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<p><b>OBJECTIVE</b>To study the clinical effects of the unilateral external fixator combined with limited internal fixation such as cannulated lag screws for the treatment of intra-articular calcaneal fractures.</p><p><b>METHODS</b>From May 2007 to February 2012,52 patients (58 feet) with intraarticular calcaneal fractures were treated with unilateral external fixator and limited internal fixation such as lag screws. Forty-five patients (51 feet) were male,7 patients (7 feet) were female,ranging in age from 18 to 64 years,averaged 36.5 years. Time from injury to surgery was 4 to 13 (6.2 +/- 0.8) days. According to Sanders classification, there were 36 cases (40 feet) with type II fractures, 13 cases (15 feet) with type III fractures, 3 cases (3 feet) with type IV fractures. All patients were examed with X-ray and CT. Böhler angle, Gissane angle, length, width, height were measured on the radiographs, respectively. The function of the feet was assessed by the Maryland grading system.</p><p><b>RESULTS</b>Fifty-one patients(57 feet) were followed up for 5 to 16 months,with an average of 7.2 months. Calcaneal Böhler angle increased from (12.65 +/- 5.32) degrees preoperatively to (30.63 +/- 4.28) degrees postoperatively. The calcaneal Gissane angle decreased from (129.87 +/- 6.25) degrees preoperatively to (122.11 +/- 4.89) degrees postoperatively. The calcaneal length increased from (64.5 +/- 7.1) mm preoperatively to (71.3 +/- 5.7) mm postoperatively. The calcaneal width decreased from (34.6 +/- 5.7) mm preoperatively to (28.2 +/- 6.1) mm postoperatively. The calcaneal height increased from (30.2 +/- 5.2) mm preoperatively to (39.3 +/- 6.4) mm postoperatively. All of the comparison between preoperative and postoperative measurements revealed statistically significant (P < 0.05). The length,width, height, Böhler angle and Gissane angle were improved significantly (P < 0.05). According to the Maryland grading system, the result was excellent in 20 feet, good in 31 feet, fair in 4 feet, pour in 2 feet,excellent and good rate was 89.5%. Three feet with wound infection or flap necrosis were healed after wound debridement and dressing exchange.</p><p><b>CONCLUSION</b>The unilateral external fixation combined with limited internal fixation is a satisfactory treatment for intra-articular calcaneal fractures in short term with less damage, few complications and good functional recovery.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Bone Screws , Calcaneus , Wounds and Injuries , General Surgery , External Fixators , Fracture Fixation , Methods , Fracture Fixation, Internal , Intra-Articular Fractures , General Surgery , Treatment OutcomeABSTRACT
P13-OMP (29.1). P13-OMP and OMP68 group challenged with P13 and P11 can be efectivly protected; P13-WCB group challenged with P13 and P11 can not be efectivly protected; the control group were died out. The P13-OMP and OMP68 of Bordetella bronchiseptica has good immunogenicity and protection, so the results of this study lay good theoretical foundation for OMP subunit vaccine.
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Objective: To prepare and evaluate the effectiveness of chitosan-carboxymethylcellulose membrane in preventing postoperative intestinal adhesion. Methods: Chitosan-carboxymethylcellulose membrane was prepared with 1:1 ratio of chitosan and carboxymethylcellulose. Glutaraldehyde and ammonium aluminium sulfate were used for cross-linkage, glycerin for enhancing plasticity; and then the product was dried. The membrane was observed with scanning electron microscopy (SEM) and its tensile strength and breaking elongation were measured. Forty-eight SD rats with ileum injury were randomly divided into A, B and C groups (n=16). During operation, the injury in group A was treated with chitosan-carboxymethylcellulose membrane, in group B with chitosan membrane, and in group C without treatment (control group). The adhesion was observed on the 14th postoperative day. Results: The tensile strength of chitosan-carboxymethylcellulose membrane was 20 MPa and the breaking elongation was 65%. SEM showed that the morphology of the membrane had crossed fibroid structures and irregular pores. The severity of adhesion in group A and B was significantly lower than that in group C (P<0.01). Milder inflammatory changes and less fibrous proliferation were found in group A and B compared with those in group C. Epithelia rehabilitated better in group A than in group B, and the proliferation of fibroblast was not significant under electron microscope. In group C, epithelia rehabilitated slowly and fibroblasts excreted collagen actively. Conclusion: Chitosan-carboxymethylcellulose membrane is feasible for suturing during operation and is effective in reducing intestinal adhesion and it is superior to chitosan membrane.
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Objective: To investigate the effect of carboxymethylchitosan on autocrine growth factor and morphology of fibroblasts cultured in vitro, so as to discuss the possible mechanism by which carboxymethylchitosan alleviates overheating and prevents adhesion in wound healing. Methods: Fibroblasts were cultured in vitro. Fibroblasts of passage 4-6 were treated with different concentrations of carboxymethylchitosan (0.01,0.1,1.0 and 10 mg/ml) for 4 days or with 0.1 mg/ml carboxymethylchitosan for 1, 2, 3, 4, 5, and 6 days. The levels of autocrine transforming growth factor-β1 (TGF-β 1) and epidermal growth factor (EGF) of fibroblasts were determined by ELISA and radioimmunoassay. The fibroblastic morphology was detected by transmission electron microscopy (TEM) and microscope after fibroblasts were treated with different strategies. Results: Carboxymethylchitosan (≥ 0.1 mg/ml) inhibited autocrine TGF-β1 of fibroblast in a time- and concentration dependent manner (P0.05). Carboxymethylchitosan (≥ 0.1 mg/ml) also inhibited the proliferation of fibroblasts and caused their ultrastructural changes. Conclusion: Carboxymethylchitosan (≥0.1 mg/ml) can inhibit fibroblasts proliferation and reduce tissue adhesion, possibly through altering fibroblast ultrastructure and selectively inhibiting secretion of TGF-β1.
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Objective:To study the effect of nerve growth factor(NGF)on bone fracture healing of inflicted T_(10)spinal cord injury(SCI)complicated with tibia fracture in rats.Methods:Totally 120 rats were randomly divided into tihia fracture group (F group,n=40),T_(10)SCI+tibia fracture group(FS group,n=40),and T_(10)SCI+tibia fracture+NGF group(FSN group,n=40).Four weeks later,the fracture sites in the 3 groups were subjected to CT scanning;the maximum transverse diameter of the fracture ends and the gray scales of non-osseous area were measured;the changes of biomechanics property of the fracture ends were determined by three-point bending test;the bone morphometry,bone density,and histomorphology of callus were determined;the expression of OCN was detected by immunohistochemical method;the osteoblast ultrastructure was observed by TEM and the expression ofⅠ,Ⅱtype collagen were examined by Western blotting.Results:The maximum transverse diameter of F group was less than those of FS group(P