ABSTRACT
Objective To investigate the clinical effect of proximal femoral nail anti-rotation (PFNA) on femoral intertrochanteric fracture in the elderly.Methods Eighty-seven elderly patients from June 2007 to March 2012,who had femoral intertrochanter fracture and received treatment of PFNA,were enrolled in this study.Patients were comprised by forty seven people with stable fracture and forty people with unstable fracture.Results They were all followed up from 4.5months to 14 months,with the average time of 7.2 months.No death were found in hospital.The operation time was 25 min in average.During operation,losing blood was 80 ml.Ambulation time was 5.5 d,and the fracture healing time was 22 weeks in average.However,there were significant differences in intraoperative resetpostoperative position of the blade between the stable and unstable fracture patients (P＜0.01).Conclusions PFNA is one of the effective methods in the treatment of intertrochanter fracture,and it has shorter operation time,less losing blood,earlier ambulation,and hardly has complications.
ABSTRACT
10.3969/j.issn.2095-4344.2013.23.011
ABSTRACT
Objective To investigate the clinical and radiographic outcome of traumatic pubic symphyseal diastases fixed with the locked plate. Methods From December 2007 to December 2009,17 patients(11 males,6 females,at mean age of 45.3 years)with pubic symphysis diastasis of unstable pelvic ring injuries were treated with open reduction and fixation with the locked plate.According to Tile classification system,five patients were with type B1 fractures,one with type B2,one with type B3,six with type C1,three with type C2 and one with type C3.All operations were performed under general anesthesia.Pubic symphyseal diastasis was treated by open reduction and fixation with the locked plate.There were 13 patients with associated posterior pelvic disruption,of which seven patients were treated by open reduction via anterior approach and fixed wich the reconstruction plates,three by close reduction and fixed with percutaneoua sacroiliac cannulated screws and three by posterior approach and fixed with M type plates. Results Of all the patients,16 patients were followed up for a mean time of 16 months(6-30months),which showed mean blood loss of 200 ml(50-600 ml)and mean hospital stay of 21 days (14-62 days).The clinical outcome was measured according to Majeed scores system,which showed excellent results in seven patients,good in seven and fair in two. Conclusions The locked plate fixation takes advantages of sailsfactory clinical outcomes with less operative trauma and a lower implant failure and wound infection rate in treatment of traumatic pubis symphysis diastasis.Locked plate fixation of symphysis call be performed alone when the posterior pelvic ring is only partially disrupted (Tile B).Posterior fixation construction should be used if the pelvic ring is under complete instability(Tile C).
ABSTRACT
BACKGROUND:Muscle transposition is a conventional method to treat muscle tissue defects,but it results in damage to another piece of muscle.For this reason,we designed this study to search for a method to in situ repair muscle tissue defects.OBJECTIVE:To investigate the conditions for in vitro induced differentiation of rat bone marrow mesenchymal stem calls(BMSCs)into skeletal muscle cells.METHODS:Following isolation and culture,passage 3 BMSCs were induced to differentiate in vitro by a combination of5-azacytidine,myogenic differentiation factor,transforming growth factor β1,and insulin like growth factor.At 9 days after induction,cells were harvested and identified by immunohistochemistry.RESULTS AND CONCLUSION:Primary cultured BMSCs exhibited an adherent,colony-like growth.After 5-7 days,multi-synaptic calls,thin and fiat polygonal cells,polygonal cells,and triangle-shaped cells were observed.After 12 days,calls confluenced and covered the whole bottom of culture flask,with slightly altered morphology of BMSCs.After 5-azacytidine induction,some calls died and grew slowly.After 7 days,cells markedly grew and soma was gradually enlarged,presenting with an oval,spindle-shaped,or irregular appearance.After 14 days,spindle-shaped calls become more.After 18-22 days,myotubes were increased in number and enlarged in volume,and myotube nucleuses were also increased.The newly formed myotubes and spindle-shaped fibroblasts were distributed in parallel interval.The immunohistochemistry of BMSCs revealed that cells were positive for CD44,with dark brown granules in the cytoplasm,especially around the nucleus,but they were negative for CD34.The immunohistochemistry of induced BMSCs demonstrated that calls were positive for desmin and skeletal muscle myosins.These findings indicate that myogenic differentiation factors and 5-azacytidine could induce the oriented differentiation of BMSCs into skeletal cells,with the presence of positive expression of desmin and skeletal muscle myosins.
ABSTRACT
Objective To evaluate the result of percutaneous internal fixation in treatment of uncomminuted ankle fractures (inner malleolus,extemal malleolus and ventral condyle). Methods A total of 26 patients with uncomminuted ankle fractures at age range of 20-55 years(mean 35.2 years)were treated with closed reduction and percutaneous internal fixation by screws,eannulated screws or Kirschuer pins under C-arm X-ray scan.All patients were followed up for 12-24 months(mean 14 months).Results All fractures were healed successfully.with healing time of 8-24 weeks(mean 10.3 weeks).According to Bourne Standard,excellent ankle function results were reposed in 15 patients,good in 9 and fair in 2,with excellence rate of 92%.There was no implant failure,postoperative infection or dehiscence. Conclusions With advantage of early rehabilitation and minor incision of the affected ankles,closed reduction and percutaneous internal fixation can be selected for transverse or oblique uncomminuted ankle fractures,especially for those patients with severe swelling or skin injury.
ABSTRACT
Objective To design a new animal model for end-to-side anastomosis of peripheral nerves and analyze the efficiency. Methods The experiment involved 28 Wistar rats,of which the left legs were set as experimental group and the right ones as control group based on mode of nerve anastomosis.In experimental group,the tibial nerves were cut off for anastomosis of the proximal end of the tibial nerves with the distolateral side of the common peroneal nerve.While in control group,the common peroneal nerves were cut off to anostmose the distal end of the peroneal nerve with the distolateral side of the tibial nerves.Electrophysiological examination was done three months later to observe and compare wave amplitude,latent period and maximal wave amplitude at set stimulus volume in both groups and compare the fiber number at distal and proximal ends of the common peroneal nerves. Results There was no significant statistical difference in regard of amplitude,latent period and maximal wave amplitude in both groups.However,the fiber number at distal end of the stoma was much more than that at proximal end in the experimental group,with statistical difference(P