ABSTRACT
The epiphysis is an unique structure in pediatric skeletons,which mainly reflect in its unique blood supply,anatomical structure,pathological basis and so on.Epiphyseal injury is common in children with skeletal injury.Fracture,tumor,infection can cause epiphysis injury,and inappropriate treatment is often easy to cause growth obstacle and skeletal deformity.Its treatment is relatively difficult.At present,there had not yet formed a consistent therapeutic strategy.Aiming at the pathobiologic basis,causes,mechanism and clinical manifestation of pediatric epiphyseal injury,now,its diagnosis,therapeutic strategy,the principle of treatment and the latest research progress were summarized,which would provide useful guidance for clinical treatment of pediatric epiphysis injury.
ABSTRACT
Objective To provide an anatomical basis for repairing the medial malleolus with bone-severed vascularized fibular head epiphysis, and to explore the effect of clinical application with this method. Methods Figures of fibular head and medial malleolus were measured on 20 fresh lower limbs specimens of child age from 2 to 12 years old, then bone-severed formula was deduced. The bone-severed composite fibular head epiphysis to repair the defect of medial malleolus were carried for 6 child patients of emergency or post-poned cases on one stage. Obersved the clinical effect by following-up. Results The angle between fibular head and stem (M) was(170±8)°, angle of fibular head sadacc(N) was (145 ±6)°, length(1.5±0.2)cm and width (1.4±0.2)cm; angle between medial malleolus and stem(1) was(152±8)°, length of the articular surface of medial malholus was(1.25 ± 0.2)cm and width (1.25 ± 0.2)cm. Angle between defect surface and tibia was(Q). Formula: angle of bone-severing X = L-N-Q, and apex at the upper 1/6 of the reversed articular surface of fibular. 6 cases with this method was completed, all healed at stage one, following-up 1 to 3 years, medial malleolos developed well and no epiphysis ossification anticipation, and the ankle joint has no inversion with its loadind and walking function good. Conclusion The fibular head epiphysis and the medial malleolus differ in shape to some extent, but good donor can be got by bone-severing, can repair the epiphysis and soft tissue defect of the medial malleolus at one stage with additional flap, developing with the child at the same time, it is a perfect method to reconstruct the traumatic defect of child medial malleohs.
ABSTRACT
[Objective]To improve the preparative method of catilage derived microcarrier and evaluate the micromechanism and biocompatibility of this metarial for injectable tissue engineering cartilage.[Methods]Fresh porcine articular cartilage were obtained and shattered in the iso-osmia liquid in 4℃.After gradient centrifugation,150-300 ?m size cartilage micelles were gathered and were subjected to 1% Triton X-100 once and physiological saline twicely.The structure of specimens were observed and assessed by inverted phase contrast microscopy,environmental scanning electron microscope.And the composition of these specimens were stained with haematoxylin-eosin,safranin-O,toluidine blue and immunohistochemistry of collagen type Ⅱ.The microcarriers were seeded with rabbit bone mesenchymal stem cells(BMSCs) and cocultured with Rotary Cell Culture System(Rotary Cell Culture System,RCCS TM).[Results]The cartilage particles had fiocculus apparence.There were numerous villus on the surface of these cartilage micelles,which were stained positive with the immunohistochemistry of collagen type Ⅱ.The inner part of these cartilage micelles were stained positively with safranin-O and toluidine blue.After coated with BMSCs and cultured in the RCCSTM,the cells grew well on the surface of the cartilage micelles and the latter could be disperse again after blowed with pipette.[Conclusion]The cartilage micelles,which have large surface area and good boicompatibility,is a new kind of microcarrier for injectable tissue engineering cartilage.