Dynamic external fixation for stabilizing Baumman angle during midanaphase in supracondylar fracture of humerus in children / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the function of preventing supracondylar fracture of the humerus and cubitus varus in children by observing Baumann angle changes with self-made Orthopedic elastic elbow brace.</p><p><b>METHODS</b>From October 2010 to April 2012,120 patients with closed Gartland II or III supracondylar fracture of the humerus diagnoised by X-ray were divided into two groups as follows:group A (62 cases, including 48 males and 14 females, with an average age of (7.27 +/- 4.36) years old, and the course of (1.48 +/- 1.26) days); group B (58 cases, including 47 males and 11 females, with an average age of (8.02 +/- 3.82) years old, and the course of (1.20 +/- 1.11) days. The two groups were treated by manipulative reduction and external fixation of small splints. Group A were used with elbow brace at 15 days after reduction, and treated for 90 days. Group B were used with external fixation of small splints and removed at 30 days. Baumann angle changes at different time periods (15 days, 30 days, 60 days, 90 days, 6 months, 1 year) after reduction and its' opposite side were recorded by X-ray. The angles of injured side and the opposite side were compared. The function of the elbow brace was evaluated at 90 days or 1 year after reduction according to Flynn.</p><p><b>RESULTS</b>All cases were followed up for over 1 year and obtained fracture healing. The incidence of cubitus varus was no one in group A and 4 cases in group B. The Baumann angles of injured side were trended to be increased with the time passing. From 30 days after reduction to 90 days, the increased angles of group B is more than that of group A (P < 0.01).</p><p><b>CONCLUSION</b>It is effective on stabilizing Baumman angle in the supracondylar fracture of the humerus of midanaphase treatment in Children by orthopedic elastic elbow brace.</p>

Clinicopathologic study of giant cell angioblastoma / 中华病理学杂志

<p><b>OBJECTIVE</b>to study the clinicopathological features, imaging characteristics, immunophenotypes and differential diagnosis of giant cell angioblastoma (GCAB).</p><p><b>METHODS</b>a case of GCAB in the left middle-upper tibia and fibula was studied by light microscopy, X-ray and CT imaging, immunohistochemistry.</p><p><b>RESULTS</b>X-ray and CT imaging showed a clearer lesion in the left middle-upper tibia than in the ipsilateral fibula with enlarged ostealleosis and increased inhomogeneously medullary cavity density, irregular thickening of cortical bone, local cortical default at the inner edge, soft tissue swelling around the abnormal bone. Histologically, tumor tissue was located between the bone trabeculae by nodular, linear and plexiform aggregates of oval-to-spindle cells, large mononucleate cells and multinucleate giant cells with prominent nucleoli and abundant granular eosinophilic cytoplasm. Some aggregates had uncentain amount of discernible lumens, either empty or containing few erythrocytes. A concentric arrangement of oval-to-spindle Cells around small-caliber vascular structures together with collagen fiber contributed to a so-called 'onion-skin' arrangement. The background showed a loose mesenchymal stroma formed of some inconspicuous spindle-fibroblast-like cells, stellate-shape mesenchymal cells, a moderate mononuclear inflammatory cell infiltrate and scattered mast cells. Immunophenotype showed the tumor cells and giant cells strongly positive for vimentin. A good many oval-to-spindle cells stained markedly for CD31 and CD34, but weakly for FVIII, while the giant cells are highlighted instead by CD68, occasionally, very few giant cells showed positive focally for FVIII, a-SMA decorated notedly the cells surrounding the endothelium-like cells but weakly positive in some other tumor cells.</p><p><b>CONCLUSION</b>GCAB is a rare, locally infiltrative but slow growing neoplastic angiogenesis with unique morphological characteristics during infancy, which may occur not only in the skin, mucosa, subcutis and deep soft tissue but also in the bone.</p>