ABSTRACT
OBJECTIVE: To evaluate the efficacy of internal fixation of lateral and medial borders for displaced scapular body fractures via the minimally invasive approach. METHODS: The internal fixation of lateral and medial borders via minimally invasive approach was applied in surgical treatment of 23 patients with scapular body comminuted fractures from January 2014 to June 2018. The lateral approach was made straightly orienting over the lateral border of scapula. The dissection was taken down to the deltoid fascia. The deltoid was retracted cephalically, revealing the external rotators. Blunt dissection was used down to the lateral border between infraspinatus and teres minor, exposing the fracture site. The medial incision was done along the medial border of the scapula over site of the fracture. Dissections were taken down to the fascia and the periosteum. A subperiosteal dissection was then performed to elevate the infraspinatus to the degree necessary to visualize the fracture. The medial and lateral borders of scapula body were fixed with plates and screws in a frame-like way. RESULTS One patient developed the delayed healing of the incisions due to liquefactive fat necrosis. The other 22 patients showed no complications of the incisions. The glenopolar angle (GPA) of fractured scapula was increased from preoperative (25±12) degrees to postoperative (41±5) degrees (P<0.01). The healing time of fractures healed was 3-8 months, with an average time of (4.4±1.3) months. CONCLUSIONS The lateral-medial combined fixation through minimally invasive surgical approach for the scapula body fractures allows visualization of fracture reduction without extensive muscular or subcutaneous flaps, and is associated with successful fracture healing and high functional scores of the shoulder.
ABSTRACT
Objective To investigate the potential mechanism that melatonin at higher concentrations inhibits the proliferation of human MG-63 osteosarcoma cells,so as to provide a certain experimental basis for the better application of melatonin in the treatment of diseases in Department of Orthopedics. Methods MG-63 cells cultured in vitro were treated with melatonin at a concentration of 4 mmol/L . Western blotting and real-time PCR method were used to analyze the effect of melatonin on the expression of cyclins and CDKs at protein and mRNA levels ,respectively. Results Western blotting and real-time PCR analyses showed that melatonin's inhibitory effect was possibly through the downregulation of cyclin D1 and CDK4 that related to the G1 phase,and downregulation of cyclin B1 and CDK1 that related to the G2/M phase. However,there was no obvious dif-ference of cyclin E,CDK2,and cyclin A,which were related to G1/S transition and S phase. Conclusion Melatonin may significantly inhibit hu-man osteosarcoma cell proliferation by inducing cell cycle arrest in a time-dependent manner,which is related to the downregulation of cyclin D1, CDK4,cyclin B1 and CDK1.