar interbody fusion (TLIF) through Wiltse approach and posterior midline approach in the treatment of degenerative lumbar spondylolisthesis.Methods A total of 37 patients with degenerative lumbar spondylolisthesis were treated between March 2008 and March 2010,including 23 patients managed by TLIF via posterior midline approach ( posterior midline approach group) and 14 by TLIF via Wiltse approach ( Wiltse approach group).The Japanese Orthopaedic Association (JOA) score and visual ltanalogue scale (VAS) before and after operation,and the interbody fusion condition in both the Wiltse approach group and posterior midline approach group were reviewed and the clinical outcomes of both groups were compared.Results The follow-up lasted for 6-26 months ( mean,15.7 months),during which both groups had obvious relief in clinical symptoms like pain of waist and legs.X-ray photographs showed good spondylolisthesis reduction and interbody fusion,with no loosening or breakage of the internal fixators.The fusion rate of Wiltse approach group and posterior midline approach group at the last follow-up were 86％ and 87％,respectively.The operation time of Wiltse approach group and posterior midline approach group was ( 117.8 +25.6) minutes and ( 128.5 ± 38.7 ) minutes respectively ( P ＞ 0.05 ).The intra-operative blood loss of Wiltse approach group and posterior midline approach group was (203.5 ± 16.4) ml and (284.4 ±27.6) ml respectively (P ＜0.05).Both groups presented significant decrease of JOA score post-opera-tively (P ＜ 0.05).Also,the two groups sbowed significant difference concerning the VAS score in low back pain one week post-operatively (P ＜ 0.05),but no significant difference in terms of VAS score in leg pain at one week after operation (P＜0.05) and VAS score in pain of low back and legs at the final follow-up ( P ＞0.05).Conclusions In the management of lumbar spondylolisthesis,TLIF via Wiltse approach and via posterior midline approach can both achieve satisfactory interbody fusion rate and clinical outcomes,but the Wiltse approach results in relatively less intra-operative blood loss and faster postoperative recovery.
ABSTRACT
Objective To compare the effect of anterior and superior reconstruction plate internal fixation in treatment of middle clavicular fractures in the old patients.Methods Thirty-nine old patients with middle clavicular fractures received anterior and superior reconstruction plate internal fixation treatment,respectively.There were 19 males and 20 females at average age of 66.7 years.The operation time,intraoperative blood loss and healing time were observed and compared in two groups.According to the Constant scoring system,shoulder functional evaluation was made at half a year after operation and the latest follow-up.Results All the patients were followed up for 10-32 months (average 18.7 months).Of the two groups,there was no statistical significance in aspects of healing time and Constant score at half a year after operation and the latest follow-up ( P ＞0.05 ).The complication of superior reconstruction plate internal fixation group was significant higher than that of anterior reconstruction plate internal fixation group,while the anterior reconstruction plate internal fixation group had shorter operation time and less intraoperative blood loss in comparison with the superior reconstruction plate internal fixation group ( P ＜ 0.05).Conclusion As for the middle clavicular fractures in the old patients,both anterior and superior reconstruction plate internal fixation can obtain satisfactory curative effect.With shorter operation time,less intraoperative bleeding and less complications,anterior reconstruction plate internal fixation is a much reliable treatment for middle clavicle fractures in the old patients and deserves wider application.