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Objective:To explore the clinical effect of repairing interphalangeal joint defect of hand with free transfer of part of the 2nd metatarsophalangeal joint tissue flap precisely cut with the aid of digital 3D printing technology.Methods:From December 2016 to December 2020, 7 patients with partial joint defects of proximal interphalangeal joints of fingers were treated in Department of Hand and Foot Surgery, Shunde Hospital Affiliated to Guangzhou Medical University(Foshan Shunde Lecong Hospital). Before surgery, three-dimensional data of hand and foot bones were collected, and the 3D printing model was used to simulate the operation in vitro. During the operation, the first dorsal metatarsal artery-the 2nd dorsal metatarsal artery was used as the pedicle, and the 2nd metatarsophalangeal joint composite tissue flap with a required size was harvested with the assistance of the navigation template to tranfer and repair the small joint defects of hand. All 7 cases entered follow-up at outpatient and telephone. Results:All 7 cases survived. Postoperative follow-up was 3-24(mean 9.5) months, Range of motion of the repaired interphalangeal joint was (56 ± 6)°; According to the Evaluation Standard of Thumb and Finger Reconstruction Function of the Society of Hand Surgery of the Chinese Medical Association, 2 cases were excellent, 4 cases were good, and 1 case was poor.Conclusion:Transfer of the free 2nd metatarsophalangeal joint tissue flap assisted by 3D printing technology in repair of the small joint defect of the hand can accurately harvest the tissue flap, which is clinically reliable.
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In order to study the effect of middle ear malformations on energy absorbance, we constructed a mechanical model that can simulate the energy absorbance of the human ear based on our previous human ear finite element model. The validation of this model was confirmed by two sets of experimental data. Based on this model, three common types of middle ear malformations,
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Humans , Ear Ossicles , Incus , MalleusABSTRACT
Objective To evaluate the method and outcomes of radiocarpal joint reconstruction via nonvascularized and vascularized fibular bone graft after distal radius bone and joint defect.Methods Between November,1966 and March,2009,27 cases with distal radius bone and joint defect due to tumor en bolc excision (24 cases) or AO C3 type fractures (3 cases) were treated with nonvascularized or vascularized fibular bone graft.There were 9 males and 18 females.The mean age of these patients at the time of surgery was 27 years (rage from 16 to 67 years).There were 14 left sides and 12 right sides and 1 bilateral side.Nine cases with vascularized and 18 cases with nonvascularized fibular bone graft for radiocarpal joint reconstruction.The bone fixed with plate or/and k-wire.DASH scores,G/W wrist scores,PRWE scores were applied for writ function evaluation and the grasp power recovery rate and bone healing time was also compared during postoperative follow up.Results All 27 patients were followed with an average follow-up time being 9 years (range from 3.5 years to 44.0 years).The average length of fibular bone harvested was 10 cm for vascularized bone graft and 9 cm for nonvascularized.The all fibular bone was healed and the average healing time was 4.7 months (range from 3-8 months).No tumor recurrence or distance metastasis occurred during the follow-up.The average DASH scores was 7.97 (2.5-17.0),G/W scores of 24 patients ranged from 1 to 2,the wrist function result was excellent,account for 88.9％,and 3 cases from 3 to 7,function was good,account for 11.1％; the average grasp power recovery rat was 85.81％ (75％-104％); the average PRWE scores were 25.3(10.5-38.0).Comparison outcomes between the nonvascularized and vascularized fibular bone graft for radiocarpal wrist joint reconstruction,there was no significant statistics difference for bone healing time,DASH,G/W,PRWE scores and grasp power recovery rate (P ＞ 0.05).There were no other complications occurred except 3 patients had mild leg pain after long distance walking and 1 case fracture following patient's accident postoperative 11 years,and healed through conservative treatment.Conclusion The nonvascularized or vascularized fibular bone graft is an excellent choice and has less complication with maximal wrist function recovery for radiocarpal joint reconstruction following distal radius bone and joint defect due to all kinds of reasons,such as tumor en bloc excision,distal radius AOC3 type comminuted fracture.The vascularized fibular graft is recommended for larger than 12 cm bone graft.
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Objective:To repair knee joint defects in rabbits with rat adipose-derived stem cells induced by cartilage-derived morphogenetic protein growth factor 1 (CDMP1) ,so as to assess the feasibility of using heterogeneity cells as the seed cells for cartilage tissue engineering. Methods: The second generation ADSCs were seeded on scaffold, cultured for another two weeks in presence of CDMP1(50 μg/L),and identified by immunohistochemistory method. Bilateral rabbit knee joint defect model was established. The left side defect was embedded with ADSCs-scaffold composite (experimental group); the right side was embedded only with the scaffold(control group). Nine rabbits were killed in each group 8,16,24, and 48 weeks after embedding and the tissues were made into slices for safranine O and haematoxylin eosin staining. Results: In the experimental group the defects were filled with white semi-transparent tissues 8 weeks after embedding, with clear boundary to the surrounding cartilage; 16 weeks after embedding, the boundary of defect was further improved but still could be seen; 24 weeks after embedding, the repair outcomes were satisfactory, with the newly-generated chondrocytes having a nearly normal morphology (sphere shape,cartilage lacuna),and safranine O and haematoxylin eosin staining results were both positive; and 48 weeks after embedding, the boundary of the repair region could be clearly seen,and the repair effects were not as satisfactory as those of after 24 weeks. In the control group the boundary between the repairing area and the normal circumjacent area was visible at all 4 time points,with clear boundary and granulation tissues; the newly generated cells took a spindle shape and were negative for H-E and safranine O staining. Conclusion: The knee joint defects of rabbits can be satisfactorily repaired by using CDMP1-induced ADSCs seeded on spongy bone scaffold of cattle, which provides a theoretical basis for using heterogeneity cells as the seed cells for cartilage tissue engineering.