Individualized posterior atlantoaxial short-segmental fixation for upper cervical injury / 中华创伤杂志

Objective To observe the individualized insertion choice in treatment of upper cervical injury with posterior atlantoaxial short-segmental pedicle screws or lateral mass screws and the relevant clinical outcome.Methods A total of 23 cases of upper cervical injuries received skull traction preoperatively.Individual surgery plan including internal fixation using pedicle screws or lateral mass screws as well as diameter,length,entry point,direction,and angle of screws was determined according to their atlantoaxial CT scan and three-dimensional reconstruction results.Results Six cases of Frankel grade C and eight of grade D were all recovered to grade E after operation.All cases presented rigid fixation and bony fusion in the follow-up of 6 to 36 months.Besides,screws were removed after bony fusion for three young cases and one case with left atlas pedicle screws emerged laterally out of cortex.Clinical outcome was all satisfactory.Conclusion Individualized posterior atlantoaxial fixation using pedicle screws or lateral mass screws is an effective way to treat upper cervical injury and gains advantages of stable threedimensional structures,short fixation segments,and few postoperative complications.

Treatment of the advanced stage avascular necrosis of femoral head combined with severe femoral anteversion with total hip arthroplasty / 中华创伤杂志

Objective To explore the operative method and clinical effect of total hip arthroplasty with normal prosthesis in treatment of the advanced stage avascular necrosis of femoral head combined with severe femoral anteversion. Methods There were 15 patients ( 15 hips) including nine males and six females, at age range of 30-42 years (mean 37 years). The femoral anteversion was 40°-50° and Harris score of (59 ± 8) points. Total hip arthroplasty with normal prosthesis was performed to reduce the femoral anteversion for 20°-30° and increase the acetabulum anteversion for 10°-15°so as to recover a good involution relationship of the femoral head and the acetabulum and avoid anterior dislocation. The imaging examination and Harris scoring were performed regularly postoperatively. Results A follow-up for mean 2.9 years (2.5-3.7 years) in 15 patients showed that all patients obtained good range of joint motion and good stability of all the hip prostheses. Harris score was (88±6) points at 2 years post-opera-tively, which was significantly better than preoperation (P < 0.01 ). Conclusions Total hip arthro-plasty with normal prosthesis can obtain good involution of the femoral head and the acetabulum in patients with advanced stage avascular necrosis of femoral head combined with severe femoral anteversion by simul-taneously regulating implant angle of femoral prosthesis and acetabular cup, which helps avoid use of small or specially made femoral stem or subtrochanteric derotational osteotomy.

Effect of minimally invasive surgery combined with allograft bone in treating compressive intra-articular calcaneal fractures / 中国基层医药

Objective To evaluate the surgical characteristics and clinical effect of percutaneous reduction with kirachner wire assisted by a small lateral incision approach for poking reduction and allngraft bone transplantation in treating compressive intra-articular calcaneal fractures. Methods A retrospective analysis was performed among 17 patients with compressive intra-articular calcaneal fractures (Sanders Ⅱ to Ⅲ ) treated by percutaneous reduction with kirachner wire assisted by a small lateral incision approach for poking reduction and allograft bone transplanta-tion. Results All the patients were followed-up for an average time of 13.5 months. The wound of 15 feet achieved primary healing, the acute rejection was found in 2 patients. The Bohler's angle was (9.58±5.25)° and Gissane an-gle was (101.15±13.83)° preoperation and was (33.55±4.17)° and (113.25±12.17)° immediate postopera-tion, showing statistically significant differences pre-and postoperation(P < 0.05). By the lately follow-up, the Bohler angle was (31.65±7.72)° and Gissane angle was (111.15±8.68)°, also showing statistically significant differ-ences when compared to preoperation (P < 0.05), there was no statistically significant differences (P > 0.05) when compared with normal X-ray. Conclusion That percutaneous reduction with kirschner wire assisted by a small lateral incision approach for poking reduction and allograft bone transplantation in treating the compressive intra-articular cal-caneal fractures (Sanders Ⅱ to Ⅲ) is minimally invasive, less complication, and it enables satisfactory recoastruc-tion of bone defects and allows metanatomic reduction and functional recovery, also maintaining restoration of calcane-al height and anatomic reduction of the posterior facet.

Comparative analysis on hemiarthroplasty and dynamic hip screws in treatment of osteoporotic femoral intertrochanteric fractures / 中华创伤杂志

Objective To discuss the differences between hemiarthroplaty and dynamic hip screws (DHS) by comparing their effect in treatment of osteoporotic femoral intertrochanteric fractures. Methods A retrospective study was done on 86 patients with femoral intertrochanteric fractures treated by hemiarthroplasty and dynamic hip screws respectively. After a follow-up for six months, the operation duration time, loss of ambulatory grades and prosthesis loosing were compared between two groups. Re-suits Operation was lasted for hmgcr time in DHS group, with significant difference between two groups. Loosening rate varied with different degree of osteoporosis in high-, moderate- and low-risk groups but not in hemiarthroplaty group. Internal fixators penetrating cortical bone occurred in DHS group, with inci-dence rate of 51.2%. On the contrary, no evidence proved loosening of prosthesis in hemiarthroplaty group. Conclusion For osteoporosis patients with intertrochanteric fracture, the hemiarthroplaty is a reasonable alternative to DHS device, for it can help obtain earlier and better functional recovery and less postoperative complication.

Effect of B-Twin intervertebral cage in treating lumbar degenerative instability with posterior mini-incision / 中国矫形外科杂志

[Objective] To explore the effect of B-Twin intervertebral cage for degenerative lumbar instability with posterior mini-incision.[Methods]Thirteen patients(13 disc-spaces)treated with B-Twin intervertebral cage in combination with autogenous morselized bone were enrolled in this study.Among the patients,11 had degenerative instability in L4、5 and 2 in L5S1.Patients were graded postoperatively with JOA scoring system.[Results]The lower back pain and leg pain were relieved significantly in all patients after operation.All were followed-up for an average of 16.2 months,and the JOA scores inproved from 4.2 preoperatively to 14.4 at the final follow-up.The good to excelleat rate was 92.3%.The bony fusions presented in an average of 19.8 weeks postoperatively by CT scan.Neither cage loosening nor neurological injury was found.[Conclusion]B-Twin intervertebral cage combined with autogenous morselized bone insertion for lumbar degenerative instability by posterior mini-incision operation is a good technique,which could achieve satisfactory clinical results with less injury.

Comparative observation on operative and non-operative effects in treatment of cervical spinal cord injury without fracture dislocation / 中华创伤杂志

Objective To compare the difference of function regain level of spinal cord after operative or non-operative treatments of cervical spinal cord injury without fracture dislocation. Methods Twenty-four cases with cervical spinal cord injury without fracture dislocation were retrospectively analyzed and divided into operative treatment group ( n =13) and non-operative treatment group ( n =11). JOA (Japanese Orthopaedic Association) scores at injury and during follow-up were recorded to make a comparison between operative treatment group and non-operative treatment group before and after treatment. Results JOA scores three months after treatment were 1.64?0.58 in the non-operative group and 3.29 ?0.90 in the operative treatment group. JOA scores 12 months after treatment were 2.00? 0.73 in the non-operative group and 4.93?0.96 in the operative treatment group. There was a significant difference statistically between both groups through t test ( P

THE TOPOGRAPHICAL PROJECTION FROM THE VENTRAL LATERAL GENICULATE NUCLEUS TO THE SUPERIOR COLLICULUS AND PRETECTUM IN THE CAT / 解剖学报

The present investigation was performed on six adult cats. The morphology and distribution of the labeled cells in the ventral lateral geniculate nucleus (LGNv) were observed. Following the injection of horseradish peroxidase (HRP) into the deeper layers of the superior colliculus the labeled cells were found to concentrate ipsilaterally in the ventral part of the rostromedial division of the LGNv. The HRP-positive cells were composed of large-sized, smaller, round and oval ceils. In the cases of injection of HRP into the rostral pretectum, the HRP-positive cells were seen bilaterally in the caudolateral division of LGNv mainly in the contralateral part, while the labeled cells were found ipsilaterally in the ventral part of caudolateral division after injection of HRP into the caudal pretectum. These cells were smaller than that large ones of superior colliculus injection. The results indicate that the projection of the LGNv to the superior colliculus and pretectum is organized topographically.