Application of pie-crusting technique of deep medial collateral ligament under arthroscopy in repairing posterior horn of medial meniscus tears / 中国骨伤

OBJECTIVE@#To explore effectiveness and safety of an inside-out, arthroscopic deep medial collateral ligament pie-crusting release in treating posterior horn of medial meniscus (PHMM) tear in tight medial tibiofemoral compartment of knee joint.@*METHODS@#From January 2016 to December 2017, 61 patients (61 knees) were underwent arthroscopic partial meniscectomies for PHMM tear in tight medial tibiofemoral compartment of knee joint, who were divided into valgus group and pie-crusting group according to exposure of PHMM region . There were 28 patients in valgus group, including 12 males and 16 females aged from 27 to 60 years old with an average age of (35.75±7.57) years old;who were performed conventional valgused knee to exporsure PHMM region. There were 33 patients in pie-crusting group, including 15 males and 18 females aged from 26 to 58 years old with an average age of (36.06±7.93) years old;who were treated with inside-out, arthroscopic deep MCL pie crusting release technique with MM-Ⅱ meniscus suture package (Smith & Nephew). Operation time, preoperative and postopertaive Lysholm score of knee joint, injury of MCL between two groups were recorded and compared.@*RESULTS@#All patients were followed up from 12 to 18 months with an average of (15.19±2.22) months. The incisions were healed at stageⅠ. There were no statistical difference in anatomical classification of PHMM between two groups(@*CONCLUSION@#The inside-out, arthroscopic deep MCL pie-crusting release for the treatment of posterior horn of medial meniscus tear in tight medial tibiofemoral could expand working apace, shorten operation time, reduce injury to MCL and obtain good clinical efficacy.

Screen and identification of the relative protein expressed in the acute tractive spinal cord injury in rats / 中华外科杂志

<p><b>OBJECTIVE</b>To screen and identify the relative protein expressed in the acute tractive spinal cord injury (TSCI) in rats.</p><p><b>METHODS</b>Ten adult Sprague Dawley rats were randomly divided into Sham group and TSCI group, 5 rats in each group. Rats from Sham group and TSCI group at 1 day after surgery were sacrificed for harvesting T₁₃-L₂ spinal tissue specimens. The extraction and quantitation of protein in the spinal tissue was finished firstly. Proteins from spinal tissue were separated by two-dimensional electrophoresis (2-DE) and identified by mass spectrometry (MS). The different expression map was established in each group, and proteins express differently was determined by comparing the level of each spot with gel imaging software and manually. Proteins were identified by High performance liquid chromatography-electrospray tandem (NanoUPLC-ESI-MS/MS) and peptide sequence tag with tandem MS combining with database respectively. After that, the function of these identified proteins was known and classified.</p><p><b>RESULTS</b>There were 22 differential protein expression spots were found between Sham group and TSCI group. Among them, 18 spots were up-regulated and 4 were down-regulated. 4 differential protein expression spots were newly found in TSCI group. Sixteen significant proteins were identified by NanoUPLC-ESI-MS/MS. Four kind of proteins were related to apoptosis, 3 in nerve signal transduction and 6 in metabolism, respectively. Unnamed proteins were 3.</p><p><b>CONCLUSIONS</b>The differential expression proteins were found between Sham group and TSCI group. These identified proteins may play important role in the process of injury and recovery through transduction nerve signal, regulating nerve cells apoptosis and metabolism.</p>

Treatment of subtrochanteric femoral fracture with long proximal femoral nail antirotation / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Subtrochanteric femoral fractures are severe injuries. Although many treatment methods have been developed, controversy exists regarding the optimal management of these fractures. This study evaluated the clinical outcome of subtrochanteric femoral fractures fixed with long proximal femoral nail antirotation (PFNA-long).</p><p><b>METHODS</b>Between October 2006 and February 2008, 25 patients with traumatic subtrochanteric fractures of the femur were treated with PFNA-long. Closed reduction and fixation were performed in 20 cases. In the remaining 5 cases, closed reduction was difficult, so limited open reduction was performed, with bone grafting in 4 cases and circumferential wiring in 4 cases.</p><p><b>RESULTS</b>The average follow-up time was 16.1 months. All subtrochanteric femoral fractures healed uneventfully except one case of delayed union. The mean union time was 26.2 weeks. Technical difficulties with nail insertion were encountered in 3 cases. No implant failure was observed.</p><p><b>CONCLUSION</b>PFNA-long is effective in treatment of subtrochanteric femoral fractures, with a high rate of bone union, minor soft tissue damage, early return to functional exercise and few implant-related complications.</p>