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Objective To evaluate the clinical efficacy of a single ilioinguinal approach in the surgical treatment of both-column acetabular fractures in which the anterior column was fixated by a reconstruction plate and the posterior column fixated by lag screws.Methods Between May 2013 and August 2016,a total of 23 patients with acetabular both-column fracture were treated through a single lioinguinal approach for fixation of both acetabular columns at Department of Orthopaedics,Jiangyin Hospital Affiliated to Medical College,Southeast University.They were 11 males and 12 females,aged from 20 to 71 years (mean,47.6 years).Operation time,amount of intraoperative blood loss,postoperative fracture reduction,union time and relevant postoperative complications were recorded.At the final follow-up,the function of affected hip was evaluated by Merie d'Aubigne-Postel scoring system.Results All the patients underwent the operation successfully.The operation time ranged from 120 to 210 minutes (mean,165.4 minutes).The intraoperative blood loss ranged from 320 to 1,120 mL (mean,554.8 mL).The 23 patients were followed up for 12 to 40 months (mean,28.1 months).All the fractures united well after 2 to 5 months (mean,3.7 months).According to the Matta's criteria,anatomic reduction was achieved in 17 cases,satisfactory reduction in 5 and unsatisfactory reduction in one,giving a satisfactory reduction rate of 95.7％;by the modified Merle d'Aubigne and Postel functional scores for the affected hip,13 cases were excellent,6 good,3 fair and one poor,giving an excellent and good rate of 82.6％.The complication rate during follow-up was 8.7％ (2/23).One case suffered from palsy of the lateral femoral cutaneous nerve but the symptom was relieved one month postoperatively without any treatment.One patient developed deep venous thrombosis at a lower extremity which responded to anticoagulant therapy.Conclusion Surgical treatment of acetabular double column fractures through a single ilioinguinal approach for fixation of the anterior column with a reconstruction plate and fixation of the posterior column with lag screws can achieve excellent control of reduction and fixation,which is less traumatic but leads to satisfactory clinical effects.
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Objective To improve the arthroscopic posterior cruciate ligament (PCL) reconstruction using tibial Inlay technique. Methods The special arthroscopic device and related fixation technique were designed. Five cadaveric knees were used to simulate the process of arthroscopic posterior cruciate ligament reconstruction using tibial Inlay technique. The knees were cut open to observe whether the outlet of the tibial tunnel shape and location met the design requirements. Thirty normal MRI films were measured to identify tunnel angle and localizer angle. Results The inner outlet of tunnel was conical shape(14 mm×7 mm×15 mm) and the outer outlet was cylinder-shaped (a diameter of 7 mm). The tibial drill was designed into a split structure and could be assembled in vitro. According to the data obtained from MRI films, the angle between the plane of posterior cruciate ligament and horizontal place was 36°-47°, and the localizer was fixed at 50°.The achilles tendon was used as implant and the allogft bones were designed into conical shape to fit the inner outlet of tunnel. The other end of implant to the proximal tibia was fixed with button plate. All reconstruction operations were performed under arthroscopy. The outcomes of procedure were satisfactory. There were no vascular or peripheral nerve injuries in the cadaveric knees The tunnel position was accurate and the shape of tunnel had met the design requirements. Conclusion Our results imply that improved arthroscopic of posterior cruciate ligament using tibial Inlay technique is simple, accurate, rapid and stable fixation.
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left ventricle=cerebral cortex =urinary bladder smooth muscle. CONCLUSION mRNA expression levels of Kir2 1 and Kir3 1 in different tissues were different, this different expressions have physiological significance.