Anterior cervical intervertebral space decompression under microscope for cervical spondylotic myelopathy in elderly patients / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects of anterior cervical intervertebral space decompression under microscope in treating cervical spondylotic myelopathy in elderly patients.</p><p><b>METHODS</b>From June 2009 to March 2012, 43 patients with cervical spondylotic myelopathy were treated with anterior cervical intervertebral space decompression and intervertebral fusion under microscope. There were 26 males and 17 females, aged from 60 to 72 years old with an average of (64.9±3.7) years. Japanese Orthopaedic Association System (JOA) score was from 7 to 12 points with an average of (9.5±1.8) points before operation. The function of nerves was assessed before and after operation according to JOA.</p><p><b>RESULTS</b>All patients were followed up from 10 to 18 months with an average of (14.7±1.6) months. Postoperative JOA score was (13.81±1.44) points (ranged, 10 to 16), had significantly higher than preoperative (P<0.01). According to the rate of the improved JOA score, 9 cases got excellent results, 26 good, 7 fair, 1 poor.</p><p><b>CONCLUSION</b>Anterior cervical intervertebral space decompression under microscope for cervical spondylotic myelopathy in elderly patients is safe and effective.</p>

Arthroscopic treatment of tibial intercondylar eminence fracture in children / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical effects of extractable steel wire for the treatment of tibial intercondylar eminence fracture in children under arthroscopy.</p><p><b>METHODS</b>From October 2008 to December 2010,21 children with intercondyloid eminence fractures were treated with fixation by extractable steel wire under arthroscopy. Among the patients, 14 patients were male and 7 patients were female,ranging in age from 7 to 14 years old with a mean of 10 years old. The period from injury to operation ranged from 3 to 8 days, with an average of 4 days. Before operation, X-ray, CT and MRI were used to determine fracture and joint injury type. Lysholm criteria were used to evaluate clinical effects.</p><p><b>RESULTS</b>All fractures were healed. The Lysholm score improved from preoperative 30.2 +/- 4.2 to postoperative 92.8 +/- 9.1; 18 patients got an excellent result and 3 good.</p><p><b>CONCLUSION</b>The extractable steel wire in treatment of tibial intercondyloid eminence fractures in children under arthroscopy has advantage of economics, firm fixation, in favour of early functional exercise, decreasing the opportunity of bony avulsion of the anterior cruciate ligament and less iatrogenic injury of osteoepiphysis due to small diameter and slick steel wire.</p>

Serum levels of cartilage oligomeric matrix protein in the diagnosis of knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To select sub-clinical patients with symptoms of knee osteoarthritis (KOA) without X-ray changes by measuring the serum level of cartilage oligomeric matrix protein (COMP) with ELISA, so as to diagnose and treat patients with knee osteoarthritis at early stage.</p><p><b>METHODS</b>The 115 patients with KOA or with symptomatic primary KOA were enrolled from August 2007 to September 2009, which was OA group; and 35 healthy people in the control group. In OA group, there were 55 males and 60 females,ranging in age from 39 to 76 years, with an average of (55 +/- 13.32) years; the body mass index (BMI) ranged from 15.1 to 29.8; the disease course ranged from 6 to 60 months. In the control group, there were 16 males and 19 females, ranging in age from 36 to 77 years, with an average of (53 +/- 12.53) years; the BMI ranged from 14.8 to 29.2. Patients with symptomatic primary knee OA of Kellgren-Lawrence (K-L) grade I-IV were evaluated. Serum level of COMP and its correlation with OA grade were analyzed by ELISA method. The patients were treated with Celecoxib capsules. The patients in OA group were followed up, and the duration ranged from 24 to 38 months (averaged, 33.4 months), and the serum level of COMP were analyzed before and after treatment.</p><p><b>RESULTS</b>The serum level of COMP in the control group varied with age (t= 2.50, P=0.02). The serum level of COMP did not correlate with gender (control group: t=0.98, P=0.34; OA group: t=0.18, P= 0.86), BMI (control group: t=0.56, P=0.92; OA group: t=0.17, P=0.85) and smoking (control group: t=1.89, P=0.08; OA group: t=0.70, P=0.49). The serum level of COMP was higher in the patients with higher K-L grades than in the patients with lower K-L grades (F=15.56, P=0.001) . The sub-clinical KOA patients without X-ray changes can be detected significant higher COMP levels than sub-clinical patients with other diseases (t=2.55, P=0.03). Therefore, according to this method, subclinical OA patients can be detected from people with other sub-clinical diseases successfully.</p><p><b>CONCLUSION</b>The serum level of COMP can be used as a potential prognostic marker to diagnose KOA.</p>

Repair of soft tissue defects on the lower limbs with the facial pedicled flap with vascular perforating branch of leg / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the operative techniques and clinical results of the facial pedicled flap with vascular perforating branch of leg.</p><p><b>METHODS</b>From May 1998 to January 2009,62 patients with soft tissue defects on the lower limbs were treated by four kinds of flap pedicled with the medial, posterior,anterolateral and posterolateral vascular perforating branches in the leg, included 50 males and 12 females, aged from 7 to 78 years old. There were 23 cases of the facial pedicled flap based on the perforating branch of the tibialis posterior artery, 9 cases of the facial pedicled flap based on the distal perforating branch of peroneal artery, 22 cases of the facial pedicled flap based on the peroneal artery perforator, 8 cases of the facial pedicled flap based on the lateral popliteal cutaneous artery.</p><p><b>RESULTS</b>The remaining flaps were completely survived except for 2 cases with epidermal necrosis and scab of distal flap, and 1 case with skin necrosis and skingrafting later. The patients were followed-up for from 1 month to 3 years, the appearance of the flaps were satisfied and the function were good.</p><p><b>CONCLUSION</b>The blood supply area of single perforator vascular of the leg is insufficient, so the presence facial pedicled flap of arterial chains will expend obviously the area of perforator flap that be good to blood supply and venous return.</p>

Repair of wound defect with exposed tibia with facial flap pedicled with vascular perforating branch of leg / 中华创伤杂志

Objective To explore the method of repairing wound defects with exposed tibia. Methods 32 patients with soft tissue defects with exposed tibia were treated with three kinds of flaps pedicled with interior,lateral and posterior vascular perforating branches in the leg,respectively.Re- suits One flap with distal part necrotic was treated with change of dressings and got one-stage healing. One case had delayed union for muscular infection under the flap.Other flaps all were successful and sur- vived.No ostemyelitis was found.Conclusion The flap pedicled with vascular perforating branches of leg has abundant blood supply and is a good method for repairing small or middle wound defect with ex- posed tibia.