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Objective:To compare the curative efficacy in the treatment of humeral surgical neck fractures between open reduction and locking plating versus closed reduction and interlocking intramedullary nailing.Methods:From July 2018 to July 2020, 60 patients with humeral surgical neck fracture were treated at Department of Orthorpaedic Trauma, Jiangmen Wuyi Hospital of Traditional Chinese Medicine. They were 24 males and 36 females, aged from 40 to 70 years and injured at the left side in 35 cases and at the right side in 25 ones. Of them, 30 underwent open reduction and locking plating (open group) and the other 30 closed reduction and interlocking intramedullary nailing (closed group). The 2 groups were compared in terms of operation time, intraoperative blood loss, surgical incision length, fracture healing time, Neer shoulder function scoring 3 months after surgery, and postoperative complications.Results:There were no statistically significant differences between the open and closed groups in preoperative general data, showing they were comparable ( P>0.05). The length of surgical incision [(5.2±1.1) cm], operation time [(34.3±12.7) min], intraoperative blood loss [(52.5±7.3) mL] and fracture healing time [(9.2±1.5) weeks] in the closed group were significantly better than those in the open group [(11.1±2.5) cm, (69.4±21.4) min, (123.5±5.2) mL and (14.2±3.4) weeks)] ( P<0.05). The excellent and good rate by Neer shoulder function scoring at 3 months after operation in the closed group (93.3%, 28/30) was significantly higher than that in the open group (66.7%, 20/30) ( P<0.05). There were no postoperative complications in either group. Conclusion:In the treatment of humeral surgical neck fractures, the curative efficacy of closed reduction and interlocking intramedullary nailing is better than that of open reduction and locking plating.
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BACKGROUND:Panax notoginseng saponins promotes bone repair by improving vascular proliferation. Therefore, the scaffolds carrying panax notoginseng saponins were supposed to be used to improve bone repair at the bone defect region. However, the biocompatibility of scaffolds remains unclear. OBJECTIVE:To evaluate the biocompatibility of panax notoginseng saponins-hydroxyapatite/chitosan scaffolds. METHODS:A new bone repair scaffold has been generated by thoroughly mixtures of 0, 0.1, 1, 10 mg panax notoginseng saponins and chitosan/hydroxyapatite using in-situ composite technique and freeze-drying technique. Morphology and mechanical property of the scaffold were observed under a scanning electron microscope. (1) Cel proliferation test:rabbit bone marrow mesenchymal stem cel s of passage 3 were cultured in four kinds of drug loaded hydroxyapatite/chitosan composite material leaching liquor. Cel s normal y cultured were considered as controls. 3-(4, 5-Dimethylthiazol-2-yl) 2, 5-diphenyl tetrazolium bromide was used to measure absorbance value of cel s in each group. (2) Hemolysis test:Rabbit anticoagulated blood was added with four kinds of drug loaded hydroxyapatite/chitosan composite material leaching liquor. Absorbance values were measured using a microplate reader in each group. (3) Pyrogen test:The four kinds of drug loaded hydroxyapatite/chitosan composite material leaching liquor and saline were respectively injected into ear vein of rabbits, and the increase of rabbit body temperature was detected. RESULTS AND CONCLUSION:Drug loaded hydroxyapatite/chitosan composite material contained three dimensional porous structure of 110μm in diameter. Drug loading process of panax notoginseng saponins did not significantly affect the porosity, pore size and density of the composite material, but decreased its breaking strength and elastic modulus. The larger amount of drug loading showed a more obvious effect. Simple hydroxyapatite/chitosan composite material had good cel ular compatibility. The composite material after drug loading obviously suppressed cel proliferation, and the larger amount of drug loading showed a more obvious effect. The composite material had good blood compatibility before and after drug loading. The composite material had good pyrogen effects before and after drug loading, but accorded with acceptable quality level of pyrogen test.
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Objective To evaluate the therapeutic effects of the integration of impaction bone grafting reconstructing femur trochanter and femoral head arthropalsty in the treatment of unstable intertrochanteric fractures in aged patients. Methods From January 2006 to December 2008,21 cases unstable intertrohanteric fractures with serious osteoporosis were treated with impaction bone grafting reconstructing the femur trochanter and femoral head arthropalsty. Results Functional assessment based on the Harris score ,great in 14 cases, good in 5 cases, medium in 2 cases. The excellent and good rate was 90. 4%. Conclusion The integration of impaction bone grafting reconstructing femur trochanter and femoral head arthropalsty is convenient to treat unstable intertrochanteric fractures in aged patients.
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Objective To evaluate the clinical effect of endoscopic sphineterotomy (EST) and endoscopic sphincterotomy associated with traditional Chinese medicine in the treatment of intrahepafic duct stones.Methods Eighty patients with common bile duet stones and intrahepatic duct stone were randomly divided into a treatment group and a control group.EST associated with traditional Chinese medicine was performed in the treatment group,and EST only was used in the control group.Clinical effects were observed.Results Common bile Duet stone clearance was achieved in 94% patients in the treatment group,contrasting 88% in the control group.There was no significant difference between them (P＞0.05).While intrahepatic duct stone clearance was 74% and 28% respectively in the treatment group and the control group,showing significant difference (P＜0.05).Conclusion It is a good way that endoscopic sphincterotomy associated with traditional Chinese medicine treating intrahepatic duct stones.