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@#Objective To explore the effect of continuous nursing intervention on limb function and nursing quality after proximal femoral nail antirotation (PFNA) internal fixation for femoral intertrochanteric fracture in the elderly. Methods From February, 2017 to November, 2018, 100 elderly patients with femoral intertrochanteric fracture who underwent PFNA internal fixation in our hospital were randomly divided into control group (n = 50) and observation group (n = 50), who accepted routine nursing and continuous nursing respectively for three months. They were assessed with Harris score and visual analogue scale for pain (VAS) before and after the intervention. The postoperative nursing effect was compared. Results The Harris score increased in both groups after the intervention (t > 45.98, P < 0.001), and increased more in the observation group than in the control group (t = 15.03, P < 0.001). The VAS score decreased in both groups after the intervention (t > 16.33, P < 0.001), and decreased more in the observation group than in the control group (t = 9.749, P < 0.001). The effect of nursing was better in the observation group than in the control group (Z = -2.272, P = 0.023). Conclusion Continuous nursing intervention can significantly improve the limb function and nursing satisfaction of elderly patients with femoral intertrochanteric fracture after PFNA.
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ObjectiveTo conduct a systematic review of the susceptibility gene polymorphism sites of primary knee osteoarthritis (PKO). MethodsThe literature on genetic susceptibility and gene polymorphisms of PKO were retrieved from PubMed, Web of Science, CNKI, Wanfang Data, and China Biomedical Literature Database from establishment of the library to December, 2020, and systematically reviewed. ResultsA total of 42 papers on the polymorphism sites of human PKO susceptibility genes were included, involving cellular signaling pathways related to PKO pathogenesis, including inflammatory response, receptor signaling pathway, transcription factor signaling pathway, bone-related signaling pathway, etc. Multiple gene polymorphism sites located in inflammatory factor genes, chemokine genes, Toll-like receptor genes, transcription factor genes, obesity-related genes, and bone-related genes. ConclusionInflammatory factor genes and bone-associated allele polymorphisms are likely to be related to PKO susceptibility.
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ObjectiveTo analyze the epidemiological and clinical characteristics of children's lower extremity amputation and amputation rehabilitation, and to explain the causes of children's amputation and the complications after amputation. MethodsFrom January, 2016 to March, 2021, 51 amputation related children were retrospectively analyzed. The correlation between the cause of amputation and complications post amputation were analyzed. ResultsTraumatic amputations accounted for 58.82%, and the main cause was traffic accidents (70%). Amputations caused by diseases accounted for 41.18%, and the main cause was congenital limb deformities (80.95%). Traumatic amputation was more likely to have stump complications than expected (P < 0.05). The possibility of stump complications after disease-specific amputation was lower than expected (P < 0.05). ConclusionTraffic trauma is the main cause of amputation in children and is characterized clinically by a high incidence of unsatisfactory stumps, mainly due to soft tissue abnormalities, and most cases require stump revision to improve the poor residuals for prosthetic restoration of ambulation. Congenital pseudarthrosis of the tibia is the main cause of disease-specific amputation, and the outcome of amputation often cannot be definitely avoided even after long-term limb preservation treatment.
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Objective To explore the efficacy of arthroscopic treatment for acute avulsion fracture of posterior cruciate ligament (PCL) using double titanium plate TightRope. Methods From December 2014 to January 2015, two cases with acute avulsion fracture of PCL were treated with double titanium plate TightRope under arthroscopy, after assessment of three dimensional reconstructive CT and MRI. Rehabili-tation was carried out after operation. Results One case succeeded with double titanium plate TightRope, and rehabilitation could be per-formed early postoperatively. Another case failed in TightRope fixation, and accepted two internal hollow screws fixation instead. Rehabili-tation was delayed until two weeks postoperatively. The function of the knee was satisfactory in the former patient after three months, who could extend the knee in a normal range, without pain or locking. The same effect was gained in the latter patient after four months. Conclu-sion For acute tibial avulsion fracture of PCL with larger and intact fragment without osteoporosis, arthroscopic restoration and fixation with double titanium plate TightRope offers the opportunity to achieve anatomic reconstruction and rigid fixation for early rehabilitation in adult patients.
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Objective To explore the role of fibrogenic cytokines and inflammatory cytokines in the pathogenesis of frozen shoulder. Methods From September, 2014 to April, 2016, 20 patients with frozen shoulder accepted arthroscopic surgery were included, ten of them were diagnosed as primary frozen shoulder (group A), the other ten were secondary frozen shoulder (group B). Other ten patients undergo-ing shoulder arthroscopy for instability (4 cases), rotator cuff injury (3 cases) and subacromial impingement (3 cases) were as the controls (group C). The mRNA levels of matrix metalloproteinase (MMP) 1, MMP3, tumour necrosis factor-α (TNF-α), interleukin (IL)-1, IL-6, IL-8, granulocyte-macrophage colony stimulating factor (GM-CSF) and M-CSF in synovium were analyzed with quantitative polymerase chain reaction. Results The expression of mRNA of MMP1, MMP3, TNF-α, IL-1, IL-6, IL-8, GM-CSF and M-CSF were more in group A and group B than in group C (P0.05). Conclusion The fibro-genic cytokines and inflammatory cytokines may play a role in the pathogenesis of frozen shoulder.
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Objective To compare the effects of non-steroidal anti-inflammatory drugs (NSAIDs) and free radical scavengers (FRS) on formation of traumatic heterotopic ossification (HO) in rabbits. Methods 48 New Zealand rabbits were randomly divided into control group (n=12), NSAIDs group (n=12), FRS group (n=12) and combination group (n=12). The model of traumatic HO was established, and the NSAIDs group, FRS group and combination group were administered indometacin intragastrically, edaravone intravenously and both, re-spectively, while the control group was administered normal saline for 4 weeks. The incidence and severity of HO were observed with X-ray 8 and 12 weeks after modeling. Results 8 and 12 weeks after operation, the incidence of HO was 33.3%and 41.7%in the NSAIDs group, 43.0%and 45.8%in the FRS group, 29.2%and 37.5%in the combination group, and 70.8%and 75.0%in the control group, respectively. The incidence and severity of HO in all the treatment groups were significantly less than those in the control group (P0.05). Conclusion The systemic application of FRS may prevent the formation of HO effectively, similar with the NSAIDs. There is no synergistic effect between them.
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@#Objective To compare the effects of non-steroidal anti-inflammatory drugs (NSAIDs) and free radical scavengers (FRS) on formation of traumatic heterotopic ossification (HO) in rabbits. Methods 48 New Zealand rabbits were randomly divided into control group (n=12), NSAIDs group (n=12), FRS group (n=12) and combination group (n=12). The model of traumatic HO was established, and the NSAIDs group, FRS group and combination group were administered indometacin intragastrically, edaravone intravenously and both, respectively, while the control group was administered normal saline for 4 weeks. The incidence and severity of HO were observed with X-ray 8 and 12 weeks after modeling. Results 8 and 12 weeks after operation, the incidence of HO was 33.3% and 41.7% in the NSAIDs group, 43.0% and 45.8% in the FRS group, 29.2% and 37.5% in the combination group, and 70.8% and 75.0% in the control group, respectively. The incidence and severity of HO in all the treatment groups were significantly less than those in the control group (P<0.05), and there was no significant difference among the treatment groups (P>0.05). Conclusion The systemic application of FRS may prevent the formation of HO effectively, similar with the NSAIDs. There is no synergistic effect between them.
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Ankle sprain without fracture or dislocation, accompanied by repeated ankle swelling is called as Anterolateral Ankle Im-pingement Syndrome. It is a major reason of chronic ankle pain and received extensive attention. This paper summarized its pathogenesis, clinical manifestations, diagnosis and treatment.
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BACKGROUND:Static compressure effect between the fracture fragments was generated by fixation itself (tension band wire and screw), but dynamic compression effects were generated during flexion. Mechanical strength and stability of patel ar fracture fixation have obvious advantages. However, there are lacks of quantitative comparative studies on static and dynamic compression effects of these fixation methods. OBJECTIVE:To observe strength changes and clinical significance of static and dynamic compression using four fixation techniques. METHODS:Standardized transverse patel ar fracture models were created with fresh cow patel as. The patel as were randomly divided into four groups:fixation was accomplished with modified tension band wiring (wire group);modified tension band with braided cable (cable group);interfragmentary screws (screw group);cannulated screw tension band with wire (cannulated screw group). Before fracture fixation, Fuji pressure-sensitive film was laid among fracture fragments to measure the pressure among fracture fragments after fixation, i.e., static and dynamic compression. Model of each group was measured as fol ows:(1) after fixation, the fixation was removed, and the Fuji pressure-sensitive film was taken out;(2) after fixation, material testing machine was used. Samples underwent a three-point bending test with a 5 000 N load, simulating dynamic compression during knee flexion. Subsequently, Fuji pressure-sensitive film was taken out. Each Fuji pressure-sensitive film was tested using prescale FPD-8010E software. Thus, average pressure among broken bone ends was obtained, and statistical analysis was performed. Static and dynamic compression among broken bone ends was compared in each group. RESULTS AND CONCLUSION:Average static compression was significantly lower in the wire group than in the cable group, screw group and cannulated screw group (P0.05). Dynamic compression was higher than static compression in the wire group (P<0.05). Results verified that compared with modified tension band wire fixation technique, cable or screw could evidently increase static compression among broken bone ends, but simultaneously weaken dynamic compression among broken bone ends.
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@#Ankle sprain without fracture or dislocation, accompanied by repeated ankle swelling is called as Anterolateral Ankle Impingement Syndrome. It is a major reason of chronic ankle pain and received extensive attention. This paper summarized its pathogenesis,clinical manifestations, diagnosis and treatment.
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@#ObjectiveToexplorethemethodtoestablishanimalmodelofearlyosteonecrosisofthefemoralhead(ONFH)inducedby steroid.Methods20healthymaleBeagleswererandomlydividedintocontrolgroupandexperimentalgroupwith10dogsineachgroup. Theexperimentalgroupwasinjectedlipopolysaccharide10μg/kgandmethylprednisolone20mg/kgfor3daysconsecutively.Thecontrol groupwasinjectednormalsaline.2monthsand4monthsafteradministration,bothgroupswereperformedmagneticresonanceimaging (MRI).5animalsweresacrificedrespectivelyat2monthsand4monthsafteradministrationineachgroup,andbilateralfemoralheadspeci-menswereobtainedtoperformhistologicalexamination.Plasmaprothrombintime(PT),activatedpartialthromboplastintime(APTT),anti-thrombinIII(AT-III)weretestedbeforeand24hafteradministration.ResultsIntheexperimentalgroup,thepathologicalresultsshowed thattherewere4ONFH2monthsand6ONFH4monthsafteradministrationandMRIdidnotshowanyabnormality.Comparedwiththe controlgroup,thePT,APTT,AT-IIIintheexperimentgroupshortenedsignificantlyafteradministration(P<0.001).ConclusionModified steroid-inducedmethodcanestablishtheanimalmodelofearlyONFH.Hypercoagulationandlowfibrinolysismaybethereasonofste-roid-inducedosteonecrosis.
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@#Heterotopic ossification is the bone formation outside skeletal system, which can lead to serious motor dysfunction. This paper reviewed the definition, pathogenesis, incidence, clinical manifestations and diagnosis, advance in prevention and treatment of heterotopic ossification to investigate the effective method in prevention and treatment of heterotopic ossification.