ABSTRACT
Objective To explore a new way assisted by digital technology to establish a quantitative index to assess the matching performance of anatomically contoured plate. Methods We collected the thin-slice CT data of 20 adults with normal tibias who had received 32-slice spiral CT scanning from April 2015 to June 2016. They were 10 males and 10 females, aged from 28 to 52 years (average, 36.2 years). 3D reconstruction of the tibias was performed with Mimics 18.0. Two brands of 8-hole anatomically contoured plate for distal tibia (Kongli versus GE) were digitized. The curve of the plate facing the bone surface was extracted. The operational process of putting the plate curve on the medial surface of the distal tibia was simulated in Rhino 5.0. The volume of the gap between plate curve and bone surface was measured. The mean distance of the gap between plate cure and bone surface was figured out after the volume divided by the plate area. The inverse value of the mean distance of the gap was used as the index for matching performance. The wall thickness analyzing tool in 3-matic Research was used to mark the various thicknesses of the gap with different colors. The matching performances of the 2 brands of plate were assessed and compared according to the matching performance index and nephogram. Results Of the Kongli 8-hole distal tibial plate, the gap volume was 3,834 mm3± 701 mm3, the mean thickness 1.8 mm ± 0.3 mm, and the matching index 0.56 ± 0.10. Of the GE 8-hole tibial plate, the gap volume was 7,690 mm3± 1,503 mm3, the mean thickness 3.0 mm ± 0.6 mm, and the matching index 0.34 ± 0.06. The significant difference in matching performance between the 2 kinds of plate favored the Kongli plate (t=10.402, P <0.01). There were no significant differences in matching per-formance between different genders among the plates of the same brand (P> 0.05). The nephogram showed a large fixed red area at the proximal part in the GE 8-hole tibial plate. Conclusions As this index for matching performance is simple and intuitive, it can be used to assess and compare the matching performances between different kinds of plates. It can be also used before operation to assess the matching performance of a specific plate for a specific patient to avoid mismatch because of individual differences.
ABSTRACT
Objective To measure the cancellous bone contents at different parts of the humeral heads of different ages and genders for data helpful for humeral head fixation.Methods Thirty-six patients with proximal humeral fracture were selected for this study who had been treated at our department with locking proximal humerus plate from June 2008 to April 2010.They were 18 men and 18 women,aged from 20 to 86 years (average,51.6 years).They were grouped according to age:group A ( ＜ 40 years),group B (40 to 60 years),and group C (＞ 60 years).A GE Sensation 16 CT scanner (GE Healtbcare,USA) was used to scan both of their affected and healthy humeral heads preoperation,with slices one mm thick.The bone density of cancellous bone was assessed by the CT value expressed in Hounsfield units.The maximum,minimum,and mean CT values were calculated for the cancellous bone in the humeral head in each image.CT images were processed by computer with custom software (Xiphoid 1.3,Image J 1.4g and Image-Pro Plus 6.0).All the data were analyzed with SPSS16.0.Results We found 4 weak point.s at the cortical bone of proximal humerus,correspondent with the 4 clinic CT types of proximal humeral fracture.The cancellous bone was the densest in the medial humeral head.The mean cancellous bone content was significantly lower in group C than in group A and B( P ＜ 0.05).There was a significant difference between men and women in group A in the BMD of cancellous bone ( t =4.744,P =0.001 ).Conclusions The cancellous bone content in the humeral head is related with age and gender.Since there is more cancellous bone in the medial part than in other parts of the humeral head,it is a reliable part for humeral head fixation.
ABSTRACT
Objective To discuss the donor site complications and the treatments of the anterolateral thiIgh flap transfer. Methods From July 1988 to July 2007,427 patients treated by anterolateral thish flap surgery were followed up.The donor sites were treated by several methods,including direct closure(49 cases),skin graft transfer(258 cases),anterolateral fascial flap transfer(27 cases),musculocutaneous flap and skin sraft transfer(65 cases), superficial epigastric artery flap transfer(28cases).The area of these flaps ranged from 30 cm×10 cm to 18 cm×7 cm.and the average follow-up was 21 months(ranged from 8 months to 54 months). All the data was analyzed by SPSS for Windows,Version 11.0.1. Results Short-term complications(within 4 weeks)and long-term complications (over 6months)were observed.The former included skin necrosis(5.4%),wound infection(4.0%),and necrosis of rectus femoris(0.5%); and the latter included chronic ulcer(4.9%), aerious scar(6.6%), serious discomfortable(5.9%),and quadriceps femoris disfunction(3.7%).The statistical results showed that there was a close correlation between the donor site morbidity and the surgical methods. Conclusion The complications of the donor site cannot be ignored.Protect the soft-tissue of the donor site carefully,design all appropriate operation plan.Careful preoperative examination and local flap transplantation can effectively decrease the rate of complications.