ABSTRACT
BACKGROUND:Various methods have been reported for the repair and reconstruction of long bone segmental defect, but al of them have different advantages and disadvantages which limit their wide application. And this stil presents as a huge problem for many orthopaedics. OBJECTIVE:To review the latest research on reconstruction and repair of long bone segmental defects at national and international level. METHODS:A computer-based retrieval was conducted in PubMed database, CNKI database and VIP database by the first author for the articles published from January 1990 to December 2012, on the repair and reconstruction of long bone segmental defect with the key words of“bone defect, long bone reconstruction, tissue engineering of bone, scaffolds, bone reconstruction, bone graft, bone tumor, tumor resection, musculoskeletal tumors, regeneration, autografts”in English and“large segment, bone defects, bone tumors, soft tissue tumors, tumor resection, tissue engineering, bone graft”in Chinese. A total of 104 articles were screened out, and final y, 52 articles were included for further research. RESULTS AND CONCLUSION:Traditional method for the repair of long bone segmental defect includes autologous or al ogeneic bone graft, bone lengthening and artificial prosthesis replacement. The development of prosthesis that was suitable for child limb salvage and consistent with the child growth characteristics has become the chal enge to child limb salvage. In order to solve the problem, we designed the prosthesis that can continuously extent, and applied for the limb salvage reconstruction of tumor. With the development of medical technology, al kinds of artificial bone, especial y bone tissue engineering and gene treatment are being gradual y used to repair bone defect, which wil further enhance the clinical evaluation of bone defect repair, and that is the direction of further research.
ABSTRACT
Objective To evaluate the efficacy of splenic autotransplantation plus lower esophagus transaction for the treatment of portal hypertension(PTH).Methods Thirty patients were divided into study group(15 cases)and control group(15 cases).Patients in study group Underwent splenic autotransplantation after splenectomy and cardia-esophageal devascularization plus lower esophagus transaction,and those in control group had all except splenic autotransplantation.The cross section area,blood velocity,blood flow of MPV(main portal vein)and changes of cardia-esophageal varices were evaluated by 3D DCE MRA at 1 week before operation and 6 months after,and blood flow and collateral circulation of transplanted spleen in the retroperitoneal space were assessed.Results In both groups,the cross section areas(cm2),mean blood velocity(cm/s)and mean blood flow(ml/s)of MPV decreased postoperatively(P＜0.05).The postoperative cross section areas(cm2)and mean blood velocity(cm/s) of MPV in study group were smaller than that in control group(P＜0.05).Esophageal and fundal variceal veins disappeared or improved equally in both groups.There was no difference in the postoperative and preoperative liver function between the two groups(P＞0.05).In study group,the planted spleen grew well in the retroperitoneal space,and with a formation of extensive collateral circulation.The postoperative serum hyaluronic acid decreased in this group(t=2.929,P＜0.05).Conclusion Splenic autotransplantation after splenectomy plus lower esophagus transection was effective for the treatment of PHT without adverse impact on liver function.