The comparative study of patients with severe polytrauma treated by damage control orthopedits in normal time and in earthquake / 中国骨伤

<p><b>OBJECTIVE</b>To compare the outcome of damage control in patients with severe polytrauma in normal time and in the earthquake of 2008 Sichuan China.</p><p><b>METHODS</b>In the retrospective study, 26 cases with severity polytrauma in peacetime and 24 cases with severe polytrauma who have mainly sustained in the earthquake of 2008 Sichuan China were involovd. The patients' demographics, the methods and effects of damage control were evaluated.</p><p><b>RESULTS</b>In the earthquake group, 24 cases succeeded in the rescuing life; among whom, 3 patients needed the further debridement and dermoplasty. In the normal time group, 26 cases succeeded in the rescuing life; among whom, 19 patients had returned to their former work and 3 patients needed the further treatment. There was no difference between two groups in therapeutic effects (P > 0.05).</p><p><b>CONCLUSION</b>Both in earthquake and in normal time, treating the severity polytrauma by damage control orthopedics can acquire satisfied effect.</p>

Testis homotransplantation: a report of 12 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of testis homotransplantation in the treatment of androgen deficiency and infertility.</p><p><b>METHODS</b>We retrospectively analyzed 12 cases of testis homotransplantation.</p><p><b>RESULTS</b>Surgical success was achieved in 11 cases, all with a significantly increased level of serum testosterone, and markedly improved secondary sex characteristics and sexual function.</p><p><b>CONCLUSION</b>Testis homotransplantation is highly effective for the treatment of androgen deficiency in males, but has little effect on spermatogenesis.</p>

Damage control orthopaedics in 53 cases of severe polytrauma who have mainly sustained orthopaedic trauma / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To discuss damage control orthopaedics in 53 cases of severe polytrauma who have mainly sustained orthopaedic trauma.</p><p><b>METHODS</b>The data of 53 cases of severe polytrauma who had mainly sustained orthopaedic trauma were retrospectively analyzed. And the methods and timing of damage control orthopaedics were discussed in this study.</p><p><b>RESULTS</b>We succeeded in rescuing the lives of all the 53 patients, and 38 patients returned to their former work.</p><p><b>CONCLUSIONS</b>Injury Severity Score (ISS(90)) should be 17 in severe polytrauma patients, but in severe polytrauma patients who have mainly sustained orthopaedic trauma, the ISS(90) of bone and joint injuries should be 16. We recommend that primary minimally-invasive external fracture stabilization should be made for extremities and pelvis in these patients to avoid additional surgical trauma and that definitive secondary fracture care should be performed after medical stabilization for these patients in intensive care unit (ICU).</p>

Application of injury severity score to multiple injuries headed by spinal cord injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the application of injury severity score ( ISS) to multiple injuries headed by spinal cord injury.</p><p><b>METHODS</b>The data of 55 cases (40 males and 15 females, aged 17-69 years, mean equal to 41 years) of multiple injuries headed by spinal cord injury treated in our hospital from January 2000 to December 2004 were reviewed and analyzed with ISS (Version of AIS-2005) to explore their relationship.</p><p><b>RESULTS</b>The ISS values increased with the number of injured regions, so did the complications. The recovery rate was negatively related to ISS values. During the period of immunity observation, the patients with ISS larger than 25 could undergo planned operations safely.</p><p><b>CONCLUSIONS</b>Treatment for multiple injuries headed by spinal cord injury closely depends on the general and local conditions of the patients. ISS may provide useful data for the choice of treatment methods.</p>

Primary total hip arthroplasty for acetabular fracture / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To explore the operative indications and operative methods of primary total hip arthroplasty for acetabular fracture and to observe the clinical curative effect.</p><p><b>METHODS</b>We retrospectively summarized and analyzed the traumatic conditions, fracture types, complications, operative time, operative techniques, and short term curative effect of 11 patients (10 males and 1 female, with a mean age of 42.4 years) with acetabular fracture who underwent primary total hip arthroplasty.</p><p><b>RESULTS</b>The patients were followed up for 6-45 months (mean=28 months). Their average Harris score of postoperative hip joint was 78.</p><p><b>CONCLUSION</b>Under strict mastery of indications, patients with acetabular fracture may undergo primary total hip arthroplasty, but stable acetabular components should be made.</p>

Surgical treatment of infected arterial injuries of the major limb / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To analyze retrospectively the surgical treatment of 21 cases of infected arterial injuries of the major limb hospitalized from 1989 to 2003 in our department.</p><p><b>METHODS</b>After a radical debridement and drainage, an autologous vessel bypass reconstruction, simple vessel ligation or amputation were carried out respectively according to each patient's condition. In order to make a better milieu for the grafts, local musculo-cutaneous flaps were translocated to cover the wounds in 9 cases.</p><p><b>RESULTS</b>1 case (4.8%) died during the treatment. 5 cases (5/21, 23.8%) underwent amputations. Blood supply reconstruction was successful in 15 cases (15/21, 71.4%). 93.3% (14/15) of the cases were successful in getting an unobstructed vessel at early stage. Thrombosis occurred in 1 case (1/15, 6.7%) and a sound result was obtained after a second operation.</p><p><b>CONCLUSIONS</b>Radical debridement combined with bypass vessel reconstruction with autologous vein and with musculo-cutaneous flap translocation is an effective treatment for infective limb vascular injuries.</p>

Revision of infected total hip replacement:a report of 30 cases / 中华创伤杂志

Objective To retrospectively study revisions for infected total hip replacements in 30 cases and discuss the bacteriological characters of the infected total hip replacements,difficulties and strategies in the revision.Methods Thirty revisions of infected total hip replacements were reviewed retrospectively.There were 12 males and 18 females,with mean age of 62.5 years(31-86 years)at revi- sion surgery.Infection was presented one month to four years(mean seven months)after THA operation. The diseases for initial operation included femoral neck fractures in 12 cases,femoral head necrosis in 11,hip osteoarthritis in five and rheumatoid arthritis in two.Twelve eases were treated by one-stage revi- sion and 18 by two-stage revision.Results Before the revision operation,the hip infection were diag- nosed by bacterial culture in 18 cases including five with Staphylococcus epidermidis,four with Staphylo- coccus aureus and nine with other bacteria.Bacteria growth appeared on the specimens from 23 hip joints during the revision surgery but not on the specimens from seven hip joints.Of 12 one-stage revisions,10 cases were followed for mean 16 months,which showed infection recurrence in two eases.Of 18 two-stage revisions,13 cases were followed for mean 20 months,which showed one case with infection recurrence. The mean Harris hip score was improved from preoperative 44 to 84 at follow-up.Conclusions 1) The main bacteria in the infected hip are antibiotic resistant Staphylococcus.2)Because the revision op- eration is difficult,careful preparation before revision is important for success.The fresh surgeon should not attempt.3)The revision strategies should vary according to specific status of the cases.The infection recurrence rate is lower when using a two-stage revision strategy.4)Application of antibiotic bone cement can help improve treatment effect and facilitate functional recovery of the joints.5)The scientific rehabil- itation after operation is very important to functional recovery.

Relationship between CIDE-B change and neuronal apoptosis under various injuring conditions / 中华创伤杂志

Objective To investigate the relationship between CIDE-B change and apoptosis by detecting expression of CIDE-B gene and protein under various injuring conditions(firearm injury and in- cision injury)and comparing neuronal apoptosis.Methods A total of 108 New Zealand rabbits were randomized into firearm injury group,incision injury group and control group.Samples were harvested at different time points after injury for measuring CIDE-B mRNA expression level by RT-PCR,demonstrating morphological distribution of CIDE-B mRNA by in situ hybridization and determining CIDE-B protein level by Western blot.Results Following nerve injury,CIDE-B mRNA expression in spinal cord was en- hanced markedly in the firearm injury group,increased from at day 1,reached peak at day 7,lasted for two weeks and declined after four weeks.CIDE-B mRNA expression was increased late,with small range in the incision injury group.The changes in CIDE-B protein level accorded with those in CIDE-B mRNA level.There was slight CIDE-B mRNA expression,distributing in spinal cord neuronal cytoplasma,in spinal cord tissues in the control group.Conclusions Following peripheral nerve injury,expressions of CIDE-B mRNA and protein are enhanced in spinal cord neurons and distributed in the grey matter of spi- nal cord.Such enhancement is more marked after firearm injury than incision injury.

Application of microsurgical technique in joint replacement / 中华显微外科杂志

Objective To report the experience of the application of microsurgery in joint replace- ment.Methods There were 22 cases,10 cases with segmental acetabular defects treated with the pedicle sartorius muscle iliac bone grafting,5 cases with vascular repair following major vascular injury of extremity during operation,6 cases with neural repair following neural injury during operation,1 case with serious injury reconstruction by elbow joint replacement and free flap.Results The operations succeeded in 22 cases without any postoperative infection.The mean follow-up was 40.1 months (3-72 months) in 22 cases,in which the joint function improved and the operative result was satisfactory with no joint pain.Conclusion Microsurgical technique can reconstruct bone and tissue defect effectively in joint replacement.