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Objective:To investigate the clinical curative effect of closed reduction and internal fixation of Jakob type II lateral humeral condyle fractures in children under ultrasound guidance.Methods:A retrospective case series analysis was made on clinical data of 59 patients with Jakob type II lateral humeral condyle fractures treated at Children's Hospital of Chongqing Medical University from August 2016 to August 2017. There were 30 males and 29 females, with the age of 1.5-8.1 years [(4.0±1.8)years]. There were 34 patients treated by open reduction and internal fixation and monitored by the X-ray (control group), and 25 patients treated by closed reduction and internal fixation and monitored by ultrasound (study group). The operation time, bleeding volume, fracture healing time, and incidence of complications were compared between the two groups. The elbow joint function was evaluated by Broberg and Morrey standard at the latest follow-up.Results:All patients were followed up for 17-31 months[(23.2±4.2)months]. The operation time and bleeding volume in control group were (50.7±22.2)minutes and (6.1±3.8)ml, obviously higher than those in study group [(21.4±3.3)minutes, (1.1±0.3)ml] ( P<0.05). The fracture healing time was (8.0±0.8)weeks in control group and (7.8±0.7)weeks in study group ( P>0.05). According to the Broberg and Morrey standard, the good and excellent rate of elbow joint function in control group was 97%, with excellent results in 31 patients, good in 2, fair in 1, and poor in 0; the good and excellent rate of elbow joint function in study group was 100%, with excellent results in 22 patients, good in 3, fair in 0 and poor in 0 ( P>0.05). In study group, wound infection or malunion was not seen, and only two patients showed postoperative wire tail irritability and recovered after the removal of wires. While in control group, wound infection was seen in 3 patients and malunion was observed in 2 patients, but all patients were with distal humerus lateral bone formations. The incidence of complications was 15% in control group, higher than 0% in study group ( P<0.05). Conclusion:Compared to open reduction internal fixation, ultrasound-guided closed reduction and internal fixation of Jakob type Ⅱ lateral humeral condyle fractures in children has similar therapeutic effect, but it can shorten operation time and reduce bleeding and complications.
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BACKGROUND:Neuroblastoma is a common solid tumor in children. Pediatric tumors are little affected by environmental factors, but closely related to child development. The suspension method is an effective and reliable method to harvest neoplastic stem cel s. OBJECTIVE:To culture the cel clones of human neuroblastoma cel line SK-N-SH and to assess the biological properties of the cel clones. METHODS:Using the suspension method with no serum media, tumor cel clones were obtained. Immunofluorescence method was used to identify whether tumor cel clones exhibit stem cel properties. SK-N-SH neuroblastoma was labeled by luciferase, and tumor cel clones and tumor cel s were seeded onto the back of nude mice to monitor cel proliferative properties in nude mice using in vivo imaging. RESULTS AND CONCLUSION:Using the suspension culture method, SK-N-SH neuroblastoma cel s could successful y develop into cloning bal s. Under serum-free culture, cloning bal s were immunofluorescently used to detect molecular markers that showed strong positive expression. Cloning bal s subcutaneously implanted into nude mice showed the strong ability of self-renewal and differentiation as stem cel s. The cel clones cultured by the suspension method strongly expressed Nestin, but weakly expressed glial fibril ary acidic protein, neuron-specific tubulin, possessing stem cel characteristics and strong proliferation and metastasis in nude mice.
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Objective To discuss the effective treatments for fracture of the medial humeral epicondyle in children.Methods Twenty-five children with fracture of the medial humeral epicondyle treated from January 2008 to June 2011 were studied,including 18 males and 7 females at age of 7-14 years (mean,11.4 years).There were 7 cases accompanied with elbow joint dislocation and 2 lateral humeral epicondyle fracture.Patients were assigned to medial elbow approach to open reduction and internal fixation with absorbable rods (Group A,n =13) and open reduction and percutaneous K-wire fixation (Group B,n =12) according to the random number table.A plaster support was applied after surgery.Functional training was initiated 2-3 weeks after operation for Group A and 4-6 weeks after adequate callus formation for Group B.Moreover,follow-up was performed at regular intervals.Results All patients were followed up for 6-41 months (mean,22 months).Mean healing time was 3.8 weeks (range,3-5 weeks) in Group A and 5.6 weeks (range,4-8 weeks) in Group B.At postoperative 6 months,Bede elbow performance score was (93.7 ± 3.3) points in Group A with 10 excellent and 3 good results and (85.3 ±6.3) points in Group B with 3 excellent,7 good,and2 fair results (t=-4.24,P＜0.05).Conclusion Open reduction and internal fixation with absorbable rods gains advantages of rigid immobilization,functional recovery and minor complication and hence is effective for treatment of medial humeral epicondyle fracture in children.
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ObjectiveTo investigate the clinical effects of minimally invasive incision in anterior traverse approach for Gartland type Ⅲ humeral supracondylar fractures in children.Methods Forty-two patients with Gartland type Ⅲ displaced supracondylar fractures of the humerus were treated through anterior traverse approach between January 2008 and April 2011.The fractures were fixed using two Kirschner wires from the medial and lateral epicondyles placed crossing each other.There were 31 males and 11 females,at age of 2.6-12 years (average 5.7 years).Three patients were with open fractures.Seven patients were combined with other fractures,four with radial nerve injury and one with median nerve injury,with time from injury to hospitalization for a range of 1 hour to 3 days.Of all the patients,30 patients were with fractures on the right side and 12 with fractures on the left side.All fractures were treated by minimally invasive incision in anterior traverse approach,when the neurovascular and muscular probing and repair were performed. Results Forty patients were followed up for 3-32 months ( average 13 months),which showed incision healing at one stage,with fracture healing time for 3-4 weeks (average 3.6 weeks).No cubitus varus or incision scar were found after operation.According to Flynn' s criteria,the effect of treatment three months after operation were excellent in 32 patients,good in four and fair in four,with excellence rate of 90％.ConclusionsThe minimally invasive incision of anterior traverse approach is characterized by minor trauma,small incision,nil scar and convenient neurovascular and muscular exploration and hence is a safe and reliable treatment for open reduction of Gartland type Ⅲ humeral supracondylar fractures in children.
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Objective To investigate the effect of intramedullary stabilization of lower limb fractures with titanium elastic nails (TENs) in children.Methods From June 2004 to October 2010,278 children were stabilized with TENs in our hospital,including 181 boys and 97 girlsat average age of 7.6 years (range,3.0-14 years).There were 162 patients with femoral fractures,of which 35 underwent open reduction and the rest closed reduction.There were 116 patients with tibial fractures,which was treated with closed reduction.Postoperative fixation lasted for 3-4 weeks.The mean hospital stay was seven days.Of all the patients,272 patients received the removal of the TENs six months after operation and 242 received more than one year of follow-up to have a further observation on the limb length,hip and knee mobility and gait condition in children.Results All the patients were followed up for 6-66 months (mean,33 months).All fractures were healed in good alignment without severe complications.There were no intraoperative complications like infections,delayed union,nonunion,TEN broken and femoral or tibial epiphysis injuries.Ten patients suffered from swell and skin irritation in the nail' s position 3-4 months after operation,and the nails were removed in advance.Nineteen patients showed unequal lengths ( within 1 cm) of the lower limbs,with normal function of the lower limb joint but with no obvious limp.According to the Flynn evaluation standard,the excellent and good rate was 100％.Conclusions Characterized by good stability,rapid healing,small incision,anatomic reduction,unimpaired periosteum,short hospital stay and few complications,intramedullary stabilization with titanium elastic nails can achieve effective fixation in the treatment of lower limb fractures in children.