ABSTRACT
Objective:To investigate the clinical effects of tibial transverse bone transport assisted by nose ring drainage (NRD) in the treatment of foot and ankle chronic osteomyelitis.Methods:A retrospective study was conducted to analyze the data of 32 patients with foot and ankle chronic osteomyelitis who had been treated at Department of Orthopedics, Beijing Rehabilitation Hospital from March 2013 to February 2022. The patients were assigned into a study group and a control group. In the control group, there were 12 males and 3 females, aged (39.5±8.8) years. The osteomyelitis was located at the distal tibia in 4 cases, at the talus in 1 case, at the calcaneus in 2 cases, at the midfoot in 4 cases and at the forefoot in 4 cases. According to the Crerny-Mader classification, there were 5 cases of type Ⅰ and 10 cases of type Ⅱ. The control group was treated with Ilizarov transverse tibial bone transport in combination with thorough debridement and anti-infection therapy. In the study group, there were 12 males and 5 females, aged (42.3±13.4) years. The osteomyelitis was located at the distal tibia in 4 cases, at the talus in 1 case, at the calcaneus in 3 cases, at the midfoot in 5 cases and at the forefoot in 4 cases. According to the Crerny-Mader classification, there were 7 cases of type Ⅰ and 10 cases of type Ⅱ. The study group was treated with NRD drainage in addition to the procedures in the control group. The curative effects were evaluated by comparing the cure, recurrence, amputation (toe amputation), antibiotic use time, wound healing time, relevant inflammatory indicators [WBC, neutrophil percentage (NEU), erythrocyte sedimentation rate (ESR), procalcitonin, interleukin-6 (IL-6), C-reactive protein (CRP)], and postoperative functional recovery between the 2 groups.Results:The 2 groups were comparable because there was no statistically significant difference in the general data between them ( P>0.05). The follow-up period was (36.0±9.8) months. There was no significant difference between the 2 groups in the cure or amputation (toe amputation) ( P>0.05), but the recurrence rate in the study group was significantly lower than that in the control group ( P<0.05). The antibiotic use time [(20.7±3.6) d] and wound healing time [(88.3±17.1) d] in the study group were significantly shorter than those [(37.9±6.5) d and (102.2±22.6) d] in the control group ( P<0.05). The ESR, IL-6 and CRP at 1 week after operation in the study group were significantly lower than those in the control group ( P<0.05), but there was no significant difference between the 2 groups in the WBC, NEU or PCT at 1 week after operation ( P>0.05). There was no significant difference either in the inflammatory indicators between the 2 groups at 1 month after operation ( P>0.05). In all patients, the inflammatory indicators like WBC, NEU, ESR, PCT, IL-6 and CRP at 1 week and 1 month after operation were significantly better than those before operation, and the Maryland foot functional score at 12 months after operation was significantly higher than the preoperative one ( P<0.05). There was no significant difference between the 2 groups in the Maryland foot functional score at 12 months after operation ( P>0.05). Conclusion:In the treatment of foot and ankle chronic osteomyelitis, compared with the Ilizarov transverse tibial bone transport, our tibial transverse bone transport assisted by NRD can achieve satisfactory therapeutic effects, shorten antibiotic use time and treatment cycle, and reduce recurrence rate.
ABSTRACT
ObjectiveTo explore the effect of trunk control training during unstable sitting on knee pain and function in patients with patellofemoral pain syndrome. MethodsFrom January, 2019 to December, 2021, 41 patients with patellofemoral pain syndrome in Beijing Rehabilitation Hospital were randomly divided into control group (n = 20) and experiment group (n = 21). Both groups accepted routine rehabilitation, and the experiment group accepted trunk control training during unstable sitting in addition, for four weeks. They were assessed with Visual Analogue Scale for pain (VAS) and Anterior Knee Pain Scale (AKPS), and measured stability indexes with Balancer before and after treatment. ResultsAll the VAS score, AKPS score, and the overall, anterior-posterior and left-right stability indexes improved in both groups after treatment (|t| > 12.089, P < 0.001); and improved more in the experiment group than in the control group (|t| > 5.864, P < 0.001). ConclusionTrunk control training during unstable sitting may improve knee pain and function, and motor control.
ABSTRACT
ObjectiveTo observe the effect of neuromuscular training on femoroacetabular impingement. MethodsFrom January, 2017 to November, 2021, 27 patients with femoroacetabular impingement in Beijing Rehabilitation Hospital were randomly divided into control group (n = 13) and observation group (n = 14). The control group accepted routine rehabilitation training, and the observation group accpeted neuromuscular training in addition. They were assessed with Visual Analogue Scale (VAS) for pain, peak torque (PT) of hip flexion and extension, Y-balance test (YBT) and simplified International Hip Outcome Tool (iHOT-12) before and after treatment. ResultsThe VAS score, PT, YBT score and iHOT-12 score improved in the observation group after treatment (|t| > 3.628, P < 0.01), while the VAS score and PT improved in the control group (|t| > 3.409, P < 0.01). After treatment, the VAS score, PT, YBT score and iHOT-12 score were better in the observation group than in the control group (|t| > 2.067, P < 0.05). ConclusionNeuromuscular training can relieve the pain of patients with femoroacetabular impingement, and improve the muscle strength and function of hip joint.
ABSTRACT
Objective: To explore the effectiveness of minimally invasive osteotomy Ilizarov technique combined with intramedullary nail for femoral lengthening. Methods: Seventy-one patients with femoral shortening deformity who met the selection criteria between January 2013 and June 2016 were randomly divided into trial group (36 cases were treated with minimally invasive osteotomy Ilizarov technique combined with intramedullary nail for femoral lengthening) and control group (35 cases were treated with simple Ilizarov technique for femoral lengthening). There was no significant difference in age, gender, causes of femoral shortening, length of femoral shortening, rate of femoral deformity between the two groups ( P>0.05). The operation duration, intraoperative blood loss, lengthening rate, external fixation duration, frequency of pin tract infection, osteotomy healing time, and range of motion (ROM) of knee at 1 year after operation were recorded and compared between the two groups. Results: The patients of two groups were followed up 12-60 months (mean, 31 months). Pin tract infection occured in 8 cases (10 pins), including 1 case (1 pin) in the trial group and 7 cases (9 pins) in the control group. There was significant difference in the incidence of pin tract infection between the two groups ( χ2=5.265, P=0.022). All patients were cured by replacing the fixation pins, changing dressing actively, application of antibiotics, and adequate postoperative care. The operation duration, intraoperative blood loss, external fixation duration, osteotomy healing time, and ROM of knee at 1 year after operation of the trial group were superior to those of the control group, showing significant differences ( P<0.05). There was no significant difference in the lengthening rate between the two groups ( t=-1.581, P=0.153). Conclusion: The minimally invasive osteotomy Ilizarov technique combined with intramedullary nail in femoral lengthening increases the operation time, but the external fixation duration and incidence of pin tract infection are significantly reduced and the function of knee is significantly improved.
ABSTRACT
BACKGROUND:As a bone scaffold material,β-tricalcium phosphate has good biocompatibility, osteoinductive, and biomechanical properties. OBJECTIVE:To study the effect of al ogeneic osteoblasts compounded withβ-tricalcium phosphate in repairing rabbit radial defects. METHODS:A total of 45 rabbit radial defect models were made and divided into three groups in random. Experimental group was repaired with the compound of al ogeneic osteoblasts andβ-tricalcium phosphate; control group withβ-tricalcium phosphate;and blank control group with nothing. The new bone formation of each group was observed and assessed by X-ray and histopathological analysis at weeks 4, 8, 16 after implantation for evaluation of the bone repairing effect. RESULTS AND CONCLUSION:With the repair time, the experimental group appeared to complete bone defect repair gradual y. By the end of 16 weeks, the X-ray showed that the bone cal us between the scaffold and the host was completely ossified, and bone defects were completely repaired in the experimental group. Histopathological observation showed continuous cortical bone formed in the defect area, and canal recanalization realized in the experimental group. Additional y, the repair effect in the experimental group was better than that in the control and blank control group at different time points (P<0.01). It is suggested that the al ogenic osteoblasts/β-tricalcium phosphate compound has the better effects on guiding bone regeneration and preventing from nonunion.
ABSTRACT
Objective To study the methods treating talar neck fractures. Methods From Oc-tober 1988 to June 2004, 66 patients with talar neck fractures were treated with different methods. Accord-ing to modified Hawkins classification, there were 14 patients with type Ⅰ fractures treated with plaster exter-nal fixation, 34 with type Ⅱ treated with manipulative reduction plus plaster external fixation, 16 with type Ⅲ treated with open reduction and internal fixation or joint fusion and 2 with type Ⅳ treated with open re-duction and internal fixation or joint fusion. There were four patients with old fractures. Results All pa-tients were followed up for mean 6.28 years and clinical outcomes evaluated according to Hawkins scoring system, which showed that 19 patients (29%) were graded excellent (including 13 type Ⅰ fractures, 5 type Ⅰ and 1 type Ⅲ), 17 good (including 1 type Ⅰ fracture, 12 type Ⅱ and 4 type Ⅲ), 18 fair (including 11 type Ⅱ fractures, 6 type Ⅲ and 1 type Ⅳ) and 12 poor (including 6 type Ⅱ, 5 type Ⅲ and 1 type Ⅳ). There occurred osteonecresis in 25 patients (38%), traumatic arthritis of ankle joint in 20 (30%) and that of subtalar joint in 26 (39%). Conclusions For type Ⅰ and Ⅱ fractures, plaster external fixation should be the choice of treatment. While open reduction and internal fixation should be done for type Ⅲ talar neck fractures and joint fusion for type Ⅳ and old fractures.
ABSTRACT
To explore the effects of different doses of puerarin on proliferation of cultured vascular endothelial cells in vitro.
ABSTRACT
[Objective]To explore the effects of axial stress regulation on healing of lengthened callus.[Method]Tibiaes of 40 rabbits divided into 2 groups were lengthened with circular external fixator.X-ray bone density and histology tests were performed.[Result]The X-ray showed lengthened callus was different after operation.In the control group,lengthened center had a serial callus and cortex had not formed,in the experimental group lengthened center had serial cortex and ttransfixial medullary cavity expects serial callus.[Conclusion]Axial stress regulation and periodicity continue to shortened micromovement stress may promote healing after bone lengthening.
ABSTRACT
[Objective]To study the mid-term outcomes about cementless total hip arthroplasty in the treatment of patients with alcoholic osteonecrosis of the femoral head.[Method]From March 1997 to June 2002,41patients(47 hips) was treatmented by cementless total hip arthroplasty,the mid-term (equal to or more than 5 years) results were evaluated both clinically and radiographically.Clinical outcomes were evaluated according to Harris evaluation score. Components migration,bone changes around the implant were measured radiologically. Kaplan-Meier analysis was performed to evaluate the surviving rate of the femoral and acetabulum components. End point was radiographical loosening or revision of the acetabular and femoral component for any reason.[Result]Forty-seven hips in 41 patients were followed up at least 5 years. The mean Harris hip score increased from preoperation(42.4?6.4)points to (91.8?4.4) points at the time of final follow up. No component was loose,No component was revised. The focal area of pelvic osteolysis in 2 hips and small focal area of femoral osteolysis in 6 hips were found. The surviving rate of the femoral and acetabulum components,was 1.0(95% confidence interval,0.98 to 1.00).[Conclusion]The mid-term outcomes about cementless total hip arthroplasty in the treatment of patients with alcoholic necrosis of femoral head had been satisfactory. Because the wear of component,osteolysis can not be avoided,clinical and radiographical follow-up for cementless total hip arthroplasty must be carried out persistently.
ABSTRACT
[Objective]To observe the therapeutic effect of the combined external fixator and traditional Chinese medicine for senile femoral intertrochanteric fracture.[Method]There were sixty-eight cases for study .Thirty-five cases in treatment group were treated with external fixator in perculaneous transhepatic through Minimally Invasive Skill (MIK),together with oral medication of traditional Chinese medicine,while thirty-three cases in the control group only underwent external fixator.[Result]All of the cases had been followed up for an average period of three years and ten months,which arranged from one year and eight month to six years and nine months . The fracture healing time in the treated group was 12.4?2.5 weeks and that in the control group was 15.5?2.9 weeks,showing significant difference between them (P